Prosthetics Amy's lecture

Question 1

When would you not wear your prosthesis?

Answer 1

should only be worn during weight bearing or going to move from standing to sitting

should not be worn during medical exams

Question 2

What are the most common causes of amputation

Answer 2

DIABETES, PVD; Trauma; Malignancy/Tumor; Congenital Anomaly

Question 3

What are the amputee rehabilitation phases?

Answer 3

preoperative; acute postoperative; pre-prosthetic; prosthetic training; long term follow up

Question 4

Health care interventions for amputees?

Answer 4

pain management, comorbidity management, psychological, residual limb management, education

Question 5

Where should our rehabilitation interventions be focused for an amputee?

Answer 5

ROM, strengthening, cardiovascular, balance, mobility, HEP

should be functional so they can participate in their daily life/routine

Question 6

What should be done during the preoperative phase

Answer 6

document prior level of function, education, plan for modifications to home and equipment needs

Question 7

What should be done during the acute postoperative phase?

Answer 7

PT eval/treatment: bed mobility, sitting balance, transfers, balance
Limb management: prevent contractures, avoid trauma, edema

Question 8

What assistive device is most common for transtibial amputee?

Answer 8

a cane

Question 9

Primary function of prosthetic knee during stance?

Answer 9

maintain extension to promote stability and prevent buckling

Question 10

Should we desensitize after an amputation?

Answer 10

YES ASAP; they have a lot of pain

Question 11

What are common post-op complications?

Answer 11

contractures (hip/knee flexion for tib and hip flex/abd for fem and ER)
Phantom pain

Question 12

What position do transfemoral patients hate?

Answer 12

be prone to prevent hip flexion contractures

Question 13

What should be done during the pre-prosthetic phase of rehab?

Answer 13

goal setting, treatment for goals, is patient candidate for prosthesis, prescription of prosthesis by physician depending on K level

Question 14

What is the preferred outcome measurement tool for an amputee?

Answer 14

Amputee Mobility Predictor (AMP)

Question 15

What should be done during the prosthetic training phase of rehabilitation?

Answer 15

skin inspection, wearing schedule, sock education, gait training, donning/doffing, balance, functional mobility

Question 16

What other professions does the prosthetic training phase work with?

Answer 16

the prosthetist, PM&R, vocational rehab

Question 17

What should a skin check consist of?

Answer 17

looking for redness, abrasions, or blisters

Question 18

What are the components of donning?

Answer 18

liners, socks, and socket

Question 19

How many socks is too many?

Answer 19

10

less socks is preferable so one 3 ply sock instead of 3 one ply socks

Question 20

Can socks be applied more than one at a time?

Answer 20

no, wrinkles is an issue with socket fit

Question 21

Where should gait training always begin

Answer 21

always in the parallel bars

Question 22

What assistive devices are acceptable for BUE support?

Answer 22

a roller walker or crutches

Question 23

What is the sequence for gait training an amputee? (7)

Answer 23

1. Standing balance
2. weight shifting: s/s; f/b; diagonal; stool
3. stepping: sound limb out then back, prosthetic out then back, activation of appropriate muscles
4. stride length and prosthetic control.
5. Side Stepping
6. Resistive Gait Training
7. Trunk rotation and arm swing

Question 24

What ADL’s should be included in GAIT training?

Answer 24

stairs, ramps, floor transfers, fall recovery, uneven surfaces, recreational activities

Question 25

What should be included in a long term follow up?

Answer 25

did they meet their goals; prevent secondary complications

Question 26

What knee type is best for a new amputee?

Answer 26

a safety knee (weight locking)

Question 27

What knee type is best for someone who uses various cadences and is able to walk on multiple terrains? (K3/4)

Answer 27

a pneumatic or hydraulic

Question 28

What population would benefit from a flexible keel foot type?

Answer 28

those who can handle pronation and supination

Question 29

What population/level would benefit from an energy storing foot

Answer 29

K4 would benefit the most

Question 30

Why is foot flat important during gait?

Answer 30

it helps to increase knee stability through extension

faster we get to it the better

Question 31

What foot type would be most beneficial for a K3 level

Answer 31

flexible keel (allows pronation and supination)

Question 32

What happens to resistance in a pneumatic/hydraulic knee when it experiences a hard force

Answer 32

resistance increases with force to keep the rate of flexion the same

Question 33

How does a bilateral transfemoral move from sit to stand?

Answer 33

has to be done solely with the upper body

Question 34

What may develop with a quadrilateral socket (femoral)

Answer 34

development of an adductor roll