West African countries are among the least developed and Persons with Disabilities in these countries are often amongst the poorest of the Poor. Physical Therapy is not well known in this context, where there is already a shortage of health resources. In order to move Physical Therapy forward in West Africa, this survey examines the impact of functional rehabilitation on the social participation of people having a lower-limb amputation in Togo. The purpose of the study is to explore the links between functional rehabilitation and social inclusion and to examine the extent to which rehabilitation has improved, or failed to improve, the social participation of persons with disabilities.

This study will allow Physical Therapists and their professional associations to demonstrate how Physical Therapy helps people to improve social participation, fights poverty, as well as supports advocacy for increased service delivery, evidence based practice and the inclusion of Physical Therapy in national health policies.

Clients of both sexes and over the age of 5 with a lower-limb amputation who received Physical Therapy treatment for a period of at least 3 months at the National Rehabilitation Centre between 2003 and 2008 and were living in the region of Lomé were selected. 35 patients met the criteria.

A qualitative interview analysis was chosen to describe the person's life before and after rehabilitation in order to identify the changes that occurred. The interviews were conducted at home by an investigator using a semi-structured guide developed from the model of Disability Creation Process (DCP), (Fougeyrollas, et al., 1998, RIPPH/SCCIDIH). DCP is a comprehensive approach in which disability is a complex phenomenon resulting from the interaction of following: risk factors, personal factors, environmental factors, lifestyle habits. Since this study conducted in Togo was considered as the first step for it to be reproduced in other countries, special attention was paid to the relevance of the questionnaire to assess the African context.

Data analysis explored personal factors, environmental factors (community attitudes, health and social system), and lifestyle habits (personal care, mobility, community involvement).

The results showed that the social participation varies depending on cause of amputation, age, quality of care received and level of income. Physical Therapy has generally improved mobility and community life. The remaining difficulties are environment-related. Professionals still need to improve patient contact. 

A questionnaire based on the Disability Creation Process (DCP) was used. This tool is now available and can be used in similar contexts. Its implementation is very cost-effective. It facilitates the evaluation of rehabilitation care’s impact in developing countries. In order to have a better overall picture of the situation and to develop better policies this study should be duplicated in other countries and for other types of impairment.

This study highlighted the changes that Physical Therapy can make in the daily lives of beneficiaries by enabling them to improve their social participation. This study contributes to Evidence based Practices in Physical Therapy  in West Africa.