Amputation Rehab

Question 1

Evaluation

Answer 1

Residual Limb Length and Shape
Vascularity
ROM
Muscle Strength
Neuro
Transfers
Balance 
Mobility

Question 2

ABI (ankle-brachial index)

Answer 2

Non-invasive measure of peripheral tissue perfusion
Used to rule out arterial disease
Should not be more than 10 mmHg difference in R to L sides

Question 3

ABI: 1.1 -1.3

Answer 3

Vessel Calcification

Question 4

ABI: 1.1 - 0.90:

Answer 4

Normal

Question 5

ABI: 0.9-0.70:

Answer 5

Mild arterial insufficiency

Question 6

ABI: 0.70-0.50:

Answer 6

Moderate arterial insufficiency, intermittent claudication

Question 7

ABI: < 0.5:

Answer 7

Severe arterial insufficiency resting pain

Question 8

ABI: < 0.3:

Answer 8

Ischemic or gangrenous extremity, Resting pain

Question 9

Post-Operative Care

Answer 9

Reduce edema and promote healing
Prevent contractures
Increase UE and LE strength
Increase mobility and self care
Promote sound limb care
Assist with limb loss adjustment

Question 10

Soft dressing advantages:

Answer 10

ease of application
ability to monitor wound
ability to change wound environment as necessary

Question 11

Soft dressing disadvantages:

Answer 11

application of elastic wrap may create varied pressure to limb creating a tourniquet effect
manipulation of soft tissue may promote prolonged and deep seated pain patterns

Question 12

Positioning:

Answer 12

Most important to maintain neutral hip and knee extension for optimal prosthetic fit and ambulation
AVOID HIP FLEXION AND ABDUCTION

Question 13

Phantom Sensation

Answer 13

Non-painful sensation or awareness experienced that gives form to a body part with specific dimensions, weight, or ROM

Question 14

Categories of phantom sensation:

Answer 14

1. Kinesthetic sensation
2. Kinetic sensation
3. Extroceptive sensation

Question 15

Kinesthetic Sensation

Answer 15

posture
length
volume

Question 16

Kinetic sensations

Answer 16

willed movements
spontaneous movements
associated movements

Question 17

Extroceptive Sensations

Answer 17

touch
temperature
pressure
other (eg:coldness of limb in OR)

Question 18

Phantom Pain

Answer 18

A painful sensation experienced within the limb that is now not part of the body.

Question 19

Onset of phantom pain:

Answer 19

Onset=1 week to several months

Usually decreases within 6 months

Question 20

What is phantom pain provoked and relieved by?

Answer 20

Provoked by emotional stress, cold, local irritants.
Relieved by wearing prosthesis, stroking,
heat, mental distraction

Question 21

Residual Limb Pain

Answer 21

Pain arising in the residual limb from a specific anatomical structure that can be identified

Question 22

Functional Level 0

Answer 22

no ability or potential for weight bearing or transfer

Question 23

Functional Level 1

Answer 23

Ability or potential to transfer and ambulate within the household with an assistive device

Question 24

Functional level 2

Answer 24

Community ambulator with the ability or potential to traverse minor environmental barriers, fixed cadence

Question 25

Functional Level 3

Answer 25

Community ambulator with the ability or potential to traverse all environmental barriers with a variable cadence

Question 26

Functional Level 4:

Answer 26

Exceeds basic ambulation, high impact, energy levels. Child, active adult or athlete.

Question 27

Five Staged of Grief:

Answer 27

Denial
Anger
Bargaining
Depression
Acceptance