Final Exam: Prosthetic Rehab Flashcards
How many phases are in Dr. Robert Gailey’s phases of rehab
5
List the Gaileys phases of rehab in order
- Immediate postoperative stage
- Immobilization is removed
- Intermediate rehab stage
- Advanced rehab stage
- Return to work or pre amp life style
Which phase is usually in a hospital or acute care setting
phase 1 - immediate post op
What does treatment look like during the first phase of gailey’s rehab
dressing education edema control transfers/bed mobility wound care phantom pain
What is the goal of the immediate postop stage of Gailey’s rehab
healing without complication
which phase of rehab is considered the key to good outcomes via a pre-prosthetic program
Phase II - immobilization removed
is a prosthetic involved in phase one
no
is a prosthetic involved in phase two
no
What does treatment look like in phase II of gailey’s rehab
I bed mobility/transfers
single limb gait
ROM/prevent contractures
Residual limb strengthening, balance, endurance
What are the goals of the pre-prosthetic program in phase II
healing without complication along with increasing strength, activity, balance, proprioception and beginning controlled ambulation
Which phase of rehab typically occurs in an outpatient setting
III - intermediate rehab
is a prosthetic involved in phase three
yes, but only a temporary one
Which phase will we see a rapid decrease in edema with some fluctuation
phase III - intermediate phase
In phase ___ of Gailey’s rehab, the patient should be I with stretching and strengthening at home. The residual limb should be at __-__% of the strength of the uninvolved side
III; 50-90
Which phase does pre-gait training and ambulation start in
III
What is the first exercise performed during pre gait training to encourage WB in prosthesis
weight shifts
Which phase of rehab is a good time for video analysis for gait deviation
IV - advanced rehab stage
What is the goal of phase 4 of Gailey’s rehab
independent ambulation with or without assistive device.
What does treatment look like in phase 4 of Gailey’s rehab
higher level balance with cadence changes
inclines, curbs, thick grass
endurance training
agility and strength
What is the goal of phase 5 of gailey’s rehab
to be discharged from PT and transition back to every day lifestyle
What is the focus of post op day 1
4
bed mobility
positioning
PROM/AROM to uninvolved joints
Sound side exercises
What is the focus of post op day 2
5
Transfer skills sitting to tolerance for 15-20 min AROM to uninvolved joints gluteal/quad sets sound side exercises
What is the main focus of post op day 3
ambulation with walker
dressing education
everything else in both day 1 and 2
What is the main focus of post op day 4
ambulation with assistive device
AROM to all joints
patient contracture and precaution education
What is the main focus of post op day 5
ambulation
HEP
patient education PRN
discharge home or to inpatient
What is the main focus of post op days 10-14
4
assess ambulation skills
dynamic strengthening exercise
AROM to all joints
patient education
When along the follow up treatment are staples removed post op
week 3
When along the follow up treatment are shrinker and healing monitored
week 4
When along the follow up treatment is a cast made for a diagnostic socket
week 6-8
When along the follow up treatment does prosthetic gait training begin
week 10-11
What does prosthetic checkout with a TT in sitting look like
comfort inspect posterior brim does suspension loosen are knees level is the residual limb forced out of the socket
What does prosthetic checkout with a TT in standing look like
pain is the knee stable pelvis level pylon vertical any gapping is the residual limb in contact with the bottom of the socket
Is pressure in standing normal
yes, but not pain
What does prosthetic checkout with a TF before donning look like
is the inside smooth
does the socket meet specification
do all joints move freely
does prosthetic checkout with a TF in sitting look like
suspension
length of shin and thigh compared to other side
comfort
can they lean forward and reach shoes
What does prosthetic checkout with a TF in standing look like
is the knee stable
pelvis level
adductor roll
What is the most important part of prosthetic checkout for TF in standing
if the knee is straight and stable
What is progression time of initial ambulation in the parallel bars
5-15 min in bars
30 min in bars
15-20 min with AD
45 min with AD
When a patient has a home wearing schedule, they should wear the prosthetic in __ min increments but not wear the prosthetic more than __ min a day in the first week
30; 90
Can a TT or TF amputee tolerate longer wear times
TF
Describe the important parts of donning socks
pull sock on firmly but not too stretched or too loose. NO wrinkles
The seam should be parallel to the suture line
clean dry socks
True or False:
When adjusting socks, the patient should add as many ply as they need to decrease discomfort.
false, add one ply at a time
During weight shifting front to back, how wide should the base of support be
2-4 inches
