Journal of Environmental and Occupational Science DOI: 10.5455/jeos.20151109115116 www.jenvos.com 196 J Environ Occup Sci ● 2015 ● Vol 4 ● Issue 4 Occupational therapy rehabilitation of lower limb amputees in the Nigeria Armed Forces Medical Services Anthonette A.I. Emechete, Chidozie Emmanuel Mbada ABSTRACT Background and objective: Soldiers are known to always sacrifice to defend the integrity of their nation and in the process may lose limbs even their lives. Injuries resulting from war are a major cause of disablement in armed forces personnel. This paper presents the outcome of a study on the Occupational Therapy Rehabilitation Programme (OTRP) of the post-war lower limb amputees at the Armed Forces Convalescent and Rehabilitation Depot, Lagos, Nigeria. Methods: Eighty soldiers (30 with above knee amputation and 50 with below knee amputation) who were given furloughs from the military authority and had satisfactorily completed physiotherapy prosthetic ambulatory training were recruited into this pre-test and post-test study. A 3-part questionnaire dealing with prosthetic use and training, social and family and work assessment was used. OTRP involved three phases; the initial assessment and evaluation phase; the intermittent phase of sequentially pre-prosthetic stump exercises, gait training, simulated vocational and job training; and the final phase of work assessment and job placement. OTRP was carried out thrice weekly for eight weeks and outcomes were assessed at inclusion and 8th week respectively. Results: The percentage difference in pre-and-post OTRP in terms of participants’ impression, usability, satisfaction and confidence in the use of prostheses was 62.5, 62.5, 45.0 and 32.5% respectively. Prosthetic use affected the sexual life of 25% of the married participants but there was no reported change following OTRP. Following OTRP, 18.8% of the participants intended to return to their previous occupation before joining the army, 44% wanted to go school, 56.3% desired better jobs; 98.8, 75.0 and 62.5% of the participants believed they could play soccer, swim and drive a car respectively. Conclusion: Occupational Therapy Rehabilitation Programme for post-war lower limb amputees who were on prostheses had positive influence on their attitude towards prosthetic use, social and family life, and perception on return to work, sports and vocation. KEY WORDS: Occupational therapy; Rehabilitation; Lower limbs; Amputee; Civil war; Soldiers Department of Medical Rehabilitation College of Health Sciences, Obafemi Awolowo University Ile-Ife, Nigeria Address for correspondence: Chidozie Emmanuel Mbada, Department of Medical Rehabilitation College of Health Sciences, Obafemi Awolowo University Ile-Ife, Nigeria, doziembada@yahoo.com Received: October 14, 2015 Accepted: November 04, 2015 Published: November 17, 2015 Original Researc INTRODUCTION Lower extremity amputation is one of the earliest known surgical operations [1, 2]. Lower extremity amputation is often viewed as failure of treatment [3] or a life-saving procedure performed to remove ischemic, infected, necrotic tissue or locally unresectable tumor [4]. Peripheral vascular disease alone or in combination with diabetes mellitus; followed by trauma are the leading causes of lower extremity amputation [4-6]. Wartime amputations, especially in battle is a major cause of disablement in armed forces personnel who are in the prime of their military career [7]. Majority of the limb loss during war results in lower extremity amputations [8]. As such, the pattern of amputation resulting from trauma in young military personnel, differ from those seen in civilians [9]. Atesalp et al [10] submits that landmine explosions cause most of the war injuries in battlefield which consequently result in amputations. Also gunshots, mortar shelling, air raid bombs and grenade bombs result in severe injuries that may necessitate amputation. Consequently, limb amputation significantly alter multiple aspects of an individual’s life including body image, elf care activities, mobility, psychosocial health, vocational and avocational activities [11]. Rehabilitation of amputees is critical for the care of soldiers who had suffered war related disablement such as limb amputation. The rehabilitation programme often requires a team of skilled professionals who will provide optimum care [12]. Kumar and Kumar [13] submits that provision of suitable prostheses and orthoses is the most effective step in returning the patient to a normal and productive place in society. However, evidence on the effectiveness of Occupational Therapy (OT) interventions in lower limb amputations is scarce [14]. This paper present the outcome of a study on the Occupational Therapy Rehabilitation Programme (OTRP) of the post-war lower limb amputees treated at the Armed Forces Convalescent and Rehabilitation Depot, Lagos, Nigeria. MATERIALS AND METHODS Eighty soldiers with lower limb amputation participated in this pre and post test study. This study was conducted by Lt Col. (Rtd) Anthonette A.I. Emechete (B.Sc OT M.Ed. MAOT) in