Rehab w/ Limb Loss (3) Flashcards
what should rehab training interventions include
open and closed chain exercises
PRE
PNF gait
exercises that improve CV fitness
ADL specific exercises
PRE –> training interventions
UE
uninvolved lower limb
PNF Gait –> training interventions
if they have temp prosthesis
when do we start exercise
post op day 1
what do we do post op day 1
AA/AROM for the RL and stretching for all limbs
what do we gradually add to exercuse
isometrics
gentle ROM
PRE (stitches out)
trunk strengthening
what do we stretch
ADDs
hip flexors and ERs
knee flexors
what do we strengthen
trunk flexion
what do we strengthen –> TF
ABD
ADD
extension
glutes
what do we strengthen TT
hip extension
knee flexion
knee extension
hip and knee extension combined
stress –> TF
hip extension
ADD
IR
stress –> TT
knee extension
hip extension
ADD
IR
stress –> trunk strengthening
core strengthening
good time to begin w/ abdominal bracing
stress –> CV training
endurance exercise
w/c mobility ex
UE ergometer
stress –> balance
sitting & standing
static and dynamic reaching exercises
stress –> manual therapy
on restricted joints and soft tissue
ambulation
w/ and w/o IPOP
precautions of ambulation
benefits
problems
progression
mobility training
ADLs –> w/c
transfers, bed mobility, etc.
mobility training –> w/c
amputation results in elevation of the COG
elevated leg rest
amputation results in elevation of the COG
pt is “top heavy”
weight anterior chair
wider base of chair
what is it critical to teach your pt –> mobility training
how to rise from the floor
what should we discuss with the pt –> mobility training
need for therapist to go into home
evaluate and treat in home
pt/family education (1)
realistic expectation
rehab progression
changes in body image
phantom sensation
pt/family education (2)
safety awareness, falls prevention
limb positioning
therex
ace wrapping/shrinker (once healed)
emotional support
restore locus control
pt in control of own destiny
outside help
what does emotional support include
re-eval
necessary referrals
goals at completion of acute post surgical phase
independent in…
independent in…–> goals
RL care
mobility, transfers, fxnal activities
HEP
care of opposite limb
RL care –> goals
bandaging
skin care
positioning
HEP –> goals
ROM and resistive exercise for RL and opposite limb
important to prevent contractures
pt education
care of opposite limb –> goals
esp w/ PVD and DM
D/C planning
factors influencing acute stay
factors influencing acute stay
payer source, level, comorbidities, age, social support & injuries
traumatic amputation
dysvascular amputations
traumatic amputation
home unless major trauma
medically stable
if not then inpatient acute rehab
dysvascular amputations
in patient rehab
acute rehab: 1-3 weeks
where do pts progress better
in patient rehab
esp w/ indications of vascular dysfxn
when can a pt be sent home and continue PT
reach STG
have resources
