8: Phases of Rehab Flashcards
What are the three phases of rehabilitation?
- Pre-prosthetic phase
- Prosthetic training phases
- LTC
What are 6 key suggestions for all phases of amputation rehab?
- Pt education
- Measure pain intensity and interference with activity
- Document pain with standardized tools
- Offer multi-modal pain management
- Assess behavioral health and psychosocial functioning
- Offer peer support interventions
When is the pre-prosthetic phase?
Between surgery and prosthetic fitting
What factors influence rehab potential?
Level of amputation, prior level of functioning, motivation, comorbidities, support, cognitive, physical conditioning, smoking, compliance
How does the presence of comorbidities effect pt prognosis?
Increase mortality and negatively affect recovery
How does pre-op ambulatory status effect pt prognosis?
Non-ambulatory and homebound status is associated with inability to use a prosthesis post-op
How does age effect pt prognosis?
> 60 at the time of surgery is associated with decrease prosthetic use, increased mortality, and decreased ability to ambulate and be independent
How does the level of amputation effect pt prognosis?
Bilateral or AKA are less likely to ambulate, use prosthesis, and be independent
Describe the general rehab goals 1-2 days post-op
ROM, bed mobility, transfers, sound limb exercises, post-op dressings
Describe the general rehab goals 3-14 days post-op
Pre-prosthetic ambulation with crutches, post-op dressings
Describe the general rehab goals 2-3 weeks post-op
Staples removed, shrinker or wrap, dynamic resistive exercises, ROM and ambulation
Describe the general rehab goals 4-6 weeks post-op
Shrinker and monitor healing, prevention of complications, casting for prosthetic socket if incision healed
How long does it typically take for the incision to heal?
6 weeks
During the pre-prosthetic phases, intervention should include what two types of exercise?
Open and closed chain
What functional mobility is included in the pre-prosthetic phase of rehab?
Bed mobility, sit to stand, transfers, ambulation without prosthesis
During the pre-prosthetic phase, why is progressive resistance added?
To improve gait, mobility, strength, CV fitness, ADL performance in order to maximize function
What type of dressing is preferred when limb protection is a priority?
Rigid dressing
What should be assessed prior to setting goals and why?
Cognitive status to assess the pt’s ability and suitability for appropriate prosthetic tech
What treatment setting is recommended for the pre-prosthetic phase?
Acute inpatient
When should mobility training be initiated?
As soon as possible
What interventions are included in pre-prosthetic training?
Skin inspection, residual limb monitoring, ROM, sensation, strengthening, functional mobility, cardiopulmonary, psychosocial, preparation for prosthesis
How often doe pt’s initially have PT?
5-7x per week