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Med Surg II Final Exam > gait deviations/designing interventions > Flashcards

gait deviations/designing interventions Flashcards

1
Q

what are 6 things analyzed during prosthetic gait?

A
  1. Width of Walking Base
  2. Step Length
  3. Loading the Prosthetic Toe
  4. Transverse Pelvic Rotation
  5. Prosthetic Knee Flexion (TF)
  6. Trunk Rotation and Arm Swing
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2
Q

During initial contact, pt needs to have _______ and strength in _______/_____

A

proprioception

hip extensors/glute medius

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3
Q

what should you look for during initial contact?

A

watch for over-swing

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4
Q

During the loading response, cue the user to ?

A

engage active hip extension (BACK WALL )

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5
Q

What can slow forward momentum during mid stance?

A
  • Lack of pelvic translation
  • Lack of muscle activation
  • Type of foot
  • Fear of putting full weight on the prosthesis
  • Pain in socket
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6
Q

______ stance is the most critical point with TF prosthetics

A

terminal stance

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7
Q

during terminal stance, the knee is in _______ with weight on the ________

A

full extension

forefoot/toes of the prosthetic

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8
Q

to release knee extension during the terminal stance, the _______ criteria must be met to release into swing phase

A

toe load

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9
Q

during pre swing, the amputee is cued to ______

A

relax

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10
Q

true or false
during the pre swing phase, there is very little hip flexion required to advance the limb due to the dynamics of the prosthetic knee settings

A

true

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11
Q

during the initial swing and mid swing, what should be monitored closed and cued as needed?

A

PELVIC ROTATION
trunk stability
foot clearance
linear forward progression of limb

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12
Q

during the terminal swing phase, the pt should be cued to?

A

to re-engage active hip extension

encourage heel strike

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13
Q

prosthetic alignment should be checked when?

A

while on the pt

off the pt

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14
Q

if the pt is leaning towards the prosthetic side then this is a ________ movement

A

compensatory

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15
Q

if the pt is leaning away from the prosthetic side the he/she are _______

A

fearful/in pain

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16
Q

common problems at the knee that can be observed during gait include?

A
  • Medial and lateral Whips
  • Collapse into Knee flexion (TT) or Knee Instability(TF)
  • Hyperextension (TT)/Excessive Terminal Impact (TF)
  • Excessive Heel Rise (TF)
  • Tilt or Pylon lean (TT) or Varus/Valgus moment(TF)
17
Q

what do you look for when observing the feet during gait?

A

step length
heel strike
step symmetry
base of support

18
Q

foot issues include:

A
  • Toe in/out
  • Foot inset/outset
  • Dorsiflexion
  • Plantarflexion
  • Stubbing prosthetic toe
  • Vaulting (sound limb)
19
Q

voluntary prosthetic knee control is?

A

Determined completely by muscular efforts of the prosthetic

user

20
Q

involuntary prosthetic knee control is?

A
  • Not related to user effort; very little user effort required
  • Created by alignment of the prosthetic components
  • Biomechanical weight line is anterior to the knee axis
  • Many knee components have safety mechanisms built in that are activated in weightbearing
21
Q

with a TF amputee, if foot is ER during the loading response the possible causes could be?

A

PF bumper or heel cushion is to firm
excessive toe out
socket rotation from loose fit or tight medial/posterior wall angle
poor muscle control

22
Q

when developing interventions for an amputee, a PT must consider?

A

• Impairments must not be ignored
• Interventions must be meaningful to the
patient in terms of who they are as a person
• Interventions must be meaningful to the patient in their specific life environment
• Experience-Dependent Neuroplasticity

23
Q

Principles of Experience-Dependent Neuroplasticity

A
  • Use it or Lose it
  • Use it and Improve it
  • Specificity
  • Repetition Matters
  • Intensity Matters
  • Salience Matters
  • Time Matters
  • Age Matters
  • Transference
  • Interference
24
Q

what two things must you have regarding the USE IT or LOSE IT phenomena?

A
  • Must have sensory stimulation of residual limb

* Must have motor activation of residual limb

25
Q

sensory stimulation of residual limb results in?

A

Reorganization of the somatosensory cortex

26
Q

what are signs of improvement when ambulating with prosthetic

A
  • Motor skill acquisition
  • Less cognitive effort
  • Efficiency
27
Q

true or false

repetition doesn’t help with neuroplasticity?

A

false repetition and intensity both matter

28
Q

true or false

age doesn’t matter with neuroplasticity

A

false younger brains learn faster

29
Q

with aging, neuroplasticty

A

is slower
is small increments of change
takes longer time for pt to learn

30
Q

when the sound limb takes over the amputated limb, this is an example of?

A

interference

31
Q

what PT must consider when dealing with new amputee?

A
  • Doesn’t know what things are supposed to feel like
  • Everything is new
  • Doesn’t understand what is wrong or even IF something is wrong
  • Doesn’t always understand what is right
  • Body image plays a part in learning

Med Surg II Final Exam (9 decks)

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