Intro to Amputations Pt 2 Flashcards
during the perioperative phase, what should your rehab interventions focus on?
open and closed chain exercises
progressive resistance
– to improve gait, mobility, strength, CV fitness, and ADL performance in order to maximize function
during the perioperative stage, rehab goals and outcomes should include _______ about residual limb length and amputation level
shared decision making
what kind of dressing should you use during the perioperative stage?
– when limb protection is priority?
rigid or semi-rigid - to promote healing and early prosthetic use
– rigid
what kind of screening should you perform prior to setting goals, to assess the patients ability and suitability for appropriate prosthetic technology?
cognitive screening
in the perioperative phase, treatment should be done in what setting?
inpatient rehab over a SNF
during the perioperative phase, when should you initiate mobility training?
as soon as possible
may include ipsilateral WB ambulation with a pylon to improve function and gait parameters
during perioperative phase, what should the care team ensure the patient achieves?
the highest level of functional independence WITHOUT a prosthesis
there is insufficient evidence to recommend for or against:
one surgical procedure over another
post-op timeline for lower limb amputation:
– days 1-2:
– day 3-14:
– weeks 2-3:
– weeks 4-6:
– ROM, bed mobility, transfers, sound limb exercises, post-op dressings
– pre-prosthetic ambulation with crutches, post-op dressings
– staples removed, shrinker or wrap, dynamic resistive exercises, ROM, ambulation
– shrinker and monitor healing, prevention of complications, casting for prosthetic socket if incision is healed
when assessing ROM, you want to check for what?
contractures
what are common contractures for:
– transtibial:
– transfemoral:
– knee flexion, hip flexion
– hip flexion, hip abduction
what are causes for contractures in amputees? (2)
poor positioning
prolonged sitting position/wheelchair use
what are consequences of getting a contracture? (2)
functional leg length discrepancy
poor prosthetic alignment
how do you manage contractures for amputees?
appropriate positioning
ambulation
prosthetic modification
casts
surgery
what is proper positioning to prevent contractures in amputees?
– hip
– knee
– prone
– sitting
– avoid ____ for TFA
neutral hip rotation
knee extension
hip and knee extension
knee extension
hip abd
what is a common emotion for a patient to feel after a traumatic amputation?
disbelief
what things should you as a PT train your patients on in the perioperative phase?
enhancing mobility:
transfer training - stand-pivot for unilateral
crutch training or wheelchair training
what are PT focus areas in the perioperative stage of an amputation?
enhance self care
assess for prosthetic potential
control edema
pain management
optimal shaping of residual limb
prevent secondary complications
function within home and community
care for sound limb
what benefits would a microprocessor knee provide over a non-mircoprocessor knee?
reduces fall risk
maximizes patient satisfaction
what must your patients undergo in order to determine the most appropriate device to achieve their functional goals?
pre-prosthetic training
when do you initiate UE prosthetic fitting?
as soon as patient can tolerate mild pressure on the residual limb
what recommendation is there insufficient evidence for during the pre-prosthetic phase?
to recommend any particular socket design, prosthetic foot categories, and suspensions and interfaces
– transdisciplinary team should consider patient goals and attributes
typically how long post-op would you wait to initiate fitting a prosthetic?
~1 month —> use in therapy only first
what are the 4 components of the Comprehensive High-Level Activity Mobility Predictor (CHAMP)?
single legged stance
edgren side step test
T-Test
illinois agility test
