Presentations Flashcards
What is the most common place for a sore to develop on the transtibial amputee?
anterior distal tibia
What is the most common place for a sore to develop on the transfemoral amputee?
lateral distal femur
How is knee extension maintained throughout stance phase?
alignment
type of components (knee, foot)
patient
Alignment phases
bench
static dynamic
Bench alignment:
foot selection knee selection sagittal plane coronal plane transverse plane
Foot selection:
length of foot
heel durometer
heel height
Knee selection
functional level of amputee
sound side strength
strength of UE
Sagittal plane
TKA alignment (promotes knee stability) flexion in socket (allows even stride length of sound side)
Coronal plane
height
M-L placement of the knee and foot
adduction angle
Transverse plane
toe out
knee rotation
Four factors of gait:
patient
prosthetic alignment
socket fit
rehab teamwork
Purpose of sock:
position limb in the socket
System challenged for sitting upright:
Trunk stability
Sitting balance
Sitting endurance
Treatment option for sitting upright:
Trunk Rhythmic rotation
Resisted trunk flexion & extension
Sitting endurance progression
Balance pad/sit disc/bosu sitting
Rhythmical stabilization: pushing into the sound leg (knee or hip to force the patient to use the prosthetic leg.
Rest ball (against wall) behind patients head while in sitting have the patient maintain the position
Treatment for sitting reach:
PNF Cone reaching Cane trunk twist Plyoball tosses with trunk reaching Wand reaches
Exercises for chair to chair transfer:
Dips for UE strength Scooting and pivoting on mat Seated prosthetic weight bearing Sitting balance on unsteady surface Planning for task is a problem for many of these patients because of preexisting conditions
Treatment for arises from chair:
Weight shifts/Rocking/Nose over toes
Partial wall squats
Triceps pushups
Stand against resistance on non-involved leg or trunk resistance
Leg press single leg
Step by step Processing/organizational skills
Treatment for standing balance:
Side to side/forward and back weight shifts
Diagonal weight shifts
Rhythmic stabilization in standing
Perturbation in standing
Standing on a 2X4, Airex pad, tilt board,
Treatment for single leg stance:
Patient stands on prosthesis Non-involved Foot on step Foot on air ex pad Foot on foam roller Foot on mini basketball Movement of non-involved leg while on any of the above noted surfaces. Ball toss, chops and lifts
Treatment ideas for standing reach
Forward and backward shift Arms swings up and back Standing against wall Heavy ball swings Standing ball throws
Nudge test treatment
Ankle strategies • Hip strategies • Step Strategies Rhythmic stabilization Forward and backward shift arms up and back Standing against wall heavy ball swings Standing ball tosses
Treatment ideas for eyes closed and picking objects off the floor
Partial Squats Partial golfers lift Lunges Cones pick-up off the floor Weighted ball pick-up off the floor
Treatment for sitting down:
Resisted sit-stand Partial wall squats Wall slides Sit squats Eccentric gluts, hamstrings, quads, gastroc
Treatment for initiation of gait
Pre-gait activities P-bars walking Multi-directional stepping Stop and go walking Ramp Walking Stool stepping exercises Ball rolls Restoration of transverse rotation of the pelvis Resisted gait Resisted hip extension/flexion
Treatment ideas of step continuity
Side walking Braiding Stop and go walking Cup walking Resisted Knee Ext/Flexion
Turning treatment idea:
Turn training
Braiding
Cup walking
Treatment ideas for variable cadence
Match therapist speed
Walking to the beat of music
Musical Chairs?
Odd Steps with variable length on each leg based on grid or therapist instructions
Treatment ideas for step over obstacle
Single leg stance on prosthetic with opposite leg movements
Hip flexor and hip extensor work in standing
Step over cones
Aerobic steps
Grid work
Treatment ideas for stairs:
Stool stepping Wall squats Lunges Squats Eccentric lowering Glut activities Spot the patient at the foot and with socket
