Fifteen physiotherapists have completed specialist training on the early rehabilitation of people with lower-limb amputations during emergencies at Beirut Arab University in Lebanon.
Held on 6–7 October 2026, the programme was organised through a collaboration between the International Committee of the Red Cross, the Lebanese Order of Physiotherapists and Beirut Arab University’s Physical Therapy Department.
The training was hosted by Dr Rami Abbas and launched by Professor Ibtissam Saab, head of the university’s Physical Therapy Department. International ICRC trainers delivered the programme to 13 physiotherapists working within ICRC-affiliated rehabilitation centres across Lebanon, alongside Beirut Arab University staff members Hussein AbuYassin and Nadine Assaad.
The initiative addressed an area of care that can strongly influence a person’s subsequent recovery and readiness for prosthetic rehabilitation.
Rehabilitation must begin before prosthetic fitting
When a lower-limb amputation occurs during a conflict, disaster or other emergency, clinical attention initially focuses on saving life, controlling bleeding, treating infection and managing the wound.
These priorities are essential, but rehabilitation should not be postponed until the wound has healed or a prosthesis becomes available.
Early rehabilitation may begin in the hospital or immediately following surgery. Its objectives can include:
- Appropriate positioning of the residual limb
- Prevention of hip and knee contractures
- Oedema and residual-limb management
- Maintenance of strength and joint movement
- Safe bed mobility and transfers
- Prevention of falls and secondary complications
- Selection and instruction in mobility aids
- Pain and phantom-limb symptom management
- Patient and family education
- Preparation for discharge and community reintegration
- Referral for prosthetic assessment when clinically appropriate
The ICRC describes early rehabilitation as part of its response from the first day of injury or disability, extending across hospital, pre-hospital and longer-term rehabilitation settings. ICRC
Why emergency-specific training matters
Delivering rehabilitation in an emergency is different from working within a stable outpatient service.
Clinicians may be supporting people with multiple injuries, complex wounds, infection, burns, fractures or psychological trauma. Hospitals can be under considerable pressure, while patients may be discharged into inaccessible housing or displaced to locations far from specialist rehabilitation services.
Equipment, mobility aids and prosthetic materials may also be in short supply.
Training helps physiotherapists make safe decisions within these constraints. It can also strengthen communication between surgical teams, nurses, rehabilitation physicians, physiotherapists, prosthetists and orthotists.
This coordination is particularly important following amputation. Decisions made during the acute stage can affect joint range, residual-limb condition, mobility, independence and the patient’s future ability to use a prosthesis.
Relevance for prosthetists and orthotists
Although the Beirut programme was delivered to physiotherapists, its subject has direct implications for the P&O profession.
Prosthetic rehabilitation does not begin when measurements are taken for a socket. Ideally, prosthetists become part of the pathway much earlier.
Early contact allows the P&O team to:
- Explain the likely stages of prosthetic rehabilitation
- Help establish realistic expectations
- Review residual-limb shape, skin condition and joint range
- Advise on compression and limb-management strategies
- Identify contractures that may complicate fitting
- Discuss suitable mobility objectives
- Coordinate prosthetic timing with wound healing and medical stability
- Plan for the patient’s home, work and community environment
Not every person with an amputation will immediately be a prosthetic candidate. Some may first require further surgery, wound management, medical stabilisation, strengthening or wheelchair provision. Others may ultimately achieve their best functional outcome through a combination of prosthetic and non-prosthetic mobility.
Early multidisciplinary assessment helps ensure that the pathway is based on the individual rather than on an assumption that device fitting must be the next step.
Building on Lebanon’s emergency experience
Lebanon has extensive experience of managing injuries arising from conflict and large-scale emergencies.
Research examining the ICRC-supported early rehabilitation response following the 2020 Beirut port explosion found that rehabilitation professionals managed people with fractures, tendon injuries, spinal trauma, polytrauma and amputations. The experience contributed to a proactive plan for improving emergency rehabilitation preparedness in Lebanon. pubmed.ncbi.nlm.nih.gov
The latest training therefore forms part of a wider effort to embed rehabilitation within emergency healthcare rather than treating it as a later, optional service.
The Lebanese Order of Physiotherapists also has an important professional role. It registers physiotherapists and students, supports standards and guidelines, evaluates professional qualifications and promotes evidence-based practice and continuing education. Vision & Mission-to-del
Bringing together the Order, a university and the ICRC creates a useful model connecting professional standards, academic education and field experience.
From short course to stronger national capacity
The immediate value of the programme lies in the skills gained by its 15 participants. Its longer-term impact will depend on how this knowledge is transferred into clinical practice.
Participants from different rehabilitation centres can become focal points for:
- Training colleagues within their facilities
- Developing shared assessment procedures
- Improving referral to prosthetic and orthotic services
- Strengthening hospital discharge planning
- Standardising patient and family education
- Supporting emergency-preparedness exercises
- Collecting information on outcomes and service gaps
Universities can also use the lessons to strengthen undergraduate and postgraduate teaching. Students should understand amputation rehabilitation as a connected clinical pathway extending from acute care to prosthetic provision, functional training and long-term participation.
A model for the wider IMEA region
Conflict, natural disasters and road traffic injuries continue to generate complex rehabilitation needs across the Middle East and Africa. Yet rehabilitation is still frequently introduced too late in the care pathway.
The Beirut programme demonstrates the value of preparing rehabilitation professionals before the next emergency occurs.
For O&P services, the lesson is equally clear: effective prosthetic care depends on what happens before the socket is fabricated. Appropriate positioning, contracture prevention, residual-limb management, mobility training and coordinated referral can all influence the eventual fitting.
The collaboration between the ICRC, the Lebanese Order of Physiotherapists and Beirut Arab University represents a practical investment in Lebanon’s rehabilitation workforce—and in more coordinated care for people facing limb loss during emergencies.
- ICRC: Emergency Preparedness and Early Rehabilitation
- ICRC Physical Rehabilitation
- Beirut Arab University
- Lebanese Order of Physiotherapists
- Research: ICRC Early Rehabilitation Response Following the Beirut Port Blast