Week 4 - Amputations, Burns, aged care, Palliative care

Question 1

2 main reasons for performing amputations?

Answer 1

1. patients health

2. patients function

Question 2

2 factors causing amputation

Answer 2

1. PVD (diabetics) - gangrenous toe. 85% diabetes related lower extremity amputations preceded by foot ulcer
2. Traumatic (mostly MVA or MBA)

Question 3

How many K levels are there?

Answer 3

4

Question 4

List the key features of the differences of K levels

Answer 4

K0 - not eligible for prothesis
k1 - single- axis, constant friction knee (household ambulator)
K2 - Single-axis, constant friction knee (community ambulator)
K3 - Fluid and pneumatic control of knees (community ambulator beyond simple locomotion (exercise, traverse most environmental barriers)
K4 - Any ankle knee system appropriate (exceeds basic ambulation, high impact, stress or energy levels for athletes.

Question 5

List the physiotherapy aims following LL amputation? (4)

Answer 5

GIMP aims

1. Continuous ax of goals, needs and abilities
2. set realistic tx plans
3. promote independence
4. re-educate mov’t patterns, optimize independent fx for ADL including self-care, aids, device use and return to work/leisure

Question 6

List issues affecting goal achievement (6)

Answer 6

1. residual limb condition
2. concurrent pathology
3. social & env’t
4. lack of motivation
5. inappropriate equipment
6. lack of specialist services

Question 7

What are the 3 features of pre-operative physiotherapy (3)

Answer 7

PEA

1. physical, functional, psychological ax
2. educate about rehab including exercise
3. Wheelchair & mobility practice

Question 8

What are the features of post-operative physiotherapy (12)

Answer 8

SPPLDD WATER

1. sutures
2. Pain
3. Physical, fx ax
4. Liaise with MDT
5. Dressing
6. Drain
7. Wound healing
8. Aids and devices
9. Transfers
10. Exercise
11. Refer for discharge

Question 9

list 2 main reasons why amputated body part is perceived (Phantom limb pain)

Answer 9

1. Nerves severed and nerve injury

2. Brain area dedicated to that part & expects sensory information, processing altered info as pain

Question 10

Mx for phantom pain (7)

Answer 10

M ARE CCC

1. Ax
2. reassure
3. Electotherapy TENS
4. compression
5. massage, relaxation
6. coordinate with analgesia
7. counseling

Question 11

Physiotherapy Ax and Mx for pre-prosthetics? (5)

Answer 11

CCELR

1. Compression, shape
2. Cardio fitness
3. exercises - strengthen, stretch
4. Liaise with MDT
5. Refer for discharge

Question 12

Physiotherapy Ax and Mx prosthetic (7)

Answer 12

PEE GAAP

1. Ax (physical, fx, psych)
2. Exercise
3. gait re-education
4. pain control
5. Progress with aids
6. ADL as part of MDT
7. Educate about residual limb care/prosthesis

Question 13

List life long management of prosthetic (6)

Answer 13

RI Race

1. exercise
2. interventions (revise)
3. Appointments (Review)
4. Community agencies (liaise)
5. Re-integration (normal living)
6. Resource (act)