P&O upper ext & GAIT Flashcards
center of gravity lies where in relation to the spine
5cm anterior to S2
normal base width (distance between heels)
6-10cm
normal cadence
80m/min; 3mph
normal step length
15-20 inches
Name the 6 determinants of gait
- pelvic rotation
- pelvic tilt/list
- knee flexion in stance
- foot mechanisms (ankle flexion/extension mechanisms)
- Knee mechanisms
- Lateral displacement of the pelvis
what is the percentage of increased energy expenditure in propelling a wheelchair in patients with paraplegia compared to ambulation in normal subjects
9% - cerny et al 1980
name the muscles that require strengthening to crutch walk (6)
crutch walking takes more energy than walking with a prosthesis
Lats Triceps Pec Major Quads Hip extensors Hip abductors
Possible causes for foot slap on initial contact
moderately weak dorsiflexors
possible causes for the following (initial contact through midstance) (4)
- genu recurvatum
- excessive foot supination
- excessive trunk extension
- excessive trunk flexion
- weak, short, or spastic quads; compensated hamstring weakness, achilles tendon contracture, plantar flexor spasticity
- compensated forefoot valgus deformity; pes cavus; short limb
- weak hip extensor or flexor; hip pain; decreased knee range of motion
- weak gluteus max and quads; hip flexion contracture
Increased metabolic expenditure above normal:
Symes amputation
15%
Increased metabolic expenditure above normal:
Traumatic TT BKA
25%
short - 40%
long - 10%
Increased metabolic expenditure above normal:
traumatic bilateral BKA
41%
Increased metabolic expenditure above normal:
traumatic TF AKA
60-70%
Increased metabolic expenditure above normal:
traumatic bilateral AKA
> 200%
Traumatic AKA and BKA
118%
Vascular TT BKA
40%
Vascular TF AKA
100%
In mangled extremity: amputation is considered if irreparable damage occurs to four of what six basic things?
skin vessels skeleton nerves extensor flexor tendons
Name the components of an upper extremity prosthesis Rx (5)
1 terminal device
- wrist unit
- socket
- elbow hinges
- shoulder
Name the 4 different types of terminal devices
passive
body-powered
externally powered hook
externally powered hands
In a _____ socket, the socket and the forearm are set in initial position of flexion and the socket encloses the olecrenon and the epicondyle of the humerus.
Muenster socket
The intimate limb encapsulation, flexion attitude, and high trim lines provide suspension. Although there is some limitation in the range of flexion and suspension, this is compensated by preflexing the socket.
preprosthetic training should include what 7 things
- limb shrinkage
- muscle strength and ROM
- postural problems
- desensitization
- scar mobilization
- ADL assessment
- HEP
what two functions are seriously affected by UE ampuation
forearme and humeral rotation