intro to prosthetic training Flashcards
what do you include in your initial assessment of pro wearer - direct
functional mobility without pro
skin assement/sensory
strength (BLE and core)
ROM
donning and doffing
transfer with pro
what do you include in your initial assessment of pro wearer - direct more
pro fit
postural assessment
amb with pro
high level mobility with pro
pain
social/psych
for transtibial where is the extra force absorbed
knee ext
hip abd/add, ER
on the amp side
transtibial - non fallers where able to compenstate where
contralateral ankle PF an hip ext
how to intially progress wear time
increase by 15 mins
then build by 30 min daily
what is the goal with wear time
8 hours at a time in 16 days
30/day in 2 weeks
what do we want to look at in sitting
the height of the knee center when compared to the hips in sitting
what are you looking for when inspecting the socket design - boney landmarks
TT - patella should fit in the patellar groove
TF - ischium
what position should you look for gapping
in WB
where do we place our hand when working on tsanding and gait kinematics
ASIS and iliac crest
managment of the knee and the trunk
intervention progression
static
dynamic
assisted
active
resistive
UE support alterations
what can be causes of decreased weight acceptance in stance
decrease coordination
decrease balance
pain
weakness
fear/lack of confidence
initial prosthetic gait training
static WB progression
standing reaching activities
simple dynamic weight shifting
repeated stepping
stepping with univolved limb onto step
gait training
STS
what is stepping backward and forwards a progression of
transverse pelvic rot
pro swing initiation
limb at terminal stance
forward pelvic rot
hip flex
knee flex (tt)
neutral hip IR/ER
ends with heel strike
pre gait/mid - late stance exercises
step tap
decrease UE support
progress difficulty with correct posturing
- step height
- step stability
- vision
guideline interventions
part to whole gait training and resisted training
interactive gaming platform
proprioceptive NM facilitation techniques
real world situations
ADLs with and without pro
gluteus max strengthing - prone hip ext with knee flexion
EMG amp was greatest with leg was abd 30-deg
glute development
uni and bilat bridging
quad hip extension
clam shells
side stepping
squatting
glute med development
side plank abd with dominent leg on the bottom
side plank add with dominent leg on the top
single limb squat
clam shell
front plank with ext
TT and stairs
up with the good down with the bad
stand behind pt
TT stair - decent
forward hand placement
Assure foot placement on step with visualization or heel strike on the step behind
do we walk reciprocally on the stairs TT
yes - based on personal abilities
TF stair rule
up with the good and down with the bad
stand down hill from the pt
look out for knee buckling
TF and descent
make sure that the knee is striaght - tap heel or pull hard on the socket
forward hannd placement
TF and reciprocal stairs
most likely no
TT limiting factors in slope negociations
Lack of DF to accommodate rise
Lack of PF push to assist up
Difficult descent due to lack of DF/ PF ROM
slopes and ramps are better with what kind of ankles
Better with hydraulic ankles
Best with microprocessor ankles
TF limiting factors in slope negociations
Difficulty ascending due to lack of concentric knee flexion (better with genium and x3)
descent difficult with knee instability
what might be the issue with car transfers for TT
NO active DF/PF
No rotation of ankle
what might be the issue with car transfers for TF
No hamstring activation
Long residual limb and prosthetic knee components may be long for console
Left
TT
car
no adaptations
