Hip/Amps/Prosthetics Flashcards
You are educating a pt. with posterolateral hip arthroplasty on how to transfer from sit to stand. What should the pt. do with their operated hip?
Transfers
Keep the operated hip in slight abduction and extended out in front.
You are instructing a pt. who just had a THR how to transfer from supine to seated EOB. How should you instruct the pt. to get out of bed?
A] get out from the operated side
B] get out from the non-operated side
C] depends on precautions
D] bridging
Bed mobility
B] get out from the non-operated side
bridging may risk pt. breaking hip precautions
True/False
A pt. was admitted to an inpatient rehab unit following THR (posterolateral approach). When lying in bed, the client should use an abduction wedge/pillow between legs.
True
body-operated prostheses
Type of Prosthetic Terminal Devices (TDs)
use specific scupla and shoulder movements to place tension on the cable that opens or closes the TD (2 types: hook and prosthetic hand)
Type of Prosthetic Terminal Devices (TDs)
Myoelectric protheses
Type of Prosthetic Terminal Devices (TDs)
uses muscle contractions detected by electrodes to open and close the TD
Type of Prosthetic Terminal Devices (TDs)
Preprosthetic Treatment
- change of dominance activities PRN
- ROM of uninvolved joints
- prep limb for prosthesis
- desensitization
- wrapping to shape and shrink residual lim (distal>prox; tension dec with proximal wrapping)
- ADL training, edu. skin care
- supportive counseling
- indvidualized treatment
Prosthetic Treatment
- wrapping to shape/decrease swelling
- desensitization
- Strengthening UE (focus: triceps)
- transfer/stand pivot training
- ADLtraining, LE dressing (most difficult)
- standing tolerance
- W/C mobility
Prostheses Training
- TD: start with TD first; manually guide patient through motions; keep 90d if transhumeral
- wrist: analyze task for efficent approach for grasp
- elbow: begin with elbow UNLOCKED; manual guide through motion; listen for click as lock activates; use mirror
- turntable (rotate elbow turnable towards/away from body using sound hand/bilateral:push pull): analyze task for efficency
A client with a unilateral transradial amputation is undergoing pre-positioning training for a myoelectric arm. Which of the following is the MOST appropriate goal?
A] Within three sessions, the client will independently don the prosthesis and obtain good electrical contacts with the electrode sites 100% of the time.
B] Within three sessions, the client will be able to open and close the myoelectric terminal device 100% of the time.
C] Within 1 week, the client will be able to accurately identify how to arrange the wrist of the myoelectric terminal device to be able to optimally grasp different objects.
D] Within 1 month, the client will be able to use the myoelectric terminal device as a functional assist and stabilizer in 100% of daily activities.
Solution: The correct answer is C.
The pre-positioning phase focuses on teaching the client with an amputation to position the terminal device for optimal grasp.
A: Learning to correctly don the prosthesis occurs during the donning and doffing phase of training.
B: Learning to open and close the prosthesis occurs during control training.
D: Functional training is the last step in prosthesis training and occurs after pre-positioning skills are obtained.
Which of the following tasks would be MOST appropriate to use during the functional training phase for a client learning to use a unilateral myoelectric terminal device (TD)?
Grasping and releasing different-sized blocks
Using scissors to cut paper
Typing on a computer keyboard
Brushing teeth
Solution: The correct answer is B.
During the functional training phase, a client is learning to incorporate the TD as a functional assist. Bilateral activities that require one dominant extremity (the hand) and one functional assist (the TD) are the best tasks for practice. Using scissors to cut paper requires the TD to be the functional assist (holding the paper).
A: This task is more appropriate for the training phase, in which a client learns the basics of how to grasp and release objects.
C: Typing does not require grasp and release. A TD is not a good choice for touch typing.
D: Tooth brushing is a unilateral task and requires more mobility than a prosthetic hand is likely to have. This task would be performed by the unaffected hand.
