Prosthetics Amy's lecture Flashcards
When would you not wear your prosthesis?
should only be worn during weight bearing or going to move from standing to sitting
should not be worn during medical exams
What are the most common causes of amputation
DIABETES, PVD; Trauma; Malignancy/Tumor; Congenital Anomaly
What are the amputee rehabilitation phases?
preoperative; acute postoperative; pre-prosthetic; prosthetic training; long term follow up
Health care interventions for amputees?
pain management, comorbidity management, psychological, residual limb management, education
Where should our rehabilitation interventions be focused for an amputee?
ROM, strengthening, cardiovascular, balance, mobility, HEP
should be functional so they can participate in their daily life/routine
What should be done during the preoperative phase
document prior level of function, education, plan for modifications to home and equipment needs
What should be done during the acute postoperative phase?
PT eval/treatment: bed mobility, sitting balance, transfers, balance
Limb management: prevent contractures, avoid trauma, edema
What assistive device is most common for transtibial amputee?
a cane
Primary function of prosthetic knee during stance?
maintain extension to promote stability and prevent buckling
Should we desensitize after an amputation?
YES ASAP; they have a lot of pain
What are common post-op complications?
contractures (hip/knee flexion for tib and hip flex/abd for fem and ER)
Phantom pain
What position do transfemoral patients hate?
be prone to prevent hip flexion contractures
What should be done during the pre-prosthetic phase of rehab?
goal setting, treatment for goals, is patient candidate for prosthesis, prescription of prosthesis by physician depending on K level
What is the preferred outcome measurement tool for an amputee?
Amputee Mobility Predictor (AMP)
What should be done during the prosthetic training phase of rehabilitation?
skin inspection, wearing schedule, sock education, gait training, donning/doffing, balance, functional mobility
What other professions does the prosthetic training phase work with?
the prosthetist, PM&R, vocational rehab
What should a skin check consist of?
looking for redness, abrasions, or blisters
What are the components of donning?
liners, socks, and socket
How many socks is too many?
10
less socks is preferable so one 3 ply sock instead of 3 one ply socks
Can socks be applied more than one at a time?
no, wrinkles is an issue with socket fit
Where should gait training always begin
always in the parallel bars
What assistive devices are acceptable for BUE support?
a roller walker or crutches
What is the sequence for gait training an amputee? (7)
- Standing balance
- weight shifting: s/s; f/b; diagonal; stool
- stepping: sound limb out then back, prosthetic out then back, activation of appropriate muscles
- stride length and prosthetic control.
- Side Stepping
- Resistive Gait Training
- Trunk rotation and arm swing
What ADL’s should be included in GAIT training?
stairs, ramps, floor transfers, fall recovery, uneven surfaces, recreational activities
What should be included in a long term follow up?
did they meet their goals; prevent secondary complications
What knee type is best for a new amputee?
a safety knee (weight locking)
What knee type is best for someone who uses various cadences and is able to walk on multiple terrains? (K3/4)
a pneumatic or hydraulic
What population would benefit from a flexible keel foot type?
those who can handle pronation and supination
What population/level would benefit from an energy storing foot
K4 would benefit the most
Why is foot flat important during gait?
it helps to increase knee stability through extension
faster we get to it the better
What foot type would be most beneficial for a K3 level
flexible keel (allows pronation and supination)
What happens to resistance in a pneumatic/hydraulic knee when it experiences a hard force
resistance increases with force to keep the rate of flexion the same
How does a bilateral transfemoral move from sit to stand?
has to be done solely with the upper body
What may develop with a quadrilateral socket (femoral)
development of an adductor roll
