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Assistive Technology Resources National AgrAbility Workshop (2001 - 2008)
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Promoting Success in Agriculture for People with Disabilities and Their Families
Focus – Lower Extremity AmputationsEach year, more than 150,000 people join the ranks of over 4 million existing amputees in the U.S. 1 Currently there are over 380,000 individuals in the U.S. who have had a lower limb amputation. 2 The types of lower extremity amputations include: foot amputations, ankle amputations, below-knee amputations, above knee amputations, and hip disarticulation (meaning the entire leg bone has been amputated). Amputations are primarily caused by injuries, cancer, diabetes, and other diseases. Peripheral vascular disease, resulting in poor blood circulation, account for 74 percent of all amputations. While John Baird experienced his leg amputation as a result of a motorcycle injury, traffic, industrial, and farm-related injuries account for approximately 23 percent of leg amputations. The remaining 3 percent of leg amputations are a result of birth defects. 2 Each year the National AgrAbility Project receives demographic information on clients working with the state AgrAbility projects. Results from 2001-2004 data show that 120 AgrAbility clients reported a lower limb amputation as their primary disability and 26 clients reported lower limb amputations as an additional disability. Of the 146 clients reporting lower limb amputations, 55 percent were amputations below the knee, 35 percent were leg amputations above the knee, 7 percent were foot amputations and 3 percent were toe amputations 3 (Chart 1). Over one third of AgrAbility clients reporting lower extremity amputations as a primary disability report a tractor or farm machinery incident as the cause of their amputation
The four major types of agricultural operations that AgrAbility clients with leg amputations were involved in were: livestock (37 percent), field grain crops (37 percent), dairy (15 percent), and hay (16 percent). This breakdown is similar to reported farming operations among all AgrAbility clients, suggesting that there is no association between type of farming and number of amputations. RehabilitationFollowing an amputation, the individual usually waits six to eight weeks before being fitted with a prosthetic device. 4 The selection of the most appropriate device depends on several factors including the level and severity of the amputation and the level and type of activities. Individuals who are less active and live a more sedentary lifestyle may choose a basic prosthetic system. Conversely, athletes and active farmers frequently require a more robust system to accommodate the variety of strenuous activities. The rehabilitation process involves: skin care training and exercises to maintain full mobility of the residual limb; residual limb shrinkage to ensure that the limb is properly shaped; and the fitting process. Rehabilitation goals are established during this process to achieve maximum independence and function in all life activities. This entire rehabilitation process can take up to six months. 5 Delays in wound healing, phantom pain, residual limb bone pain, and infections can all have an impact on the fitting process. 6 Farmers who have had a leg amputation are at risk of acquiring secondary injuries due to a slip, fall or an injury to the residual limb (the stump). Exploring preventative measures with a physician, prosthetist, or an AgrAbility staff person can be helpful in developing a plan to reduce these risks.
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