Pre-Prosthetics Training Flashcards
When doing your exam, what are some things to consider specifically for amputees?
- can they don/doff prosthetics and shrinker
- positioning of limb
- fit of prosthetics
- equipment
- fit of protector
T or F: amputees should always have something on the residual limb
T
what are some equipment amputees may need?
- slide board
- at least 2 shrinkers
- donner
- possibly knee immobilizer
household ambulators should be able to ambulate ______ feet while community ambulators should be able to ambulate _______ feet
50
150
Do pts with traumatic or vascular amputations have a better prognosis
traumatic
usually traumatic amputations discharge to _________
home
Phase 1 of rehab
pre-operative
*not always possible to have
T or F: you should go ahead and start ordering equipment in the pre-operative phase
T: if you know it is going to be an amputation
phase 2 of rehab
surgery day
when is PT usually starter for amputees
post-op day 1
phase 3 of rehab
acute post-operative
2-5 days without complications
what is one of the most important things in the acute postoperative phase and why?
POSITIONING
*you want to prevent contractures because the prosthetic can only account for so much loss of ROM
what motions do you want to focus on to prevent joint contractures?
1 - hip ext
2 - hip adduction
3 - knee ext
how much knee and hip flexion can a prosthetic compensate for
5 knee flexion
15 hip flexion
stump protector/knee immobilizers are worn _____ in the acute postop phase
23/7
*take off to shower
what kind of transfer usually works well for a LE amputation in the acute post-op phase
slide board
3 positioning DOs for amputees
- lay prone several times a day
- use a limb protector
- minimize prolonged hip/knee flexion
3 positioning DONTs for amputees
- place pillow under knee or thigh
- place pillow between legs
- sit with knee flexed or without support
what are some benefits of postop dressings
- control swelling
- shape limbs
- protect incision
- desensitize
- assist with drainage
you want the residual limb to be ______ shaped
cylindrical
how should you wrap an ACE wrap
- figure 8
- distal compression more than proximal
- no clips or tape to skin, no wrinkles
what population are non-removable rigid dressings good for
cognitively impaired
IPOPs
immediate post-op prosthesis
*these are great, by typically only used with young/traumatic (insurance coverage)
if you walk into a pts room 3 days postop and there is no dressing what should you do
ask questions! there should be a dressing
*risk of limb developing abnormal shape
3 stages of incisional healing
1 - inflammatory (0-5 days)
2 - fibroblastic (5-21 days)
3 - remodeling (>21 days)
phase 4 of rehab
pre-prosthetic phase (weeks 2-3)
what are some exercises you can do in the pre-prosthetic phase for transfemoral amputation
- bridge over bolster
- SAQ (unaffected leg)
- SLR (unaffected leg)
- side-lying hip add with bolster
- prone hip ext
- prone add squeeze
- prone knee flex (unaffected leg)
- quadriped leg lift
- bosu ball
what are some exercises you can do in the pre-prosthetic phase for transtibial amputation
-quad set
-SAQ
-SLR
-bridging w/ bolster
-prone knee flex
-push ups
-tall kneeling rotation
*and all of the transfemoral ones!
phase 5 of rehab
prosthetic prescription
staples are usually removed about _______ month(s) postop and then you can get prescribed a prosthetic
1
what are some criteria that affect prosthetic prescription
- skin integrity
- shape of limb
- strength/ROM/mobility
- financial
- pt desire
phase 6 of rehab
prosthetic training
L-test
basically a TUG for amputees… involves 90 degree turns though
T or F: post amputation pain is typically normal
T
phantom sensations
feelings other than pain in missing body part
are phantom sensations usually more distal or proximal
distal
are phantom sensations painful
no
T or F: phantom sensations usually decrease with time
T
phantom pain
pain associated with the amputated segment
T or F: prosthetic limb use has been correlated to decrease phantom pain
T
T or F: phantom pain is more common in patients who had pain prior to surgery
T
T or F: there is a single mechanism for phantom pain
F: not really sure what causes it
what are some possible PT treatments for phantom pain
- nerve stimulation
- KT tape
- mirror therapy
- desensitizing program
- virtual reality
phase 7 of rehab
community integration
phase 8 of rehab
follow up
*every few months for the first 18 months
