Occupational therapy with people who have had lower limb amputations Evidence-based guidelines

1. Occupational therapy with people who have had lower limb amputations Evidence-based guidelines College of Occupational Therapists Specialist Section – Trauma and Orthopaedics

2. Key aims • Provide an evidence-based resource for occupational therapists working with adults with acquired unilateral or bilateral lower limb amputation • To facilitate evidence-based practice • To support occupational therapy and service managers in service provision and planning The guidelines are applicable to any setting

3. Areas covered • Functional rehabilitation • Environment • Psychology • Prosthetic use • Assessment tools and outcome measures • Cognition • Work • Leisure and recreation

4. Methodology Guideline development group established Guideline topic and scope established Critical appraisal of articles Review of findings Literature search Development of evidence-based guidelines Peer review and stakeholder consultation Published COT 2011 Final draft approved by COT Practice Publications Group

5. Evidence-based recommendations Recommendations are based on the evidence available within 29 critically appraised papers Each article is assigned: • An evidence score V–I (Low–High) • A quality score 0–10 (Low–High)

6. Recommendations – Functional Rehabilitation

7. Recommendations – Environment

8. Recommendations – Psychology

9. Recommendations – Prosthetic use

10. Recommendations – Assessment tools and outcome measures

11. Continued

12. Recommendations – Cognition

13. Recommendations – Work Recommendations – Leisure and recreation

14. Impact of evidence-based guidelines for you • Challenges / affirms your current practice • Informs your practice • Provides evidence to support your practice (completion of Audit Form) • Provides a vehicle for you to justify your practice

15. Impact of evidence-based guidelines for managers • Provides evidence of the need for occupational therapy input into services for people who have had lower limb amputation • Provides a structure to audit the work of occupational therapists within the service to improve service quality • Provides a vehicle for justifying service provision

16. Impact of evidence-based guidelines for service users • In being adopted by services and occupational therapists, the guidelines should improve the consistency and quality of intervention for users of services • Gives assurance that practitioners use the available evidence to support interventions

17. Impact for evidence-based guidelines for commissioners • Articulates the need for occupational therapy interventions within services for people with lower limb amputation • May help educate commissioners to identify learning needs for the workforce • Associated audit form provides a mechanism to review service delivery in accordance with the evidence

18. Help from COT/BAOT • Link up with your BAOT networks to gain advice and support. Find out through your BAOT regional group or the COT Specialist Section you belong to whether they have resources that can help you. • iLOD is designed to be a one-stop shop for all your CPD needs and it was developed to make it simple for BAOT members to meet the HPC’s baseline standards for CPD. If you are having difficulties or need support contact professional.enquiries@cot.co.uk