This case study examines the total physiotherapy care of a 50-year-old male patient, who had a right-sided displaced distal tibia and fibula fracture, a talus fracture due to a road traffic accident, and an above-knee amputation due to a serious infection. Enhancing muscle strength, reducing pain from phantom limbs, avoiding problems, maintaining range of motion, increasing endurance, and promoting functional independence in the postoperative period were the main goals of the patient's rehabilitation. The recovery plan included an intensive four-week program of physiotherapy care. The regimen included a variety of interventions, such as pain management, edema control, wound healing techniques, range of motion (ROM) exercises, muscle strengthening activities, mobility and transfer exercises, cardiovascular endurance training, psychosocial support, education on prosthetic use, and independence in daily living activities. ROM measures, manual muscle testing, and functional independence measure scores were used to evaluate the patient's improvement. The patient's physical health and level of functional independence both exhibited significant improvements, according to the statistics. Following treatment, the patient's ROM, muscle strength, and overall functional independence all improved. The study highlights the positive impacts of physical therapy interventions on the patient's quality of life, mobility, and self-sufficiency following the amputation and subsequent recovery. These findings support the patient's transition to a more self-sufficient and active lifestyle by providing valuable insights into the efficient use of physiotherapy and the comprehensive post-amputation treatment plan.

Copyright © 2024, Biyani et al.

BACKGROUND

Extracorporeal membrane oxygenation (ECMO) is crucial in the management of severe cardiopulmonary dysfunction. Although early rehabilitation in the ICU has been shown to reduce ICU-acquired weakness and improve patient outcomes, there is limited evidence on structured rehabilitation programs for patients on ECMO.

OBJECTIVES

We evaluated the safety, feasibility, and preliminary effectiveness of a standardized daily program combining mobility therapy and resistance training during ECMO support.

DESIGN

The primary outcome was time on exercise training per day. Task performance, repetitions in resistance exercises, adverse events, hospital disposition, and body mass index (BMI) changes were documented.

SETTING

Prospective single-center pilot study.

SUBJECTS

Subjects on ECMO (n = 20, 47 ± 15 years old, 80% male, 95% venovenous ECMO).

INTERVENTIONS

Subjects received a protocolized regimen: morning mobility with physical/occupational therapy (PT/OT) using a tilt/verticalization bed, activities of daily living, and graded transitions (sitting, standing, ambulation), followed by afternoon resistance exercises with a clinical exercise physiologist (≥ 5 d/wk).

MEASUREMENTS AND MAIN RESULTS

Two minor adverse events occurred, which both resolved immediately. Day-28 survival was 95%, and in-hospital survival was 85%. Among survivors, 56% were discharged home, and 44% experienced an increase in BMI from admission to discharge. Daily therapy times averaged 21 minutes for PT/OT (median: 20), 30 minutes for resistance sessions (median: 27), and 35 minutes of combined daily exercise (median: 35, maximum: 122). Longer session times correlated with faster supine-to-sitting transitions in PT/OT (p = 0.002). In resistance trainings, longer session times were associated with significantly increased repetitions in bicep and triceps flexion and extensions, chest press, shoulder press, and hip/knee flexion (p < 0.001).

CONCLUSIONS

A structured daily program that combines mobility, verticalization, and resistance exercises during ECMO was feasible and safe. More time in sessions was associated with better functional performance. Larger controlled studies are needed to determine effects on recovery and long-term outcomes.

Copyright © 2026 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

BACKGROUND

The global neo-coronary pneumonia epidemic has increased the workload of healthcare institutions in various countries and directly affected the physical and psychological recovery of the vast majority of patients requiring hospitalization in China. We anticipate that post-total knee arthroplasty kinesiophobia may have an impact on patients' postoperative pain scores, knee function, and ability to care for themselves in daily life. The purpose of this study is to conduct a micro-video intervention via WeChat to verify the impact of this method on the rapid recovery of patients with kinesiophobia after total knee arthroplasty during neo-coronary pneumonia.

METHODS

Using convenience sampling method, 78 patients with kinesiophobia after artificial total knee arthroplasty who met the exclusion criteria were selected and randomly grouped, with the control group receiving routine off-line instruction and the intervention group receiving micro-video intervention, and the changes in the relevant indexes of the two groups of patients at different time points on postoperative day 1, 3 and 7 were recorded and analyzed.

RESULTS

There were no statistical differences in the scores of kinesiophobia, pain, knee flexion mobility (ROM) and ability to take care of daily life between the two groups on the first postoperative day (P > .05). On postoperative day 3 and 7, there were statistical differences in Tampa Scale for kinesiophobia, pain, activities of daily living scale score and ROM between the two groups (P < .01), and the first time of getting out of bed between the two groups (P < .05), and by repeated-measures ANOVA, there were statistically significant time points, groups and interaction effects of the outcome indicators between the 2 groups (P < .01), indicating that the intervention group reconstructed the patients' postoperative kinesiophobiaand hyperactivity. The level of pain awareness facilitates the patient's acquisition of the correct functional exercises to make them change their misbehavior.

CONCLUSIONS

WeChat micro-video can reduce the fear of movement score and pain score in patients with kinesiophobia after unilateral total knee arthroplasty, shorten the first time out of bed, and improve their joint mobility and daily living ability.

ETHICS

This study has passed the ethical review of the hospital where it was conducted and has been filed, Ethics Approval Number: 20181203-01.

Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

Purpura fulminans (PF) is a rare and life-threatening syndrome characterized by cutaneous purpura resulting from disseminated intravascular coagulation (DIC) and intravascular thrombosis. PF typically develops as a severe complication of infections and is associated with high mortality rates. Effective treatment involves early recognition, aggressive resuscitation, appropriate antibiotic therapy, and the correction of coagulation abnormalities. Nevertheless, despite effective treatment, patients often ultimately require amputation of the affected limbs. This case report details the rehabilitation process of a patient with PF who underwent quadruple amputation. The patient, a 48-year-old male, underwent quadruple amputation due to PF. After intensive care, he was admitted to a convalescent rehabilitation ward for prosthetic rehabilitation. The rehabilitation process combined physical and occupational therapy to facilitate independent living through the use of upper and lower limb prostheses and assistive devices. The patient presented with ulcerative lesions on the anterior surfaces of both knee joints upon admission. During treatment, he developed osteomyelitis of the right patella, which required intravenous antibiotics and limited rehabilitation to bed-based exercises. Following the administration of intravenous therapy, the prosthetist proceeded with the fabrication of lower limb prostheses. Subsequently, the patient was able to commence standing and gait training, and by the time of discharge, he was able to walk without a cane. Upper limb prostheses enabled independence in activities of daily living (ADLs) such as eating, dressing, and toileting. He was also able to perform cooking-related activities that are part of the instrumental activities of daily living (IADLs). This case highlights the importance and achievable outcomes of rehabilitation for patients with PF who have undergone quadruple amputation. A multidisciplinary approach utilizing both upper and lower limb prostheses, as well as assistive devices, enabled significant functional recovery.

Copyright © 2024, Tanaka et al.