Rehab w/ Limb Loss (1) Flashcards
rehab is the process of
preparing the body to reach maximum potential
helping the pt compensate for loss
prosthetic use
what does the actual timeline depend on
co-morbidities
activity level
etc
overall goals
return to PLOF
pre-disability fxn
independent as possible
shorter time to prosthesis
better the results
phases of rehab
perioperative
pre-prosthetic
prosthetic training
life long care
perioperative
pre operative phase
amputation/reconstruction
acute post operative
pre prosthetic
prosthetic preparation
prosthetic prescription/fabrication
prosthetic training
prosthetic training phase
life long care
community integration
vocational rehab
follow up
what does pre-op rehab include
assessment
education
exercise program
d/c planning
assessment –> pre op
pt condition/px
dysvascular pts
pt goals
dysvascular pt –> assessment –> pre op
discuss prior state of fxn
education–> pre op
prosthesis
phantom limb sensation
foot care/prevention
care of remaining limb is
important
how do we take care of the RL
wash daily w/ bland soap
keep warm
avoid injury
meticulous nail care
no garters
daily exercise
exercise program –> pre op
strength training
endurance
breathing
ADL
strength training –> exercise program –> pre op
UE/uninvolved
pain limits exercise on affected extremity
UE important
d/c planning –> pre op
facility placement
AD
ultimate independence
perioperative phase includes
amputation and reconstruction
decision about –> perioperative
the care of the healing RL is made at the time of surgery
types of limb dressings
soft
rigid
soft dressing
ACE wrap
shrinker
compression pump
rigid dressing
custom rigid removable dressing (RRD)
prefabricated rigid removable dressing (RRD)
w/ or w/o IPOP (immediate post op prosthesis)
when is ace bandage started
ASAP after surgery
where should the dressing be –> ACE
surgical dressing
over incision
how long do you keep the ACE on
24 hrs a dady
when is the ACE rewrapped
2-3x a day or as needed
when do they WB –> ACE
delayed until healing
when do we start removable rigid dressing
immediately after surgery
removable rigid dressings
custom removable RD
prefabricated removable RD
Custom removable RD
rigid dressing
plaster cast
when is Custom removable RD removed
daily for inspection
has–> Custom removable RD
pylon
foot
once fitted –> Custom removable RD
can not be off for more than 10 min
prefabricated removable RD
rigid removable dressing
sometimes –> prefabricated removable RD
w/ protective silicon gel liner
is –> prefabricated removable RD
bi valve
velcro
how long do you WB after –> protocol –> RD
12 hrs after
limited ambulation w/ –> protocol –> RD
20-40 lbs of force
DC –> protocol –> RD
approx 2 weeks
inspect –> protocol –> RD
regularly
what does RD do –> protocol –> RD
even w/o WBing
it protects and shapes the RL during healing
what should they have –> protocol –> RD
well healed
well shaped RL
advantages of RD
decreased flexion contracture
protects healing limb
edema control and shaping of RL
decreased pain
prosthesis ready soon
INSPECT THE LIMB
disadvantages of RD
lack of mobility unless use IPOP (pylon)
excessive pressure during WB –> causes breakdown
advantages of ace bandage
cheap
adjust for shape
easy to apply
inspect healing limb
disadvantages of Ace bandage
improper technique will inhibit circulation
falls off/staff skill etc.
increase incidence knee flex contracture
complication d/t decreased mobility
increased hospital stay
ace bandage is a viable option for
compression
what is needed –> ACE
careful technique
lengthens –> ACE
time from surgery to prosthesis
doesnt –> ACE
protect again trauma
better for –> ACE
dysvascular pt
rigid removable dressing –> summary
pre fab removable preferable
good for –> rigid removable dressing
healing
prevention of trauma
mobility
quicker –> rigid removable dressing
time to prosthesis
careful w/ –> rigid removable dressing
WBing
