E. Carlos. Princeton University.
Medications included alen- Introduction/Background: Avascular necrosis is the death of bone dronate order genuine lasix on-line blood pressure quadriplegic, zoledronic acid buy 40 mg lasix blood pressure monitor reviews, risedronate or ibandronic acid along with tissue due to a lack of blood supply quality lasix 40mg blood pressure erectile dysfunction. Also called osteonecrosis, a low or high dose of calcium plus vitamin D supplements. Patient was diagnosed with malign melanoma vitamin-D supplementation tended to have a greater improvement on right sacral region. Conclusion: Cognitive functions of women with these combination therapy patient experienced right hip pain and postmenopausal osteoporosis remained unaltered, whereas bone limitations. Higher doses of calcium vitamin d supplements were likely treated with 30 session hyperbaric oxygen treatment which did not to have better cognitive effects compared to lower doses. Patient addmited to our rehabilitation J Rehabil Med Suppl 55 Poster Abstracts 97 center for his joint pain and limitations with wheel chair dependent hadaye Tajrish Hospital from Apr 2009 to Apr 2010. Results: After 1 month, both the physiotherapy the patients general health condition and disabilities before treating and dry needling groups had decreased resting, night, and activ- with radiotherapy and chemotherapy. Yahyazadeh3 diology, Adana, Turkey 1Shiraz University of Medical sciences, Physical Medicine & Reha- bilitation- Geriatric Research Center, Shiraz, Iran; 2Shiraz Univer- Introduction/Background: The aim of this prospective pre-study sity of Medical Sciences, Physical Medicine & Rehabilitation- Shi- was to evaluate the effects of lidocaine injections to the trigger 3 points in the trapezius muscle on pain and disability in patients raz Burn Research Center, Shiraz, Iran; Farhangian University, with myofascial pain syndrome. Material and Methods: 20 patients Department of Languages, Shiraz, Iran (15 women and 5 men) with myofascial trigger points in the trape- Introduction/Background: Carpal tunnel syndrome is the most com- zius muscle were included in the study, and clinical examinations mon neurological entrapment in upper extremity and peripheral were used for the diagnosis. It was compared the Shear Wave Velocities (Vs) of the physical examination in diagnostic approach. Shear study was to compare some of these tests in diagnosis of mild carpal Wave Vs of the lesions were analyzed. All patients were treated with a 1 ml% Some different electrodiagnostic methods such as: Interpolation, 10 lidocaine injections to the trigger points by the same physiatrist. Results: The mean age method was sensory part of interpolation (sensitivity: 96% and speci- of the study population was found 43. After the lidocain injection sensitive method to detect mild cases of carpal tunnel syndrome. Conclusion: In patients with myofascial trigger points in the trapezius muscle, lidocain injec- 320 tions effectively improved the disability, and pain. Toshikazu1 prevalence of myofascial pain syndrome and lack of consensus in 1Kyoto Prefectural University of Medicine, Orthopaedics, Kyoto, the best treatment choice, we conducted this study to compare the Japan, 2Kyoto Prefectural University of Medicine, Rehabilitation effectiveness of physiotherapy with dry needling. The diagnosis is clinical and imaging is needed radical neck dissection with preservation of the accessory nerve, in- to confrm the diagnosis and to decide on the appropriate treatment cluding twenty-six men and four women with a mean age of 60. Results: At the time of rehabilitation starting after tion was entered in to the study. The correlation between different clinical tests and ultrasonographic fndings were assessed statistically. Results: Ultrasonographic fndings showed good correlation with clinical 323 fndings. We recommend its use in regular practice because it is Kashf3 user friendly and free from the risk of radiation. Ultrasound helps 1University of Social Welfare and Rehabilitation Sciences, Physi- in reaching at a correct diagnosis because many a times the clinical cal Therapy Department, Tehran, Iran, 2University of Social Wel- features may not give the accurate picture even in best hands. Thus the aim of this study was to evaluate the effect of 6 weeks shoulder girdle muscle exercises on the subacromial Introduction/Background: The aim of this study was to evaluate space and scapulohumeral rhythm in the subjects with scapular the coexistence of C5 and/or C6 root compression with rotator cuff dyskinesis. Material and Methods: Twenty subjects with obvious pathologies and its effect on pain and disability with clinical signs scapular dyskinesis were participated in the study. Material and Methods: The study with ter 6 weeks exercise program any alteration of scapular orientation 65 patients who fulflled the inclusion and exclusion criteria of the was assessed obviously by scapular dyskinesis test also the anterior study and who applied to our outpatient clinic with pain radiating outlet of subacromial space was measured via the acromiuhumeral from neck to shoulder. Exercise program consisted of stretch- were separated into two groups as patients with and without upper ing, strengthening and postural correction. These groups were compared in were given information about the anatomy and the importance regard to impingement grades, rotator cuff and bicipital muscle pa- of scapular position in shoulder kinematics. The pain domain of research needed to investigate the infuence of internal factors. Patients were followed up for one year to judge syndrome was also found at both groups. All groups were given a home exercise programme 3 times fore each treatment and one month, after completion of therapy. Hayani Objectives: To study the therapeutic effect of combining Mul- Al-nisr1 ligan technique with neck muscle training fortreatment of nerve 1Hospital General Universitario de Castellón, Physical Medicine root type of cervical spondylosis and observe its role in prevent- and Rehabilitation, Castellón, Spain ing recurrence. Methods: Eighty-six patients with nerve root type cervical spondylopathy were randomly divided into a control and Introduction/Background: Several treatments are available to treat an experimental group. Material and Methods: Chinese medical massage therapy as a supplement and the Mulli- From 14 Feb, 2002 and 30 Sep, 2015, a prospective longitudinal gan manipulation and neck muscle strength training are adopted in descriptive study was performed on treatment with a Piezoelectric the experimental group. This study aimed activities that initially existed in 98 (100%), persisted in 2 (2. Mean fux density, number of pulses applied, and improve- in such patients, as well as assessing the extent of such relations. Introduction/Background: Alteration in head posture and neck muscles activation has been observed among neck pain patients due to variation of motor dysfunction. Motor dysfunction can fur- 332 ther lead to changes in thoracic and rib cage mechanics. Milet1 40 subjects (20 healthy and 20 neck pain subjects) were recruited based on the selected criteria as set by the study protocol. Finally, the chest expansion was measured us- Introduction/Background: Epicondylitis is a common, painful ing measuring tape. Results: The results of the study showed a signifcant pathophysiologic process is a tendinosis that can occur by micro- difference (p<0. It is present in 1% to 3% of the general tern, chest expansion between healthy and neck pain groups. Different rehabilitation techniques and addition, there is also an alteration of breathing pattern among treatments are being used, that can include: rest, physiotherapy, neck pain patients. Conclusion: The study proposed that ment is recommended when functional impotence and pain persist, neck pain patients may predispose to alteration in respiratory in- despite all the other treatments already mentioned. This study recommends that respiratory exercise could Methods: Clinical case of male patient diagnosed with epicondyli- be included as part of rehabilitation measures among neck pain tis, refractory to usual rehabilitation treatments. Sixteen had pain involving single site while in 15 cases has completed two sessions of fenestration, ranking a score of 85 more than 2 sites were involved, with low back being the most at the Mayo Elbow Score. The First episode of pain occurred during 5–15 for treating epicondylitis but most of them still have little scien- years of service in (36. Most of them agreed (110) that rest is ultrasound-guided fenestration, with or without chemodenervation, needed to get better, and neglecting problems of this kind can cause should be considered as a therapeutic approach. Although its spontaneous evolution edge of the results of the clinical assessment. Results: Impingement is often favorable, it can be much longer and unusual among dia- manoeuvres (Hawkins, Neer and Yocum) seem sensitive enough, betic patients. Jobe’s manoeuvre evoking a supraspinatus lesion by the sessing the outcome of the treatment then comparing the results be- demonstration of weakness and/or pain seems to have the same per- tween the two populations. Material and Methods: We carried out formance profle with a sensitivity of 72% and a specifcity of 40%.
A calcific barrier is apparent purchase lasix 40mg otc pulse pressure 55 mmhg, and the tooth is ready for definitive obturation and restoration buy lasix 100mg overnight delivery hypertension xerostomia. Splinting immobilizes the tooth in the correct anatomical position so that further trauma is prevented and healing can occur buy lasix online pills blood pressure medication most common. A functional splint involves one, and a rigid splint two, abutment teeth either side of the injured tooth. The splinting period should be as short as possible and the splint should allow some functional movement to prevent replacement root resorption (ankylosis). As a general rule exarticulation (avulsion) injuries require 7-10 days and luxation injuries 2-3 weeks of functional splinting. Excessive mobility leads to the fracture site becoming filled with granulation tissue. Although acrylic resin does not have the bond strength to enamel as the composite resin it is suitable for all types of functional splinting (Fig. Bend a flexible orthodontic wire to fit the middle third of the labial surface of the injured tooth and one abutment tooth either side. Isolate, dry, and etch middle of crown of teeth with 37% phosphoric acid for 30 s, wash, and dry. Apply 3-mm diameter circle either of unfilled then filled composite resin or of acrylic resin, to the centre of the crowns. Position the wire into the filling material then apply more composite or acrylic resin. Use a brush lubricated with unfilled composite resin to mould and smooth the composite. Acrylic resin is more difficult to handle and smoothing and excess removal can be done with a flat plastic instrument. For a rigid splint use the same technique but incorporate two abutment teeth on either side of the injured tooth. These splints should not impinge on the gingiva and should allow assessment of colour change and sensitivity testing. Cut metal to size, long enough to extend over two or three teeth on each side of the injured tooth and wide enough to extend over the incisal edges and 3-4 mm over the labial and palatal gingiva. These are used where it is impossible to make a satisfactory splint by the direct method, for example, a 7-8 year old with traumatized maxillary incisors, unerupted lateral incisors, and either carious or absent primary canines. Both methods require alginate impressions and very loose teeth may need to be supported by wax, metal foil, or wire ligature so they are not removed with the impression. There is full palatal coverage and the acrylic is extended over the incisal edges for 2-3 mm of the labial surfaces of the anterior teeth. The occlusal surfaces of the posterior teeth should be covered to prevent any occlusal contact in the anterior region. Both forms of laboratory splint allow functional movement and therefore promote normal periodontal healing. The treatment for both these injuries is: (1) occlusal relief; (2) soft diet for 7 days; (3) immobilization with a splint if teeth have fully formed apices or if t. The treatment for both these injuries is: (1) atraumatic repositioning with gentle but firm digital pressure (Fig. If marginal breakdown is present then it should be retained for a further 2-3 weeks. For both these injuries the decision whether to progress to endodontic treatment depends on the combination of clinical and radiographic signs at regular review (Fig. Thirty-five per cent of mature teeth that have undergone lateral luxation show subsequent evidence of surface resorption. In some cases of lateral luxation the displacement cannot be reduced with gentle finger pressure. It is not advisable to use more force as this can further damage the periodontal ligament. Orthodontic appliances, either a removable or a sectional fixed appliance can be used to reduce the displacement over a period of a few weeks (Fig. Intrusive luxation These injuries are the result of an axial, apical impact and there is extensive damage to p. Both categories can be discussed depending on whether the intrusive injury is: mild(<3 mm); moderate (3- 6 mm); or severe (>6 mm). Disimpact (with forceps if necessary) and either allow to erupt spontaneously for 2-4 months before extruding orthodontically or apply orthodontic forces early. Monitor pulpal status clinically and radiographically at regular intervals during the first 6 months after injury, and then 6 monthly, and start endodontics if necessary: Non-setting calcium hydroxide in root canal does not preclude against orthodontic movement. Orthodontic extrusion is probably indicated straight away although some authors have advocated conservative treatment. The danger of a tooth ankylosing in an intruded position should always be borne in mind and in this respect active treatment is preferable to a conservative approach. Elective pulp extirpation will be necessary for all significant intrusive luxation injuries in closed apex teeth (Table 12. Maintain non-setting calcium hydroxide in root canal during orthodontic movement before obturation with gutta percha (Fig. At the initial examination both open and closed apex teeth should receive antibiotics, chlorhexidine mouthwash, and a soft diet. The risk of pulpal necrosis in these injuries is high, especially in the closed apex (Table 12. Avulsion and replantation Replantation should nearly always be attempted even though it may offer only a temporary solution due to the frequent occurrence of external inflammatory resorption (e. Even when resorption occurs the tooth may be retained for years acting as a natural space maintainer and preserving the height and width of the alveolus to facilitate later implant placement. Successful healing after replantation can only occur if there is minimal damage to the pulp and the p. Understandably non-dentists may be unhappy to replant the tooth and milk is an effective iso-osmolar medium. Endodontics⎯commence prior to splint removal for categories (b) and (c): (a) open apex. If resorption is progressing unhalted keep non-setting calcium hydroxide in the tooth until exfoliation, changing it 6 monthly. However, these teeth require regular clinical and radiographic review because once e. Replantation of teeth with a dry storage time of greater than 1 h The consenus opinion is that teeth with very immature apices should not be replanted. The incidence of resorption, ankylosis, and subsequent loss is high due to the high rate of bone remodelling in this age group.
Lastly buy lasix without prescription blood pressure medication for adhd, another infection that is common in burned patients is the development of scalp folliculitis (Fig buy lasix on line amex blood pressure xls. Burns to the scalp that heal secondarily are susceptible to chronic growth of organisms in remaining hair follicles that result in ulceration and open wounds buy lasix paypal heart attack aspirin. Donor sites taken from the scalp because of limited donor sites in other areas can also result in this problem. Initial therapy is aimed at topical treatment to eradicate organisms and allow healing. Because gram-positive organisms predominate, mupirocin is commonly used; alternatively, acetic acid washes are employed. After a reasonable course of treatment (two to three weeks), if the wound does not heal, split thickness grafting may be required. Nonetheless, infections in the severely burned are still common and can be lethal, highlighted by burn wound infection and pneumonia. Infections common to other critically ill patients are also seen in burn patients and require similar therapeutic interventions. Further strategies to prevent and treat infections in burned patients are still needed and are being actively researched. Burn incidence and medical care use in the United States: estimates, trends, and data sources. A study in mortality in a burn unit: standards for the evaluation for alternative methods of treatment. Determinants of mortality in pediatric patients with greater than 70% full-thickness total body surface area thermal injury treated by early total excision and grafting. Hemodynamic changes in the early post-burn patient: the influence of fluid administration and of a vasodilator (hydralazine). An evaluation of the safety of early vs delayed enteral support and effects on clinical, nutritional, and endocrine outcomes after severe burns. Survival benefit in critically ill burned patients receiving decontamination of the digestive tract: a randomized placebo-controlled, double-blind trial. Selective decontamination of the digestive tract in severely burned pediatric patients. Survival benefit conferred by topical antimicrobial preparations in burn patients; an historical perspective. The time related changes of antimicrobial resistance patterns and predominant bacterial profiles of burn wounds and body flora of burned patients. Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics. Multi-resistant Acinetobacter baumannii on a burns unit — clinical risk factors and prognosis. Direct costs of multi-drug resistant Acinetobacter baumannii in the burn unit of a public teaching hospital. Intravenous colistin for the treatment of multi-drug resistant, Gram-negative infection in the pediatric burn population. Systemic candida infection in burn patients: a case-control study of management patterns and outcomes. Fungal wound infection (not colonisation) is independently associated with mortality in burn patients. Incidence of systemic fungal infection and related mortality following severe burns. Correlation between quantitative and qualitative burn wound biopsy culture and surface alginate swab culture. Comparative evaluation of surface swab and quantitative full thickness wound biopsy culture in burn patients. Use of burn wound biopsies in the diagnosis and treatment of burn wound infection. Correlation of culture with histopathology in fungal burn wound colonisation and infection. Frozen section technique to evaluate early burn wound biopsy: comparison with the rapid section technique. The Incidence of bacteremia following burn wound manipulation in the early post-burn period. Evaluation of white blood cell count, neutrophil percentage, and elevated temperature as predictors of bloodstream infection in burn patients. Enteral feeding intolerance: an indicator of sepsis associated mortality in burned children. The risk factors and time course of sepsis and organ dysfunction after burn trauma. Incidence, outcome, and long-term consequences of herpes simplex-virus type 1 reactivation presenting as a facial rash in intubated adult burn patients treated with acyclovir. Pneumonia in patients with severe burns; a classification according to the carrier state. A prospective study of hospital acquired infections in burn patients at a tertiary care referral centre in North India. Association between the presence of the Panton- Valentine leukocidin-encoding gene and a lower rate of survival among hospitalized pulmonary patients with staphylococcal disease. Catheter infection risk related to the distance between insertion site and burned area. Infections Related to Steroids in 22 Immunosuppressive/Immunomodulating Agents in Critical Care Lesley Ann Saketkoo and Luis R. Espinoza Section of Rheumatology, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U. Discussion will focus on complications of therapy in relation mainly to serious infections—defined as infection that is fatal, life threatening, or causing prolonged hospitalization. The use of biologic agents as they are newer therapies will be highlighted in the discussion. However, its use is fraught with a catalogue of damaging and disabling complications that will not be listed here. For this reason, it has been used as a bridge therapy during the time it takes for other less harmful therapeutics to take effect. The hospital-based physician needs to be aware of two potentially devastating complications in the management of the in-patient receiving exogenous corticosteroids: (i) hypothalamic suppression leading to adrenal insufficiency and (ii) risk of serious infection. Consensus in defining levels of immune suppression with glucocorticoid use is difficult to reach due to immunologic complexities inherent in underlying diseases being treated with corticosteroids as well as variances in patient sensitivity based on genetic make-up. But it is generally accepted that the degree of immune suppression increases with level of dosing and observation of physical changes such as cushingoid features, striae, and vascular friability. Level of dosing effecting immune response has been suggested through vaccine response studies and studies ascertaining infections as follows: l Daily prednisone of 10 mg (or its equivalent) or a greater or cumulative dose of 700 mg carried an increased relative risk of 1. Depending on the severity of the illness, glucocorticoids may indeed need to be supplemented to address hypothalamic stress caused by the illness itself.
Therefore discount lasix 100mg on line heart attack xiami, attention and cognition cheap lasix 100mg with amex define pulse pressure quizlet, is a leading complication with detrimental training during hemodialysis session for 12 weeks might improve outcomes during hospitalization among older adults order line lasix pulse pressure compliance. Cancer rehabilita- Documentation of delirium status at admission improved from 11% tion inpatients have a number of risk factors that could make them to 98%. Material and Methods: Patients presenting requires well-orchestrated effort of multiple disciplines, including to rehabilitation during Apr 2015 and Oct 2015 were identifed referring hospitals beyond the rehabilitation facility. Future studies and as part of their initial physical assessment, calf measurements are needed to tailor the interventions utilizing specifc resources of were taken on both lower extremities. Only 1 patient had a difference in his/her calf measurement to war- Sherrington , S. This presentation re- views the approaches to “treatment” of frailty used in two rand- omized trials to ascertain whether a common approach can be ap- plied both in frailty and pre-frailty. Both applied interdiscipli- nary multifactorial interventions based on phenotypic characteris- 50 tics using Cardiovascular Health Study criteria and comprehensive geriatric assessment. Barrett6 be delivered with coordination from a key staff member (physi- 1Kessler Institute for Rehabilitation, Physical Medicine and Re- cal therapists). Adher- Kessler Institute for Rehabilitation, Occupational Therapy Ser- 4 ence to the interventions was limited in both groups. However, the percentage of obese patients with sarco- ment” programs are feasible and will be associated with beneft if penia has increased. This study aimed to investigate the effect of adequate levels of adherence are achieved. Mate- rial and Methods: A total of 62 patients were randomly assigned 52 to either an experimental group (n=32) or control group (n=30). Results: A statistically signifcant improvement of Specialties and Dentistry, Napoli, Italy, 2Second University of Na- all measures was observed in both the experimental and control ples, Physical and Mental Health and Preventive Medicine, Napoli, groups after intervention (all p<0. However, the experimen- Italy tal group exhibited a signifcantly superior improvement compared with the control group (p<0. Conclusion: Elastic-band resist- Introduction/Background: Osteoporosis is a chronic condition char- ance exercise exerted a signifcant benefcial effect on the physical acterized by loss of bone density and deterioration of bone strength function in elder female with sarcopenic obesity. Fall is generally should include a control group that does not receive any interven- the main cause of fractures. Hip fractures are the most common tion, and should follow the patients up for longer than we did. The objective of this study was to evaluate the characteristics and circumstances of the falls in patients with hip fractures. Iolascon1 lowing data: age, gender, fracture site, number of falls in the last 12 months and the year before the fall, characteristics of the fall 1Second University of Naples, Department of Medical and Surgi- that led to the fracture, including extrinsic and intrinsic risk factors. The majority Introduction/Background: The market of dietary supplements fell on their side (54%) but there were a signifcant percentage of and nutraceuticals is growing worldwide, in particular aimed to patients (>40%) who fell with other injury mechanisms. Our fndings support the to reduce muscle mass and physical performance in these subjects. PubMed Search Builder the terms: “bone”, “skeletal muscle” and 1 5 6 “central nervous system”/“brain”/“cognitive function”; we selected Tsan-Hon , , 1 the effective micronutrients; we identifed the effective and safe Shuang Ho Hospital-Taipei Medical University, Department of dosage regimens. Results: After an evaluation of scientifc publica- Physical Medicine and Rehabilitation, Taipei, Taiwan, 2National tions in medical literature in the last 10 years, with an evidence- Taiwan University, School and Graduate Institute of Physical Ther- based approach, we selected 12 positive relevant studies (1 system- apy- College of Medicine, Taipei, Taiwan, 3Shuang Ho Hospital, atic review, 7 randomized controlled trials, 3 prospective cohort Department of Physical Medicine and Rehabilitation, Taipei, Tai- studies, and 1 international society guideline recommendations). Conclusion: Our scoping review showed that the 16 selected Introduction/Background: Sarcopenia is associated with loss of micronutrients in appropriate doses might have an ancillary role in muscle mass and also with an increased risk of physical disability musculoskeletal and cognitive functions in older people. Infec- Biglarian3 tion/abscess was more common in patients with >5 years disease 1University of Social Welfare and Rehabilitation Sciences, Ira- duration (p=0. Percentage of the neuromas in below knee nian Research Center on Aging, Tehran, Iran, 2Iran University of amputees was signifcantly higher than non-below knee amputees Medical Sciences, Department of Basic Sciences in Rehabilita- (45. Neuroma was found to be signifcant stump pathology in patients with below knee level amputation. Introduction/Background: Pain is a frequently undetected and un- dertreated health problem among nursing home residents which is not studied adequately. Kusumaningsih1 through cluster sampling method and their residents were invited to 1 Jakarta, Indonesia participate in the study. Results: The mean age of the participants cortisol circulating level with phantom limb phenomen was done in was 74. Pain signifcantly interfered with adults traumatic limb amputee without stump pain. Measurement general activity, mood, walking, normal work, relations with oth- was done twice, before and after. Based on the Cortisol serum level was examined using radioimmunoassay meth- results, factors such as age, gender and education were signifcantly od. A pilot study to validate of the score and the by appropriate training of health care personnel of nursing homes. Further studies on the effcacy show signifcance difference in the decrease of cortisol level within of management strategies of pain used in nursing homes may help six months in each group (p=0. Pearson correlation show signifcance negative correlation between decrease in cortisol level and increase in telescoping grade (r=– 0. Signifcant positive correlation between decrease in cortisol level and decrease in phantom pain intensity (r=0. Signifcance negative correlation between decrease in cortisol level and increase in referred phantom limb sensation (r=– 56 0. Within six months observation period, the changing pat- 1 1 1 1 tern of phantom limb phenomen in adult traumatic limb amputee or K. Material and Methods: A chart review was performed to identify demographic Introduction/Background: Ambulation forms an important part of and clinical data including the age (current and at the time of inju- rehabilitation program after lower limb amputations. Diabetes Mel- ry), disease duration, gender, reason for amputation, affected limb litus and its complications are commonly associated with below number, side and level of limb loss and ultrasonographic fndings J Rehabil Med Suppl 55 Oral Abstracts 21 knee amputation. Inspite of this, there is an absence of studies on 1The Chinese University of Hong Kong, Department of Orthopae- the effect of diabetes on the post operative ambulation of an ampu- dics & Traumatology, Shatin, Hong Kong- China tee. This study analysed the role of diabetes as an independent fac- tor affecting post operative ambulation and compared it with non Introduction/Background: A cross-sectional study was carried out diabetics in below knee amputation. Material and Methods: In this to evaluate the use of prosthesis, mobility, and quality of life on 24 study a total of 105 below knee amputation patients were followed. Their bilitation programme having passed the 7th year after 2008 Sichuan post operative ambulatory level was compared by using Pinzur et Earthquake. Results: Adult tes Mellitus is an independent factor which has an adverse effect on amputees, comparing with young amputees, experienced worse the functional outcome of a patient after below knee amputation. Effects experiencing stump and phantom pain were also University of Hannover, Physical Medicine and Rehabilitation, greatly affected by age. Usage of prosthesis is also encouraged for Hannover, Germany better rehabilitation and mobility.