Pre-Prosthetic

Question 1

When does the pre-prosthetic phase occur?

Answer 1

6-8 weeks after surgery; but there is a lot of grey and overlapping

Question 2

When does the pre-prosthetic phase begin?

Answer 2

When the limb is fully healed. (the process at this stage is more and more PATIENT-DRIVEN)

Question 3

What are the primary goals for the pre-prosthetic phase?

Answer 3

1. Determining prosthetic potential

2. Get patient ready for the prosthesis

Question 4

What co-morbidities can have an impact on prosthetic potential? (6)

Answer 4

1. CV disease and impairment (inc energy demand)
2. Dysvascular amputations (DM, PVD, PAD) (considerations for circulation, healing, and sensation)
3. Traumatic amputations (TBI, potential skin grafts!, burns, MS injuries)
4. Ca related amputation (stability of weight, treatments, lymphedema)
5. Cognition
6. Congenital (all other developmental issues)

Question 5

What are behavioral / emotional preparation for prosthetic?

Answer 5

1. Provide support but avoid overwhelming the patient (introduce new info in stages, assure for retention)
2. Support (groups, 1:1 peer visits, written material)
3. Age considerations
4. Prosthetic interviews
5. Motivation and compliance (clarify pt’s goals - they should drive the rehab program)

Question 6

What is the formula for motivation?

Answer 6

(Wants * Beliefs * Rewards) / Costs

Question 7

How do you prepare the residual limb in the pre-prosthetic phase?

Answer 7

Move to AGGRESSIVE SHAPING and shrinkage of the residual limb

Make the patient more responsible for their limb

Manage scars, prevent contractures, assess for PROTECTIVE SENSATION

Question 8

Where do you test for protection sensation for a BKA (TT)? (5)

Answer 8

Tibial tubercle
Fibular head
Medial tibial plateau
Distal fibula
Distal tibia

Question 9

Where do you test for protective sensation for AKA (TF)? (4)

Answer 9

Pubis bone
Proximal femur
Distal femur
Lateral hip / greater troch area

Question 10

Should you use lengthy and “canned” HEPs?

Answer 10

No

Question 11

What are three examples of rehab interventions learned in class in pre-prosthetic phase?

Answer 11

Balance, core strength, and retraining the COG.

body blade, sit on ball, turn to side, kneel on stool

Question 12

Should you go into the community without your prosthesis?

Answer 12

Yes, and train for recreational activities without a prosthesis too

Question 13

What does the end of the pre-prosthesis stage bring?

Answer 13

Brings initial prosthetic prescription generation, if applicable.

Question 14

What factor influences the type of prosthesis prescribed?

Answer 14

Functional level

Question 15

What can assist at this stage with determining prosthetic potential and level?

Answer 15

Amp NO PRO