Final Exam: Prosthetic Rehab

Question 1

How many phases are in Dr. Robert Gailey’s phases of rehab

Answer 1

5

Question 2

List the Gaileys phases of rehab in order

Answer 2

1. Immediate postoperative stage
2. Immobilization is removed
3. Intermediate rehab stage
4. Advanced rehab stage
5. Return to work or pre amp life style

Question 3

Which phase is usually in a hospital or acute care setting

Answer 3

phase 1 - immediate post op

Question 4

What does treatment look like during the first phase of gailey’s rehab

Answer 4

dressing education
edema control
transfers/bed mobility
wound care
phantom pain

Question 5

What is the goal of the immediate postop stage of Gailey’s rehab

Answer 5

healing without complication

Question 6

which phase of rehab is considered the key to good outcomes via a pre-prosthetic program

Answer 6

Phase II - immobilization removed

Question 7

is a prosthetic involved in phase one

Answer 7

no

Question 8

is a prosthetic involved in phase two

Answer 8

no

Question 9

What does treatment look like in phase II of gailey’s rehab

Answer 9

I bed mobility/transfers
single limb gait
ROM/prevent contractures
Residual limb strengthening, balance, endurance

Question 10

What are the goals of the pre-prosthetic program in phase II

Answer 10

healing without complication along with increasing strength, activity, balance, proprioception and beginning controlled ambulation

Question 11

Which phase of rehab typically occurs in an outpatient setting

Answer 11

III - intermediate rehab

Question 12

is a prosthetic involved in phase three

Answer 12

yes, but only a temporary one

Question 13

Which phase will we see a rapid decrease in edema with some fluctuation

Answer 13

phase III - intermediate phase

Question 14

In phase ___ of Gailey’s rehab, the patient should be I with stretching and strengthening at home. The residual limb should be at __-__% of the strength of the uninvolved side

Answer 14

III; 50-90

Question 15

Which phase does pre-gait training and ambulation start in

Answer 15

III

Question 16

What is the first exercise performed during pre gait training to encourage WB in prosthesis

Answer 16

weight shifts

Question 17

Which phase of rehab is a good time for video analysis for gait deviation

Answer 17

IV - advanced rehab stage

Question 18

What is the goal of phase 4 of Gailey’s rehab

Answer 18

independent ambulation with or without assistive device.

Question 19

What does treatment look like in phase 4 of Gailey’s rehab

Answer 19

higher level balance with cadence changes
inclines, curbs, thick grass
endurance training
agility and strength

Question 20

What is the goal of phase 5 of gailey’s rehab

Answer 20

to be discharged from PT and transition back to every day lifestyle

Question 21

What is the focus of post op day 1

4

Answer 21

bed mobility
positioning
PROM/AROM to uninvolved joints
Sound side exercises

Question 22

What is the focus of post op day 2

5

Answer 22

Transfer skills
sitting to tolerance for 15-20 min
AROM to uninvolved joints
gluteal/quad sets
sound side exercises

Question 23

What is the main focus of post op day 3

Answer 23

ambulation with walker
dressing education
everything else in both day 1 and 2

Question 24

What is the main focus of post op day 4

Answer 24

ambulation with assistive device
AROM to all joints
patient contracture and precaution education

Question 25

What is the main focus of post op day 5

Answer 25

ambulation HEP patient education PRN discharge home or to inpatient

Question 26

What is the main focus of post op days 10-14 | 4

Answer 26

assess ambulation skills dynamic strengthening exercise AROM to all joints patient education

Question 27

When along the follow up treatment are staples removed post op

Answer 27

week 3

Question 28

When along the follow up treatment are shrinker and healing monitored

Answer 28

week 4

Question 29

When along the follow up treatment is a cast made for a diagnostic socket

Answer 29

week 6-8

Question 30

When along the follow up treatment does prosthetic gait training begin

Answer 30

week 10-11

Question 31

What does prosthetic checkout with a TT in sitting look like

Answer 31

``` comfort inspect posterior brim does suspension loosen are knees level is the residual limb forced out of the socket ```

Question 32

What does prosthetic checkout with a TT in standing look like

Answer 32

``` pain is the knee stable pelvis level pylon vertical any gapping is the residual limb in contact with the bottom of the socket ```

Question 33

Is pressure in standing normal

Answer 33

yes, but not pain

Question 34

What does prosthetic checkout with a TF before donning look like

Answer 34

is the inside smooth does the socket meet specification do all joints move freely

Question 35

does prosthetic checkout with a TF in sitting look like

Answer 35

suspension length of shin and thigh compared to other side comfort can they lean forward and reach shoes

Question 36

What does prosthetic checkout with a TF in standing look like

Answer 36

is the knee stable pelvis level adductor roll

Question 37

What is the most important part of prosthetic checkout for TF in standing

Answer 37

if the knee is straight and stable

Question 38

What is progression time of initial ambulation in the parallel bars

Answer 38

5-15 min in bars 30 min in bars 15-20 min with AD 45 min with AD

Question 39

When a patient has a home wearing schedule, they should wear the prosthetic in __ min increments but not wear the prosthetic more than __ min a day in the first week

Answer 39

30; 90

Question 40

Can a TT or TF amputee tolerate longer wear times

Answer 40

TF

Question 41

Describe the important parts of donning socks

Answer 41

pull sock on firmly but not too stretched or too loose. NO wrinkles The seam should be parallel to the suture line clean dry socks

Question 42

True or False: When adjusting socks, the patient should add as many ply as they need to decrease discomfort.

Answer 42

false, add one ply at a time

Question 43

During weight shifting front to back, how wide should the base of support be

Answer 43

2-4 inches