Prosthetic Phase (2)

Question 1

what is an important part of rehab

Answer 1

gait training

assists in pulling all skills together (balance, strength, prosthetic control)

Question 2

how do we begin gait training

Answer 2

begin with parts of gait (partial practice)

work towards whole skill

Question 3

ground practice

Answer 3

good for specific skills like balance and prosthetic control

Question 4

treadmill practice

Answer 4

works to pull skills together

good for long term conditioning and home use for “lifelong care”

Question 5

sequencing of gait training

Answer 5

balance exercises

weight shift

control

ambulation

endurance (treadmill)

Question 6

what should gait training include

Answer 6

hills, ramps, inclines

Question 7

hills, ramps, inclines

Answer 7

lateral ascent/descent

Question 8

lateral ascent/descent

Answer 8

beginner

intermediate

expert

Question 9

beginner lateral ascent/descent

Answer 9

intact side always facing uphill

uphill: w/ sound side leading

downhill: with prosthetic side leading

Question 10

intermediate lateral ascent/descent

Answer 10

zig zag/diagonal

Question 11

expert lateral ascent/descent

Answer 11

face hill and negotiate

verbal cue for pt to decline

difficult to do step over step if steep

Question 12

goals at the end of prosthetic phase

Answer 12

be independent in

-donning and doffing
-exercises
-ambulation w/ or w/o an AD
-ADL activities

Question 13

main differences b/w K1 and K2

Answer 13

obstacles navigated in daily life

ability/need to be limited community ambulatory

variable cadence is not required at either of these levels

Question 14

what does the pt need to advance from K1 to K2

Answer 14

obstacle training

improvement of physical limitation

gait specific training

Question 15

what must training for K1-2 include

Answer 15

obstacle training

curbs, stairs, uneven surfaces, inclines/declines

Question 16

general rules of training –> K1 to K2

Answer 16

up with good

large inclines/declines benefit from the ability to step-step upwards

reciprocating downstairs possible but not necessary (TT)

Question 17

what should we consider –> K1 to K2

Answer 17

ROM

strength

balance

gait

Question 18

ROM –> K1 to K2

Answer 18

hip

prone extension

knee extension

promote manual techniques

contract relax

encourage full ROM, esp extension

Question 19

promote manual techniques –> ROM –> K1 to K2

Answer 19

joint mob of hip and knee, sacrum and L/S

hip anteriorly to get into extension, posteriorly to have femoral head sit back in the socket

Question 20

strength –> K1 to K2

Answer 20

hip extensors, ABD

for TT: knee extensors

Question 21

balance –> K1 to K2

Answer 21

prosthetic leg stance phase

balance progression

biofeedback

Question 22

gait –> K1 to K2

Answer 22

pelvic initiation

step length (increase it)

“breaking” the knee joint (control TT, TF)

Question 23

main differences b/w K2 and K3

Answer 23

ability/need to be an unlimited community ambulator

variable cadence is required

Question 24

what does the pt need to advance –> K2 to K3

Answer 24

previous rehab program (strengthening, stretching, balance)

addition of gait focus

Question 25

addition of gait focus –> K2 to K3

Answer 25

components (quality of gait, step length, cadence variation, gait speed)

putting it all together

Question 26

how are ADs and K-levels determines

Answer 26

physicians

prosthetist

PT

Question 27

physicians –> AD and K level

Answer 27

must be in their notes

recommendation from PT

Question 28

recommendation from PT –> AD and K level

Answer 28

fxnal capabilities and long term prognosis

Question 29

prosthetist –> AD and K level

Answer 29

AMP

notes to MD

PT feedback

Question 30

PT –> AD and K level

Answer 30

recommendations

notes are critical

AMPPro

Question 31

K1 –> K2

Answer 31

no w/c to the MD visit

Question 32

K2 –> K3

Answer 32

no walker to MD visit