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Ortho Eval > Week 7 - OT Management of Selected LE Conditions (after midterm) > Flashcards

Week 7 - OT Management of Selected LE Conditions (after midterm) Flashcards

1
Q

Name 4 OT general roles and goals for LE conditions.

A
  • general conditioning exercises (GCE’s) to bilateral UEs
  • BADLs, IADLs, mobility
  • psychological adaptation
  • return to physical activity
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2
Q

what % of the individuals who have an amputation due to vascular disease die within 5 years of amputation?

A

nearly half

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3
Q

Of persons with diabetes who have a LE amputation, up to what % will require amputation of the second leg within 2-3 years?

A

55%

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4
Q

most amputations occur in which people (age and why)?

A

people older than 65 and are due to some type of associated disease like peripheral vascular disease (PVD) or diabetes.

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5
Q

name 4 main causes of LE amputation.

A
  • PVD (peripheral vascular disease - arteriosclerosis)
  • trauma (GSW, MVA, war)
  • cancer
  • congenital
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6
Q

name the 7 stages of rehab after limb loss.

A
  1. pre-operative phase
  2. acute post-operative phase
  3. pre-prosthetic phase
  4. prosthetic prescription phase
  5. prosthetic training phase
  6. reintegration phase
  7. maintenance phase
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7
Q

name 7 roles of OTs in lower limb amputations.

A
  • BADLs (bed mobility, dressing)
  • identify falls risk factors
  • environmental modification
  • assess for psychological issues
  • consider body image issues
  • consider reintegration to or maintenance of work role
  • participation in recreational activities
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8
Q

name 7 OT assessments for lower limb amputations.

A
  • premorbid functional level and cognition
  • support systems
  • discuss goals/expectations: realistic?
  • home assessment
  • environmental factors
  • transfers/mobility
  • BADLs and IADLs
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9
Q

name 7 OT assessments for lower limb amputations.

A
  • premorbid functional level and cognition
  • support systems
  • discuss goals/expectations: realistic?
  • home assessment
  • environmental factors
  • transfers/mobility
  • BADLs and IADLs
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10
Q

with an increase in amputations due to war, there has also been in increase in what 2 things?

A
  • research

- development of prostheses

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11
Q

Name some OT interventions during the pre-prosthetic phase.

A

ADL intervention in activities defined by the Barthel index:

  • bed to chair transfer
  • bathing/showering
  • dressing
  • toileting
  • feeding
  • grooming
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12
Q

what should the frequency of OT interventions be during the pre-prosthetic phase?

A

45 minute session, 5x/week

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13
Q

what is an indicator of success of OT interventions during the pre-prosthetic phase of OT?

A

independence in all 6 activities without supervision/physical assistance

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14
Q

what is the goal of limb shrinkage?

A

to have a tapered distal end so that the prosthetic will fit

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15
Q

wrap limb in a figure 8 pattern - pt. should be able to do this independently

A

elastic bandage

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16
Q

used in lieu of the bandage

A

elastic shrinker

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17
Q

must be replaced frequently as limb shrinks

A

removable rigid dressing

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18
Q

ideal for ensuring success in rehab

A

immediate post-op prosthesis

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19
Q
  • strongly recommended for bilateral amputations
  • reduces dependency for self-care activities
  • increases the likelihood of acceptance of the permanent prosthesis
A

early post-op prosthesis

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20
Q

what is the goal of desensitization?

A

accustom the limb to touch and pressure for wearing of the prosthesis

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21
Q

name 4 methods of desensitization.

A
  • weight bearing on various surfaces
  • massage
  • tapping and rubbing
  • wrapping
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22
Q

increase or maintain ROM at all joints ___ to the amputation.

A

proximal

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23
Q

____ ____ increases balance, postural control, and endurance.

A

core strengthening

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24
Q

___ level amputations can cause a shift in the COG.

A

high

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25
Q

high level amputations can cause a shift in the ___.

A

COG

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26
Q

incorporate ___ ___ into bilateral tasks during ADLs.

A

residual limb

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27
Q

incorporate residual limb into ___ ___ during ADLs.

A

bilateral tasks

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28
Q

feels as if part is still there

A

phantom limb sensation

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29
Q

phantom limb sensation is most common in what type of amputations?

A

traumatic amputations

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30
Q

phantom limb sensation is a ___ part of ___ post surgery.

A

normal, healing

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31
Q

phantom limb sensation feelings are strongest in what type of amputations?

A

UE amputations

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32
Q

why does phantom limb sensation occur?

A

due to the neural connections which exist within the brain even after the limb has been removed

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33
Q

limb sensation often remains, but patients learn to ___ it.

A

accept

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34
Q

phantom limb sensation may be useful for control of prostheses which use ___ ___.

A

myoelectric control

35
Q
  • feels as if part is still there but painful
  • may be short or long term
  • felt as an intense burning, crushing, shooting, stabbing pain
A

phantom limb pain

36
Q

which types of amputations is phantom limb pain most common in?

A

hand and foot and traumatic amputations

37
Q

phantom limb pain increases with ___.

A

stress

38
Q

what has the best results for phantom limb pain?

A

desensitization

39
Q

name 4 roles of the OT during prosthetic training phase.

A
  • mobility
  • ADLs
  • strengthening
  • psychological (body image)
40
Q

for loss of the dominant limb, ___ ____ will be foremost

A

dominance retraining

41
Q

t/f - amputees must be able to perform ADLs without the prosthesis as well.

A

true

42
Q

Name 4 roles of the OT for bilateral amputees.

A
  • decrease dependence, frustration
  • post op. provide pt. with universal cuff (UE)
  • early fitting of at least one prosthetic
  • encourage the use of other body parts to get activities done
43
Q

Name 3 roles of the OT in the reintegration phase.

A
  • environment - home modification, W/C evaluation
  • pre-vocational exploration - functional capacity eval.
  • to assist vocational counselor - interest inventory, work skills/habits, motivation
44
Q

designed with the incorporation of an increased wheelbase width, creating a better balanced, more stable chair to offset the imbalance created due to a missing limb.

A

Series 1 Amputee W/C

45
Q

what are the energy requirements for ambulation with prosthesis for a unilateral BK amputee?

A

10-20%

46
Q

what are the energy requirements for ambulation with prosthesis for a bilateral BK amputee?

A

20-40%

47
Q

what are the energy requirements for ambulation with prosthesis for a unilateral AK amputee?

A

60-70%

48
Q

what are the energy requirements for ambulation with prosthesis for a bilateral AK amputee?

A

> 200%

49
Q

hip fractures are associated with what?

A

increased mortality and morbidity

50
Q

which types of fractures are most common in females before 75 y/o?

A

distal radius fractures

51
Q

which types of fractures are most common in females after 75 y/o?

A

hip fractures

52
Q

the ability of the patient to regain ____ is DIRECTLY related to his/her ability to survive.

A

ambulation

53
Q

Name ambulation precautions for total hip replacement (THR) pts.

A
  • assistive devices as per MD and PT

- frequent, short walks

54
Q

Name sitting precautions for total hip replacement (THR) pts.

A
  • use chair with arms

- NO: low chairs, recliners, sit in bottom of tub, bending forward, crossing legs

55
Q

Name sleeping precautions for total hip replacement (THR) pts.

A
  • on back, legs abducted with pillow

- no waterbeds

56
Q

Name standing precautions for total hip replacement (THR) pts.

A
  • no bending at waist.

- no stooping, kneeling, squatting

57
Q

Name car precautions for total hip replacement (THR) pts.

A
  • no driving for 6 weeks

- use pillow to elevate if necessary

58
Q

Name exercise and activity precautions for total hip replacement (THR) pts.

A
  • continue with exercise as per PT.

- sex after 6 weeks, passive position

59
Q

Name household changes precautions for total hip replacement (THR) pts.

A
  • no scatter rugs
  • raised toilet seat if necessary
  • stool/bench in tub for shower
60
Q

Name 3 roles of the OT in treatment of back pain.

A
  • using proper body mechanics which include using larger joints in movement
  • conserving energy by balancing work and rest
  • listening to pain signals to avoid overexertion.
61
Q

what is the most proximal LE amputation?

A

hemipelvectomy

62
Q

what is a disarticulation amputation?

A

occurs through the joint

63
Q

what do the classifications of short/medium/long have to do with?

A

how much and level of disability person is given after amputation

64
Q

surgeon determines level of amputation based on blood flow

A

severe gangrene

65
Q

OTs generally not involved in this stage

A

pre-operative phase

66
Q

stage that occurs right away after surgery

A

acute post-operative phase

67
Q

critical that pt. is getting ready for a prosthesis and back to activities during this stage.

A

pre-prosthetic phase

68
Q

to see what’s available , what can pt. do, what is his/her ADL status and COGNITIVE STATUS

A

prosthetic prescription phase

69
Q

getting person ready to do their ADLs with and without prosthesis.

A

prosthetic training phase

70
Q

helping pt. get back into their lives

A

reintegration phase

71
Q

helping pt. get back into their lives

A

reintegration phase

72
Q

how they maintain function, the prosthesis, etc.

A

maintenance phase

73
Q

what is one of the main OT assessments for amputees?

A

cognition

74
Q

___ ___ & ___ is critical for getting ready for prosthesis.

A

limb shaping and shrinking

75
Q

immediate post-op prosthesis is not the ____ ____.

A

permanent prosthesis

76
Q

name 3 purposes for limb wrapping.

A
  • decrease fluids
  • increase circulation
  • shape limb for prosthetic fittings
77
Q

which motion should you avoid in limb wrapping? & why?

A

circular motion - creates a problem bc it contains fluid and doesn’t push it out, creates additional swelling

78
Q

describe the progression of wrapping movements.

A

-start from medial side, across distal end, around back, in a figure 8 motion.

79
Q

why is the figure 8 motion beneficial for limb wrapping?

A

forces fluids up and out, and doesn’t allow it to pool in distal end and create additional swelling

80
Q

how should a LE amputee be positioned in a W/C?

A

-keep knees extended so he/she is not developing knee flexion contractures

81
Q

what should be done to prevent hip contractures occuring from sitting in a W/C?

A

lie on stomach afterwards

82
Q

the amputee W/C is made specifically for a shift in what?

A

COG

83
Q
  • ___ level amputations can cause a shift in the ___.
A

high, COG

84
Q

in an amputee w/c the __ wheels are set __ more bc ___ is further ___ for the individual.

A

back, back, COG, back

Ortho Eval (24 decks)

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