Rehabilitation Flashcards
Key Concepts for the FRCS exam
What are the 2 phases of Gait?
Stance phase comprises 60% of the gait cycle; swing phase comprises 40% of the gait cycle.
What % of stance is double limb support?
12%
The body’s center of gravity (COG) while being propelled forward is also subject
to ……..cm vertical and ………cm lateral displacements.
5cm
6cm
Antalgic gait results in…
decreased stance phase
The required increase in energy expenditure for ambulation in bilateral transtibial amputation ?
41%
unilateral transfemoral amputation energy needed?
65%
the factor most predictive of successful wound healing after amputation?
Transcutaneous partial pressure of oxygen [TcPO2 ]
what is the most important laboratory value for healing after amputation?
Albumin
How do u avoid overgrowth in paediatric amputations?
stump capping or disarticulations
What should be performed with transmetatarsal and Lisfranc amputations to prevent late
development of equinus or equinovarus deformity.
Percutaneous Achilles tendon lengthening
In Lisfranc amputations, the soft tissue at the fifth metatarsal base should be preserved… Why?
because this represents the insertion site of peroneus brevis and tertius, which act as antagonists to the posterior tibial tendon. Failure to preserve these tissues results in
inversion during gait
What is special about a Symes amputation?
more energy efficient than a midfoot amputation, despite the fact that it is at a more proximal level.
what parameter is necessary for a symes amputation?
The posterior tibial artery must be patent to ensure healing. The heel pad must be secured
Optimal bone length for BKA?
12cm
what type of amputation did the LEAP study show to have the slowest walking speed and lowest satisfaction?
Knee disarticulation
Optimal bone length for AKA?
12CM
In transfemoral amputation, ………………… is crucial for maintaining femoral adduction during gait with a prosthesis.
adductor myodesis
Transecting the adductor magnus results in a loss of …..% of the adductor pull.
70%
Define what is a prosthesis?
a device or artificial substitute designed to replace, as much as possible, the function or appearance of a missing limb or body part. Prosthetics is defined as the specialty relating to prostheses and their use.
……………commonly used for midlength transradial amputation
Myoelectric prostheses
type of prosthesis for heavy labour?
Body-powered prostheses are used for heavy labor. The terminal device is activated by shoulder flexion and abduction.
Short forearm amputations, elbow disarticulations, and above-elbow amputations necessitate what kind of suspension?
supracondylar suspension
what kind of foot is good for uneven terrain?
articulated feet
type of feet for high demand activities?
non articulated long keel feet
how does knee centre of rotation affect the knee in gait?
Knee center of rotation posterior to line of weight bearing promotes control in stance phase, but flexion is difficult.
• Knee center of rotation anterior to weight bearing makes flexion
easier, but control is poor.
type of knee most ambulatory patients with transfemoral amputations?
Microprocessor knees with polycentric (four-bar linkage) configuration
type of knee for older patients?
Stance-phase control (safety) knee prostheses
most common prosthetic knee in children.
The constant-friction knee
The preferred method of suspension for transtibial prosthetic
prosthetic sleeves is the gel liner with locking pin
Problems are common in prosthetics. Foot placement too anterior results in?
increased knee extension and patellar pain.
Too soft a heel results in?
excessive knee extension
too hard a heel causes?
knee flexion and lateral rotation of the toes.
Define an Orthosis?
“a device that is externally applied or attached to a body segment and that facilitates or improves function by supporting, correcting or compensating for skeletal deformity or weakness
an arthritic or stiff midfoot during midstance as the foot changes from accepting the
weight-bearing load to pushing off.. what type of orthosis should be recommended?
A rocker sole
foot drop?
A posterior leaf spring AFO
Surgical intervention in adult-acquired spasticity should be delayed until
patient achieves maximal spontaneous motor recovery (6 months for stroke and 12 to 18 months for traumatic brain injury
Equinus deformity is treated by?
percutaneous Achilles tendon lengthening.
Dynamic varus-producing force in adults is the result of ? and how dou you treat this?
out-of-phase tibialis anterior muscle activity during the stance phase.
dynamic varus deformity is corrected by either split (SPATT) or complete lateral transfer of the tibialis anterior muscle
what is post polio syndrome?
Postpolio syndrome is not a reactivation of the polio virus. It is an aging phenomenon by which more nerve cells become inactive.
symptoms of post poliosyndrome?
progressive muscle and joint weakness and pain, general fatigue and exhaustion with minimal activity, muscle atrophy, breathing or swallowing problems, sleep-related breathing disorders (e.g., obstructive sleep apnea), and
decreased tolerance of cold temperatures
risk factors for post polio syndrome?
severity of initial polio illness, initial diagnosis as an adolescent or adult, greater recovery from initial illness, and physical activity to the point of exhaustion or fatigue.
treatment of post polio syndrome?
limited exercise combined with periods of rest so that muscles are maintained but not overtaxed.
