Pre-Prosthetic Management Flashcards

1
Q

how should you test ROM in the pre-prosthetic population

A

gross UE and trunk, definitive in B LE of remaining joints

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2
Q

what LE ranges are really important to maintain

A

extension

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3
Q

what are the three major ROM considerations for pre-prosthetic practice

A
  1. early and aggressive ROM 2. avoid elevation of limb on pillows 3. prone is the best position
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4
Q

what would be your recommendation for wheelchair hip/knee flexion contracture prevention

A

extension boards/splints

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5
Q

what muscle groups track with gait speed and 6mw performance

A

hip extensors

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6
Q

what muscle groups track with cadence and weight bearing in static stance

A

hip abductors

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7
Q

what muscle groups track with stride length

A

knee extensors

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8
Q

what is conservative mgmt of hypersensitivity

A

habituation and down regulation of the NS

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9
Q

what is conservative mgmt of hyposensitivity

A

education

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10
Q

T/F: the majority of amputees experience pain

A

true - approx 95% of amputees experience some type of pain

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11
Q

what types of pain, from most to least common, are likely to be experienced by pre-prosthetic individuals

A

phantom pain, residual limb pain, then back pain

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12
Q

what are prescription treatments for phantom limb pain

A

mirror treatment, graded motor imagery, meds, TNS, acupunture, biofeedback, pressure/compression

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13
Q

what is a strong predictor of prosthetic success

A

SLS on sound limb

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14
Q

what is the most appropriate balance scale for amputees

A

ABC scale - subjective questions of confidence in certain tasks

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15
Q

how can you test CV status in the amputee population (4)

A

UE ergo, unilateral LE ergo, w/c propulsion, ambulation with AD

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16
Q

from lowest VO2 increase to highest VO2 increase, what are the metabolic costs of various amputations

A

TTA trauma < TTA vascular < TFA trauma < TFA vascular < hip dis, hemi pelv, B TFA

17
Q

it is (more/less) efficient to walk with a prosthesis with or without an AD than without prosthesis using an AD

A

more

18
Q

in a vascular amputee, VO2 max (inc/dec) but the energy cost (inc/dec); therefore, _____

A

dec; inc; tasks are disproportionally more difficult for this population

19
Q

ability to train at >___% VO2 max may be assoc with successful prosthetic outcome

A

50%

20
Q

what is the prevalence of skin issues in the amputee population

A

moderate 35-65%

21
Q

what is choke syndrome

A

limb not all the way down in the prosthesis leading to decreased venous outflow

22
Q

how long do we re-apply ace wrap

A

ideally every 4 hours but a minimum of 2x/d

23
Q

what are the goals of RL wrapping

A

control edema, wound healing, and shaping for prosthesis

24
Q

what four ranges of motion are most critical to maintain in the pre-prosthesis population

A

hip and knee extension, adduction, and IR

25
Q

what three key functional skills determine prosthetic candidacy

A

independence in dressing, transferring, and walking

26
Q

if the patient is not independent in ambulation in ____wks after amputation, then he/she is unlikely to be a good prosthesis candidate

A

6-8 weeks