Comprehensive Rehabilitation for a Multilimb Amputee: A Case Report

Multilimb amputation poses a significant challenge to an individual's mobility, independence, and overall quality of life. Comprehensive rehabilitation is essential for these patients to restore functional abilities and facilitate their reintegration into society. This case study details the rehabilitation of a 23-year-old male who sustained bilateral transradial and right transtibial amputations due to an electric burn injury. Upon presentation, the patient exhibited severe functional limitations, with complete dependence on caregivers for mobility, self-care, and activities of daily living (ADLs). A structured inpatient rehabilitation program was initiated, focusing on stump care, contracture prevention, range of motion, strengthening exercises, and functional training. He was educated on prosthetic options and fitted with customized prostheses, including a right cosmofunctional prosthesis with a hook terminal device, a left cosmofunctional prosthesis with a hand terminal device, a right patellar tendon-bearing above-knee prosthesis with supracondylar suspension, and an ankle-foot orthosis for his left foot's equinus deformity. Rehabilitation emphasized upper limb prosthetic adaptation, progressive gait training, and stair-climbing exercises to enhance mobility and self-sufficiency. At the time of discharge, the patient demonstrated significant improvement in functional independence. His Nottingham Extended Activities of Daily Living (NEADL) score increased from 0 to 27, out of a maximum score of 66, indicating partial autonomy. A follow-up assessment conducted three months later revealed continued progress, with his NEADL score reaching 47 out of 66, reflecting enhanced mobility and self-reliance. The NEADL scale, with scores ranging from 0 (complete dependence) to 66 (full independence), offers a comprehensive measure of functional ability across domains such as mobility, kitchen activities, domestic tasks, and leisure. The patient's improvement from 0 to 47 illustrates a substantial functional gain and increasing independence in daily life. This report highlights the importance of a structured rehabilitation program in promoting functional recovery and social reintegration in multilimb amputees. Early intervention, patient motivation, prosthetic rehabilitation, and a multidisciplinary approach play crucial roles in optimizing outcomes. The findings emphasize that with appropriate rehabilitation strategies, multilimb amputees can achieve a high level of independence, mobility, and meaningful engagement in their daily lives.