Prosthetic Rehab Flashcards
What are the 5 phases of rehab?
Phase I- Immediate Postoperative Stage
Phase II- Immobilization is Removed
Phase III- Intermediate Rehabilitation Stage
Phase IV- Advanced Rehabilitation Stage
Phase V- Return to work or Pre-amputation life style
At what stage can they transition back to their normal lifestyle?
phase V
When can pre gait training start
a. phase II
b. phase III
c. phase IV
d. phase V
phase III
At what stage should you have them practice obstacles, functional skills, balance, agility, endurance training?
a. phase II
b. phase III
c. phase IV
d. phase V
phase IV
Treatment during phase I includes
dressing education, shrinker wear edema control hypersensitivity bed mobility transfers self care mild osmetric strengthening/cardiovascular
What is the primary goal in phase I?
a. edema control
b. function
c. healing without complication
d. all of the above
healing without complication
Phase I is usually in the
a. acute care setting
b. outpatient setting
c. in the home
acute care setting
What stage is pre-prosthetic program training started?
a. phase I
b. phase II
c. phase III
d. phase IV
phase II
What is key to good outcomes in phase II?
pre-prosthetic program
There is a prosthesis at phase II - immobilization is removed (True/false)
false
no prosthesis
At what phase can single limb gait start?
a. phase I
b. phase II
c. phase III
d. phase IV
phase II
bed mobility and transfers should be _ in phase II
independent
Goals with pre-prosthetic program healing without _ increase _ increase _ improve _ stimulate _ begin controlled _
strength activity balance proprioception ambulation
Phase III is usually in what setting?
a. acute care setting
b. hospital setting
c. home
d. outpatient setting
outpatient
in phase III the patient should be _ in stretching and strengthening at home
independent
edema is consistent and does not fluctuate in phase III (true/false)
false
fluctuates, rapid decrease
start with what ply of sock
a. ply 1
b. ply 2
c. ply 3
d. ply 4
ply 1
in phase III pre-gait training can begin with _ _ and ambulation with _ and _
weight shifts
feedback and gradual correction
What phase includes a lot of functional and advanced activities?
a. phase I
b. phase II
c. phase III
d. phase IV
phase IV
the goal with phase IV is
independent ambulation with or without assistive device
Post op day 1 includes
bed mobility
positioning
PROM/AROM to uninvolved joints
sound side exercise
What day post op can transfer skills begin?
a. post op day 1
b. post op day 2
c. post op day 3
d. post op day 4
post op day 2
AROM to only the uninvoled joints should be completed in post op day _ and _
day 1 and 2
Sitting tolerance can start on what day post op?
a. post op day 1
b. post op day 2
c. post op day 3
d. post op day 4
post op day 2
What day post op can patients start to ambulate with a walker?
a. post op day 1
b. post op day 2
c. post op day 3
d. post op day 4
post op day 3
What day post op can patients complete PROM or AROM to involved joint?
a. post op day 1
b. post op day 2
c. post op day 3
d. post op day 4
post op day 3
What day post op should AROM to all joints be worked on?
a. post op day 2
b. post op day 3
c. post op day 4
d. post op day 5
post op day 4
What day post op is their HEP given?
a. post op day 2
b. post op day 3
c. post op day 4
d. post op day 5
post op day 5
What day post op can dynamic strengthening exercises start?
post op day 10-14
When should their ambulation skills around their home be assessed?
post op day 10-14
Week _: staples removed
a. 3
b. 4
c. 6-8
d. 10-11
3
week _: shrinker and healing monitoring
a. 3
b. 4
c. 6-8
d. 10-11
4
week -: cast for diagnostic socket
a. 3
b. 4
c. 6-8
d. 10-11
6-8
week -: prosthetic gait training
a. 3
b. 4
c. 6-8
d. 10-11
10-11
For transtibial prosthetic checkout what should be looked at in sitting
comfortable with sole of shoe falt on floor inspect posterior brim residual limb in socket suspension loosen with sitting? knees level
For transtibial prosthetic checkout what should be looked at in standing
pain knee stable pelvis level pylon vertical sole maintain contact gapping at the brim of the socket residual limb in contact with bottom of socket
For transfemoral prosthetic checkout before donning
inside smoothly finished
socket meet specification
joints move freely
For transfemoral prosthetic checkout what should be looked at in sitting
suspension
length correspond?
sit comfortably
able to lean forward
For transfemoral prosthetic checkout what should be looked at in standing
socket _
knee _
pelvis _
socket fit properly knee stable pelvis level weight bearing socket maintain good contact adductor roll
Initial ambulation in parallel bars will begin with - minutes and assess skin, progress to _ minutes as appropriate
5-15
30
progress to _ after parellel bars
AD
How often should skin be inspected week 1?
a. every 15 mins
b. every 30 mins
c. every hour
d. every 5 hours
every 30 minutes
During week 2-3 they can switch
30 min on: 30 min off
45 min on: 30 min off
60 min on: 30 min off
Safegaurds to be aware of
changes in weight bearing changes in type of AD used changes in limb volume changes in body weight changes in amputee walking velocity
It is important to keep socks dry all day (true/false)
true
What education do amputees need when starting gait training?
residual limb inspection sound limb inspection donning/doffing wear time sock ply weight bearing, center of mass, base of support
Patients should expect to be in pain (True/false)
false
pressure not pain
When practicing standing balance for single UE support on the prosthetic side have them
shift COM over the sound limb
The cane should be plased on the (prosthetic side/sound side)
prosthetic side
In general for gait training progress from
double UE support
single UE support
no UE support
Their BOS should be how far apart?
2-4 inches
weight shifting should be done in what directions?
side to side
front to back
diagonal
step pattern
Weight shift diagnoal with practicted knee _ for TF need to work on _ _
flexion
pelvic rotation
for swinging through for a single step with a mechanical knee
push the knee straight to pull themselves forward
for swinging through for a single step with a microprocessor knee
it can load and get normal gait
forward ambulation can be _ for better pelvic control
resisted
What are some advanced gait training activities that are good for ambulation?
side stepping retro gait tandem gait karaoke/grapevine practice turning with foot placement toe and heel pivot
For ramps, amputees should do what type of gait pattern
up with the good and down with the band
for ramps, amputees should keep their weight on _ going down and on their _ going up
heels
toes
Transfemoral amputees with mechanical knee should do what type of gait pattern
step to pattern ascend/descend
Transfemoral amputees with microprocessor should do what type of gait pattern
ride down
step to ascending