Pre-Prosthetic Management

Question 1

what are the 6 goals of the pre-prosthetic phase?

Answer 1

independence with residual limb care
demonstrating HEP accurately (strength, ROM, BALANCE! for soft tissue and joint mobility) to prep for pro
fall prevention
maximizing fn w/o prosthesis
care of intact limb–if vascular
minimize comorbidities

Question 2

what is the AMP-noPRO?

Answer 2

20 item assessment of functional mobility w/o prosthesis with scoring range of 0-38, 43 w/ AD that predicts likelihood of prosthetic use and just good outcome measure for this phase. High scores are better

Question 3

what is the AMP-PRO?

Answer 3

21 item assessment of functional mobility w/ prosthesis with scoring range of 0-42 that is progressively harder. High scores are better

Question 4

what are some systemic post-op complications you might expect in the pre-prosthetic phase?

Answer 4

change in cognition, prolonged bed rest, fatigue and vital change, falls, UTI, co-morbidities

Question 5

Is phantom sensation felt more in the distal or proximal portion of the limb? What kind of stimuli is it most responsive to?

Answer 5

distal; external stimuli like dressings or bandages

Question 6

what are some common treatment recommendations for PLP?

Answer 6

patient education!, compression, relaxation and mindfulness techniques, desensitization, mirror therapy, modalities (often in combo with meds)

Question 7

what is the intent behind our length and volume measure in the residual limb assessment?

Answer 7

volume: insight to edema control
length: muscle pull expectations-that likely shouldn’t change over time

Question 8

what are 3 examples of shapes we want to avoid in the residual limb? (Think edema control )

Answer 8

light bulb
dog ears
conical (pointy)

Question 9

True or false: a shrinker should not be worn with your prosthetic device

Answer 9

True

Question 10

Which is priority at this phase, adequate ROM or strength?

Answer 10

ROM

Question 11

How should strengthening exercises progress after amputation?

Answer 11

1.ROM and motor activation
2. motor control w/in range (alt or w/ resistance)
3. true strengthening (gait specific an functional)
4.prosthesis

Question 12

what are the common assistive devices of gait training in the preprosthetic phase?

Answer 12

standard walker, BAC (bilateral axillary crutch)

Question 13

what are K levels? How many are there

Answer 13

Medicare scale of 0-4 indicating appropriateness of prosthetic device based on surface, function and speed

Question 14

Describe a K0 level

Answer 14

unable and lacks potential to ambulate or transfer safely w/o assistance and prosthetic won’t enhance QOL

Question 15

Describe a K1 level

Answer 15

able /potential. to use pro for ambulation on level surface @ fixed cadence (limited household)

Question 16

Describe a K2 level

Answer 16

able/potential to traverse low level barriers (steps, curbs, uneven surfaces) limited community ambulator

Question 17

Describe a K3 level

Answer 17

able to abulate w/ variable cadence. Community ambulator who can get around and engage in activity that demands prosthesis above simple locomotion

Question 18

Describe a K4 level

Answer 18

ability for prosthetic ambulation that exceeds basic skill–typical for child, active adult or athlete