Phases of Rehabilitation Flashcards
What are the settings that rehabilitation may occur?
- Acute care
- Sub acute
- Acute Rehab
- Home health care
- Outpatient
What are the phases of rehab?
- Pre Prosthetic Phase (between surgery & prosthetic fitting)
- Prosthetic Training (Starts with delivery of prosthesis)
- Long term care/ Lifelong Care
Name some factors that influence rehab potential
- Level of amputation
- Prior level of functioning
- Motivation
- Comorbidity
- Emotion/Social Support
- Cognitive impairment
- Physical conditioning
- Smoking
- Compliance
What may negatively affect a person’s prognosis following LE amputation?
- Presence of morbidities
- Pre-op ambulatory status
- Age > 60
- Level of amputation
- Post-op complications
- Cognitive status
- Barriers to returning to previous living environment
If the prosthesis is a traditional one that uses suction to attach the remaining limb when does the patient usually receive it?
- 6 wks later after the site is healed
In regards to the post-operative timeline what occurs during days 1-2?
- ROM
- Bed mobility
- Transfers
- Sound limb exercises
- Post-op dressings
In regards to the post-operative timeline what occurs during days 3-14?
- Pre Prosthetic ambulation w/ crutches
- Post op dressings
In regards to the post-operative timeline what occurs during weeks 2-3?
- Staples removed
- Shrinker or wrap
- Dynamic resistive exercises
- ROM & ambulation
In regards to the post-operative timeline what occurs during weeks 4-6?
- Shrinker & monitor healing
- Prevention of complications
- Casting for prosthetic socket if incision is healed
During the pre-prosthetic phase what does the interventions include?
- Open & Closed chain exercises
During the pre-prosthetic phase what functional mobility activities are performed?
- Bed mobility
- STS
- Transfers
- Ambulation w/o Prosthesis
During the pre-prosthetic phase progressive resistance is used to improve?
- Gait
- Mobility
- Strength
- Cardiovascular fitness
- ADL performance
- All done to maximize function
During the pre-prosthetic phase what type of dressing is preferred when limb protection is a priority?
Rigid
During the pre-prosthetic phase what type of screening should be performed?
Cognitive
T/F: Rehab goals & outcome be included in shared decisions making about residual limb length & amputation level
True
Treatment should be recommended in (acute inpatient rehab or SNF) over (acute inpatient rehab or SNF)
Treatment should be recommended in acute inpatient rehab over a SNF
During the pre-prosthetic phase when should mobility training be implemented?
ASAP
During the pre-prosthetic phase to improve function & gait parameters mobility training may include what?
Ipsilateral WB ambulation w/ a pylon
T/F: During the pre-prosthetic phase there is no need for communication between surgical team & non-surgical team to occur
False
During the Pre-Prosthetic phase care team should ensure patient achieves what?
Their highest level of functional independence w/o prosthesis
Name what can all be included during Pre-Prosthetic Training
- Skin inspection
- Residual limb monitoring
- ROM
- Sensation
- Strengthening
- Functional mobility
- Cardiopulmonary
- Psychosocial
- Patient is collaborating w/ medical team including prosthetist to prepare for prosthetic
During Pre-Prosthetic Phase what is the frequency of treatment?
- Initially pts seen 5-7 times weekly in hospital or rehab
- Treatment can be decreased when pt is independent w/ exercises & positioning
- Frequency will decrease when pt is receiving home health care or outpatient services
When is it suggested short term goals be achieved?
- 3-5 days in patients who were independent prior to acute care hospital admission
If STG do not appear to be met during the inpatient acute care hospital stay when what rehab should be considered?
- Inpatient rehab