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Amp/Pros > Special Populations > Flashcards

Special Populations Flashcards

1
Q

What is the major cause of bilateral LE loss?

A

Dysvascular disease

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2
Q

T/F Rehab is heavily impacted for patients with bilateral LE loss

A

True

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3
Q

What is a indicator of successful bilateral success when patient goes from unilateral to bilateral amputee?

A

Successful unilateral prosthetic

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4
Q

How does energy expenditure change for bilateral compared to unilateral amputee?

A

Increased energy expenditure

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5
Q

Why is there an increased fear of falling for bilateral amputee?

A
  1. BOS dramatically reduced
  2. decreased proprioception
  3. Lack of anterior support
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6
Q

What should you emphasize and teach to a bilateral amputee?

A
  1. transfers and trunk control

2. Teach how to fall and recover

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7
Q

Describe the components of a BTT amputee?

A
  1. Tend to have the same foot/ankle on each limb
  2. Absorb shock
  3. Protect the limb
  4. Suspension
    - Decrease pistoning
    - Vacuum/suction is preferred
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8
Q

Describe the components of a BTF amputee?

A
  1. RELIABLE stance and swing phase control from the knee unit
  2. Stability from the ankle/foot (solid ankles)
  3. Ischial containment socket
  4. Suction suspension with appropriate liner
  5. “Stubbies”
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9
Q

Rehab considerations for BTT/BTF amputee?

A 
Balance
Transfers
W/C skills
Falling & recovery
UE Strength
Gait
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10
Q

Who has better prognosis:

  1. TF and TT
  2. BTF
A
  1. TF and TT
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11
Q

For patient with TF and TT, what should you emphasize on the TT side?

A

Strength

Prosthetic components

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12
Q

Describe gait for bilateral amputee:

A
  1. Wide based with decreased speed
  2. Typically use some AD
  3. Very taxing
  4. Community barriers
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13
Q

T/F Even if ambulatory ALL B LE amputees need to have proficient WC skills

A

True

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14
Q

T/F Bilateral rehab progression is not the same as unilateral.

A

False, Although slower, general progression is still the same

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15
Q

T/F Increased likelihood of gait deviations with bilateral amputee

A

True

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16
Q

What challenges will pediatric amputee face?

A 
Motor development and milestones
Learning
Psychosocial
Skeletal
Neuromuscular
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17
Q

Describe the components of pediatric amputees:

A

Basic components are the same, but smaller
Durability
Less choice
Age appropriate

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18
Q

Accommodating growth and use of prosthetics for pediatrics:
grade school -
Teenagers -

A

grade school - 12-18 months

Teenagers - 18-24 months

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19
Q

What is rotationplasty and when is it typically used?

A
  • Knee joint is removed, lower leg is turned and attached to femur – ankle now functions as a knee
  • Used for tumors of the distal femur or proximal tibia – typically peds
  • Prosthetic usually similar to TT
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20
Q

Will patient receiving rotationplasty experience phantom limb pain?

A

No, and quick return to function

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21
Q

When rehab with pediatric amputee, which is more important, ROM or Strength of patient?

A

ROM > Strength

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22
Q

What should you educate parent of pediatric amputee on?

A

Skin care
Device function
Donning/doffing

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23
Q

What should a therapist think about when working with pediatric amputee?

A
  1. Make therapy age appropriate
  2. Encourage use of prosthesis
  3. Encourage adaptive sports
  4. Be realistic
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24
Q

What is the goal when working with high-level amputee rehab?

A

allow for participation in physical exercise and/or sports

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25
Q

What team responsibilities when working with high-level amputee rehab?

A

Injury prevention
Motivation
Education

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26
Q

When getting high level athlete back to sports, what aspects should therapist consider in regard to patient/residual limb?

A
  1. Acceptable gait – walking and running
  2. Stable volume
  3. Skin condition
  4. Baseline health
  5. Reason for amputation
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27
Q

Who is a part of the team working with high-level amputee rehab?

A
  1. Patient
  2. Coach
  3. Prosthetist
  4. Strength and Conditioning Coach
  5. Physical Therapist
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28
Q

What is the role of the prosthetist when working with high-level amputee?

A
  1. Designs prosthetic that is relevant to the increased demand of the amputee athlete
  2. Modifies componentry to maximize function and reduce injury risk
  3. Frequent communication
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29
Q

What is the role of a coach when working with high-level amputee?

A
  1. Must understand muscle function, imbalance, and injury risk concepts
  2. Produce a tailored and individualized program
  3. Careful monitoring
  4. Frequent communication
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30
Q

What is the role of a strength and conditioning specialist when working with high-level amputee?

A
  1. Develops optimal conditioning for the specific sport or activity
  2. Individualized plan to target all aspects:
    - Strength
    - Power
    - Stability
    - Endurance
    - Balance
    - CV fitness
  3. Frequent communication
  4. Monitoring
31
Q

As a therapist we would do a basic assessment of a high-level amputee for what purpose?

A

Seek medical clearance as necessary to determine readiness of amputee

32
Q

As a therapist we would do a readiness assessment of a high-level amputee, which includes what?

A
  1. Gait, CV fitness, core strength, balance, proprioception, muscle imbalances
  2. History of previous participation
  3. History of previous injury
  4. Frequent communication
33
Q

What aspects involved with therapist intervention on basic strength and conditioning for high-level amputee?

A

UE/LE
Injury prevention
Coordination with CSCS

34
Q

What aspects involved with therapist intervention on core stability for high-level amputee?

A

Improve power output
Provide for stable base
Sport specific

35
Q

What aspects involved with therapist intervention on gait training for high-level amputee?

A

Identify deviations
To correct or not correct?
Running assessment

36
Q

For TTA, how is the strength of intact limb in relation to amputated leg?

A

Less difference in strength between two legs that normal

37
Q

Why might hip musculature be overactive in TTA high-level amputees?

A
  • ↑ energy absorption and generation at the hip of the amputated leg
  • Compensates for lack of PF
38
Q

Eccentric ____ power is increased in sound limb while eccentric _____ power was greater in amputated leg of high-level amputees.

A

Eccentric HS power is increased in sound limb, but eccentric quad power was greater in amputated leg

39
Q

What is the CV impact of amputees?

A
  1. Lower VO2 max than able-bodied individuals (Chin et al 2012)
  2. Lower anaerobic thresholds (Chin et al 2012)
40
Q

Describe mechanical overload in regard to amputees?

A
  • Already have non-optimal biomechanics
  • Compensatory mechanisms
  • Over-reliance on sound limb
41
Q

What is a compensatory mechanisms during normal gait?

A

Asymmetrical overload of sound limb during normal gait

42
Q

What is a compensatory mechanisms of knee total work for TTA?

A

Knee total work less on amputated side v. intact side (TTA)

43
Q

What is a compensatory mechanisms for hip energy generation on amputated side?

A

Increased hip energy generation on amputated side

44
Q

If RL is painful, what happens to all compensatory mechanisms?

A

All increased

45
Q

Because there is higher energy demand and less muscle to generate force, what happens to recovery time necessary of amputees?

A

Increased recovery time

46
Q

Overload is dependent of what two factors?

A
  1. Patient

2. Amputation level

47
Q

When strengthening amputee, what should be addressed first?

A

Address compensatory movements through rehabilitation efforts first

48
Q

T/F Strengthening should be sport specific

A

True

49
Q

T/F Principles of strengthening and endurance training are different than able bodied individuals

A

False, the same

50
Q

T/F The amputated limb may fatigue faster than the sound limb or the cardiovascular system

A

true

51
Q

Common to see what compensatory patterns with prosthetic running?

A
  1. Circumduction

2. Vaulting

52
Q

Compensatory patterns are worse in what two amputee populations?

A

TFA and B amputees

53
Q

Why is it difficult to maintain posture during prosthetic running?

A

due to limb length differences

54
Q

T/F It is more difficult for prosthetic runners to run in straight line versus running corners.

A

False, OK for straight line running (hard to run corners)

55
Q

T/F It is hard for prosthetic runners to stop.

A

True, can’t control eccentrically

56
Q

What is step 1 of prosthetic running?

A

Trust the prosthesis

57
Q

What exercises can help facilitate trust of the prosthesis during running?

A

Develop hip extensor strength

58
Q

What is step 2 of prosthetic running?

A
  • Hip Extension

- Loads the forefoot of the prosthesis

59
Q

Why do you need adequate hip ext ROM and strength during prosthetic running?

A
  • Need to pull through stance phase

- Causes speed and power

60
Q

Increase of hip extension will have what effect on contralateral stride length?

A

Increase contralateral stride length

61
Q

What is step 3 of prosthetic running?

A
  • Stride symmetry
  • Focus on creating equal and relaxed strides
  • Find appropriate pace
62
Q

Stride symmetry is often easier in what amputee populations?

A

Bilateral

63
Q

What is step 4 of prosthetic running?

A

Arm carriage - Add in appropriate arm movements if not already (arms close to body)

64
Q

Describe effect of prosthetic running on start

A
  • ↓ Symmetry during start (not getting energy return at start)
  • Acceleration phase requires continuous adaptation by the runner
65
Q

___ (decrease/increase) demand in muscle work in prosthetic sprinting as compared to able bodied sprinters.

A

Increased

66
Q

____(symmetrical/asymmetrical) stride length, stride time, and impact loads in prosthetic sprinting as compared to able bodied

A

Asymmetrical

67
Q

____ (decrease/increase) mechanical work on sound limb in prosthetic sprinting as compared to able bodied

A

Increased

68
Q

_% reduction in force in prosthetic sprinting as compared to able bodied

A

10%

69
Q

What are the advantages of prosthetic cycling?

A
  • Can be started earlier than running
  • May not require specialized prosthesis
  • Low impact
  • Can allow for balance loss
70
Q

Common modifications for prosthetic cycling?

A

Pedal systems
Shortened, wider crank arm
Recumbent bikes

71
Q

T/F Because of risk of overload, there must be a balance to avoid considerable setbacks

A

True

72
Q

T/F Amputee can progress to high-level athletics before finishing “normal” rehab

A

False, Needs to be finished with “normal” rehab before progressing, have a mature limb

73
Q

T/F Running blades do not increase performance

A

True

Amp/Pros (12 decks)

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