Post Amputation Treatment Flashcards
Advantages and disadvantages of compressive soft dressing
Advantages
- easy to apply
- inexpensive
- easy access to incision
Disadvantages
- little edema control
- frequent rewrapping
- inconsistent technique
Advantages and disadvantages of shrinker
Advantages
- provides compression to help with shaping
- easy to apply
- inexpensive
Disadvantages
- sutures removed
- requires changing
- tourniquet effect
Advantages and disadvantages of semi-rigid dressing
Advantages
- better edema control - does not allow for swelling
- inexpensive
Disadvantages
- frequent changing
- no patient application
- no access to incision
Advantages and disadvantages of IPOP (immediate post op prosthetic)
Advantages
- great edema control
- excellent protection
- controls pain
- allows patient to be ambulatory from day 1 (can only put 10% weight on it)
Disadvantages
- No access to incision
- more expensive
- requires training
What needs to be determined during the pain assessment after an amputation?
- location
- type
- nature
- intensity
Phantom limb sensation vs phantom limb pain
sensation - painless awareness of the amputated limb, possibly accompanied by tingling
pain - brain continues to receive painful sensory messages from the nerves that originally carried messages from amputated limb
How to measure residual limb length for transtibial and transfemoral?
TT - medial joint line to end of limb
TF - ischial tuberosity or greater tubercle to end of limb
What is the ideal shape for transtibial and transfemoral residual limb?
TT - tapered cylindrical shape
TF - more conical shape
What should be assessed with the contralateral/intact limb?
- diabetic foot screen (if appropriate)
- sensory testing
- strength/ROM testing
- DVT screen
What are common DVT symptoms?
- swelling (calf/entire leg)
- local tenderness along deep venous system
- increased redness/warmth
While laying ________ (to prevent hip flexure contracture), which side should the patient face to create an _______ moment on the involved side.
- prone
- have the patient face their intact side
- creates an extensor moment on the involved side to help prevent hip flexure contracture
What are the 2 main goals for strengthening in early post-op therex?
- address identified muscle performance impairments
- maximize overall strength to prep for prosthetic gait
What should be worked on for strengthening immediately post-op?
- isometric and AROM of joint proximal to the amputation
- core strength
- contralateral limb
What are the key muscles for stretching/AROM for Transtibial? Transfemoral?
TT
- hamstrings
- hip flexors
- contralateral gastroc-soleus (gets tight b/c it is being used more)
TF
- hip flexors
- hip abductors
- hip ER
- lumbar extensors
- contralateral LE
What are the key muscles for strengthening for Transtibial? Transfemoral?
TT
- quads
- hamstrings
- glut max
- glut med
- abdominals
- UE
TF
- glut max
- glut med
- hip adductors
- abdominals
- lumbar spine
- pelvic floor
- UE
What motions need to be emphasized and stretched for transfemoral patients?
- emphasize hip extension, abduction, and pelvic movement
- frequent prone laying or alternative iliospoas stretching
K0 level
No ability or potential to ambulate or transfer safely with or without assistance; prosthesis does not enhance QoL
- not a prosthetic user
K1 level
Able to or potential to use prosthesis for transfers or ambulation on level surfaces at fixed cadence. Limited and unlimited household ambulatory
- limited and unlimited household ambulators
K2 levels
Ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs, or uneven surfaces. Limited community ambulatory
- limited community ambulatory
K3 level
Ability for ambulation with variable cadence. Community ambulator who has the ability to traverse most barriers and may engage in vocations, therapeutic, or exercise that demands a prosthesis beyond simple locomotion
- unlimited community ambulator
K4 levels
Ability for prosthetic ambulation that exceeds basic skills, exhibiting high impact, stress, or energy levels. Typical of the child, active adult, or athlete.
- ability for prosthetic ambulation that exceeds basic skills, exhibiting high impact, stress, or energy levels
Do you want a higher or lower score for the AMPPro?
higher score is better
