Prosthetic and Orthotics

Question 1

Define each Medicare Functional Level and the recommend Prosthesis of each

Answer 1

K0: Nonambulatory
- No Prosthesis allowed

K1: Limited transfers or limited household ambulator
- manual lock or stance-control knee SACH or single-axis foot

K2: Unlimited household but limited community ambulator
- Pneumatic or polycentric knee Multi-axis foot

K3: Unlimited Community ambulator
- Hydraulic Knee energy-storing foot

K4: High Energy Activities i.e. sports
- Same as K3

Question 2

List the Phases of The Gait Cycle

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Answer 2

Stance Phase 60%

1. Initial Contact/Heel strike
2. Loading response/Flat foot
3. Midstance
4. Terminal Stance/Heel off
5. Pre-swing/Toe off

Swing Phase 40%

6. Initial Swing/Acceleration
7. Midswing
8. Terminal Swing/Deceleration

Question 3

How much time of gait cycle is spent in double-limb support?

Answer 3

20%

Question 4

List the 6 determinants of gait

Answer 4

1. Pelvic Rotation
2. Pelvic Tilt
3. Knee flexion during stance
4. Foot Mechanisms
5. Knee Mechanisms
6. Lateral Displacement of pelvis
   * first five limit vertical displacement of COG, the last limits horizontal displacement.

Question 5

What muscles require strengthening in preparation for crutch walking?

Answer 5

Lats
Triceps
Pec Major
Quads
Hip extensors
Hip Abductors