Maiko Ishizaka, RPT, Yohei Imai, RPT, Shoko Murata, MD, PhD, Tetsuya Okazaki, MD, PhD
Jpn J Compr Rehabil Sci 16: 30-36, 2025
Background: This report describes the rehabilitation
experience of a left-sided transfemoral amputee. The
patient developed rheumatoid arthritis and multiple
pyogenic arthritis immediately after left transfemoral
amputation; additionally, he had multiple joint
dysfunction and complications of immobilization,
which altered his activities of daily living (ADL). He
experienced difficulties in maintaining his economic
status and living in his environment.
Case presentation: The patient was in his 50s, and at
the beginning of the intervention, upper limb joint
pain due to rheumatoid arthritis, muscle weakness of
the limbs and trunk, reduced exercise tolerance caused
by immobilization, and ADL disturbances, including
one-leg standing, made prosthetic gait training
impossible. Nevertheless, the patient was young, and
his physical activity had been preserved until the left
transfemoral amputation. Therefore, we speculated
that he could achieve a prosthetic gait by improving
the complications of immobilization under appropriate
rheumatoid arthritis control. Rehabilitation training
was conducted to improve ADL ability in stages taking
rheumatoid arthritis into consideration, and social
resources were utilized. Finally, he achieved prosthetic
gait ability, which was necessary for survival in his
living environment, and was discharged.
Discussion: Even in cases where successful prosthetic
ambulation is considered difficult during lower limb
amputation, it is important not to exclude a patient
from prosthesis fabrication by carefully predicting
residual abilities that could be acquired afterward.
Key words: transfemoral (above knee) amputation, rheumatoid arthritis, prosthesis gait, team approach