PPAM%20AID%20-%20PNEUMATIC%20POST%20AMPUTATION%20MOBILITY%20AID%20Sheila%20Hughes%202008

1
PPAM AID- PNEUMATIC POST AMPUTATION MOBILITY
AIDSheila Hughes 2008
2

• Original design was by Professor Little from RPA
  in 1971. Comprised an inflatable air splint with
  a rigid aluminium frame and a telescopic shank
  and a SACH foot
• In 1982 Bonner in the USA trialled a air leg
  which had an inner air bag that was placed over
  the stump and an outer fibreglass shell.Again it
  had a metal shank and a SACH foot.

3

• Research Dept at Roehamton Hospital London
  combined the two designs and added their own
  touch.
• Their mobility aid comprises an aluminium frame
  with a rocker foot, a small inner bag which is
  placed over the distal stump and an outer stump
  sleeve which extends into the groin.

4

• Used for transtibial and transfemoral amputees
• Use same aluminium support frame but different
  stump bags
• Cannot be used for bilateral amputees

5

• Partial weight bearing aid only
• Used primarily in the parallel bars
• Some patients can progress to crutches but never
  used with sticks

6

• Can be used from approx 7 days post-op, dependent
  on initial wound healing
• Accurate documentation of wound progress is
  essential
• Never used if wound is infected or if wound is
  dehiscing
• Can be applied over stump dressings,stump
  shrinkers , bandages or over trousers

7
Method

• Pump a small amount of air into the inner bag
• Turn it inwards to form a shallow cup which is
  then placed on the end of the stump
• The larger outer stump sleeve is then slipped
  over the inner cushion and placed with the top
  end in contact with the patients groin.

8

• A rigid frame is then placed over the outside of
  the bag
• Need to leave at least 2 inches between the top
  of the frame and the top of the outer bag.

9

• The webbing is placed at the bottom of the frame
  to support the distal end of the outer sleeve.
• The rocker foot should be in a position such
  that the remaining limb is slightly shorter
• Place strap over opposite shoulder and attach to
  frame.

10

• Support the frame whilst inflating
• The outer bag is inflated to 40mmHg for walking
• On weight bearing there will be some shortening
  and some adjustment may need to be made to the
  length.

11

• Worn for 5- 10 mins initially and then the stump
  must be examined
• Gradually build up wearing time
• Whenever the patient is sitting the outer sleeve
  must be deflated a little and the leg elevated to
  prevent the circulation being compromised

12
Benefits

• Psychological boost
• Patient is upright and weight bearing
• Provides total stump contact
• Aids in oedema reduction
• Can give some indication about whether or not
  they will be prosthetic users
• Can be reused for other amputees

13
Drawbacks

• Lack of knee flexion/extension when mobilising
• Can introduce gait deviations eg. circumduction.
  More apparent with transfemorals.
• Initial stages are time consuming