CURRENT TRENDS IN THE REHABILITATION OF PATIENTS WITH LOWER LIMB AMPUTATION
Authors: Yarmoshevych O. S. , Nesterchuk N. E. , Mykhailova I. O. , Semenchuk O. V. , Dovnich E. A. , Sierkov O. Yu. 
Published: October 2024

Amputation of a lower limb is a serious intervention that has a profound impact on a person's life and ability to work. The loss of a limb often causes significant physical and psychological changes that require comprehensive rehabilitation. The patient faces new physical limitations, such as loss of mobility, changes in balance and the need to adapt to prostheses.  According to a report by the Wall Street Journal, since the beginning of the Russian-Ukrainian war, the number of people in need of amputation in Ukraine has risen to levels not seen since the First World War. The publication estimates that between 20,000 and 50,000 Ukrainians have lost one or two limbs. Therefore, the study of current trends in the rehabilitation of patients with lower limb amputation in the context of war in Ukraine is extremely relevant.
Purpose. To analyse and systematise current trends in the rehabilitation of patients with lower limb amputation.  
Materials and methods. To achieve the objectives of the study, the researchers analysed scientific literature and systematised information using electronic databases such as PubMed, Google Scholar and others.
Research results. Today, physical therapy for patients with lower limb amputation is characterised by a combination of traditional rehabilitation methods and innovative approaches. Kireev and others developed an algorithm that includes rehabilitation activities at 4 main stages. Preoperative rehabilitation, stage I, is aimed at improving postoperative outcomes. It has been suggested that the preoperative programme used in the treatment of young patients with lower limb amputation should consist of chest physiotherapy, muscle and joint mobility training, focusing on maintaining strength and function. During the second stage, before prosthetics, the rehabilitation process includes the aforementioned therapeutic gymnastics and physiotherapy, as well as massage and kinesiotaping. Important issues in preparing an amputated stump for prosthetics include preparing the postoperative wound and scar, controlling edema, preventing muscle atrophy, and preventing the formation of contractures in the joints of the amputated lower limb. In addition to the above-mentioned traditional methods, innovative approaches are actively used at the stage of training with a prosthesis: robotic prostheses, biofeedback technologies, and VR technologies. Giacomo Valle's research has shown that the use of a robotic prosthesis in combination with biofeedback technology not only increases the patient's movement speed, but also increases his or her confidence. Research by Rami L. Abbas demonstrated the feasibility of using VR technologies, which showed a significant improvement in the balance markers, TUG, DGI and BBS tests (P < 0.05). Lifelong rehabilitation, stage IV, involves monitoring the patient for psychosocial adaptation, stump skin pathologies, pain, musculoskeletal disorders, cardiovascular diseases, other chronic diseases, health, and ensuring the use of appropriate footwear for the contralateral limb.
Conclusions. Thus, the current trends in combining traditional methods with innovative approaches in the rehabilitation of patients with lower limb amputation are appropriate and justified. It is through the use of therapeutic gymnastics, massage and kinesiotaping in combination with the use of biofeedback technologies, robotic systems and virtual reality that the best results are achieved.