Pre-Prosthetic Management

Question 1

how should you test ROM in the pre-prosthetic population

Answer 1

gross UE and trunk, definitive in B LE of remaining joints

Question 2

what LE ranges are really important to maintain

Answer 2

extension

Question 3

what are the three major ROM considerations for pre-prosthetic practice

Answer 3

1. early and aggressive ROM 2. avoid elevation of limb on pillows 3. prone is the best position

Question 4

what would be your recommendation for wheelchair hip/knee flexion contracture prevention

Answer 4

extension boards/splints

Question 5

what muscle groups track with gait speed and 6mw performance

Answer 5

hip extensors

Question 6

what muscle groups track with cadence and weight bearing in static stance

Answer 6

hip abductors

Question 7

what muscle groups track with stride length

Answer 7

knee extensors

Question 8

what is conservative mgmt of hypersensitivity

Answer 8

habituation and down regulation of the NS

Question 9

what is conservative mgmt of hyposensitivity

Answer 9

education

Question 10

T/F: the majority of amputees experience pain

Answer 10

true - approx 95% of amputees experience some type of pain

Question 11

what types of pain, from most to least common, are likely to be experienced by pre-prosthetic individuals

Answer 11

phantom pain, residual limb pain, then back pain

Question 12

what are prescription treatments for phantom limb pain

Answer 12

mirror treatment, graded motor imagery, meds, TNS, acupunture, biofeedback, pressure/compression

Question 13

what is a strong predictor of prosthetic success

Answer 13

SLS on sound limb

Question 14

what is the most appropriate balance scale for amputees

Answer 14

ABC scale - subjective questions of confidence in certain tasks

Question 15

how can you test CV status in the amputee population (4)

Answer 15

UE ergo, unilateral LE ergo, w/c propulsion, ambulation with AD

Question 16

from lowest VO2 increase to highest VO2 increase, what are the metabolic costs of various amputations

Answer 16

TTA trauma < TTA vascular < TFA trauma < TFA vascular < hip dis, hemi pelv, B TFA

Question 17

it is (more/less) efficient to walk with a prosthesis with or without an AD than without prosthesis using an AD

Answer 17

more

Question 18

in a vascular amputee, VO2 max (inc/dec) but the energy cost (inc/dec); therefore, _____

Answer 18

dec; inc; tasks are disproportionally more difficult for this population

Question 19

ability to train at >___% VO2 max may be assoc with successful prosthetic outcome

Answer 19

50%

Question 20

what is the prevalence of skin issues in the amputee population

Answer 20

moderate 35-65%

Question 21

what is choke syndrome

Answer 21

limb not all the way down in the prosthesis leading to decreased venous outflow

Question 22

how long do we re-apply ace wrap

Answer 22

ideally every 4 hours but a minimum of 2x/d

Question 23

what are the goals of RL wrapping

Answer 23

control edema, wound healing, and shaping for prosthesis

Question 24

what four ranges of motion are most critical to maintain in the pre-prosthesis population

Answer 24

hip and knee extension, adduction, and IR

Question 25

what three key functional skills determine prosthetic candidacy

Answer 25

independence in dressing, transferring, and walking

Question 26

if the patient is not independent in ambulation in ____wks after amputation, then he/she is unlikely to be a good prosthesis candidate

Answer 26

6-8 weeks