Conventional Treatment: (Strengthening exercises of residual limb, Gait training, Deep Breathing exercise)

Lower Limb Amputation Above Knee (Injury)

PMRT begins by assuming a comfortable position of lying down, sitting or leaning back.
Patient is asked to take a breathe in and intentionally contract muscle and hold muscle and after that release all tension and focus on sensation of relaxation. Each muscle group is tensed for 5-7 seconds and relaxed for 20-30 seconds. PMRT is given twice a day for one week.

Progressive Muscle Relaxation Technique

Strengthening exercises of residual limb: After amputation strengthening exercises of residual limb is necessary to prevent shortening of muscles and tightening of joints, moreover it is necessary to make residual limb strong and flexible in order to use a prosthesis. This include Hip abduction, prone hip extension and Prone position. Gait training: This include standing exercises in the parallel bars with or without the prosthesis. Initial walking exercises in which the patient is taught to raise each knee alternately and to try to take weight on his limb as much as possible. Deep Breathing exercise: Deep breathing 10-15 repetitions twice a day.

Conventional treatment

Riphah International University

Progressive Muscle Relaxation Technique on Lower Limb Amputation

Effects of Progressive Muscle Relaxation Technique on Pulmonary Functions and Stress on Lower Limb Amputation

Changes from the Baseline, the digital spirometer is used in clinical setting to analyze Forced vital Capacity in Liters

Changes from the Baseline, the digital spirometer is used in clinical setting to analyze Forced Expiratory Volume in 1 second FEV1 in Liters

Changes from the Baseline, the digital spirometer is used in clinical setting to analyze peak expiratory flow PEF in Liter/second

Perceived stress scale was developed in 1983, (36) and most commonly used to measure the degree to which situation in one's life are appraised as stressful. Modified perceived stress scale which consist of 10 items. Each item is rated on a 5-point scale ranging from never (0) to almost always (4).

Diabetic foot routine treatment without intervention

On the basis of routine treatment of diabetic foot, adipose stem cells will be added to treat diabetic foot

Diabetes Mellitus Foot Ulcer

intramuscular injection of adipose stem cells treat diabetic foot

MSCs treatment

Clinical Study of Adipose-derived Stem Cells in the Treatment of Diabetic Foot

Ulcer healing rate = number of cases of complete wound healing / total number of ulcers in this group

Amputation rate = number of amputations / total number of amputations in this group

Evaluate patients' limbs blood flow by ultrasound，We will record blood flow velocities, for example， 4ml/second.

The ratio of ankle artery pressure to brachial artery pressure was obtained by measuring the contractile pressure of the posterior tibial artery, anterior tibial artery and brachial artery of the ankle.ABI≥0.9 means normal,0.8≥ABI≥0.7means mild arterial obstruction,0.6≥ABI≥0.4means moderate arterial obstruction,ABI＜0.4means severe arterial obstruction.

Evaluate patients'oxygen level by TcPO2,TcPO2＜20mmHg means very severe lesion.

Evaluate patients' limbs blood flow by CTA,We will record blood flow velocities, for example， 4ml/second.

Evaluate patients' limbs blood flow by Rutherford classification，Grade 0: Normal Grade 1: Walking over 500 meters with lameness Grade 2: Walking 200-500 meters with lameness Grade 3: Walking within 200 meters with lameness Grade 4: Resting pain Grade 5: Small ulcer Grade 6: Large ulcer.

Evaluate patients' degree of pain by Wong-Baker Faces Pain Rating Scale.There are 6 faces in the Wong-Baker Pain Scale. The first face represents a pain score of 0, and indicates "no hurt". The second face represents a pain score of 2, and indicates "hurts a little bit." The third face represents a pain score of 4, and indicates "hurts a little more". The fourth face represents a pain score of 6, and indicates "hurts even more". The fifth face represents a pain score of 8, and indicates "hurts a whole lot"; the sixth face represents a pain score of 10, and indicates "hurts worst.

diabetic foot/fatigue

Progressive Muscle Relaxation Technique on Lower Limb Amputation

Clinical Study of Adipose-derived Stem Cells in the Treatment of Diabetic Foot

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