Flashcards in Post-Prosthetic Deck (22)
What are three facts of the prosthetic training phase in regards to coping and functional living?
1. Prosthetic stage hopefully starts the final stages of coping with the amputation
2. Cosmetics can be an important part of coping.
3. Stage represents the beginning of the process of returning to functional living
Should you use a walker during gait training?
No. (but if you must, use RW)
What are two possible sources of pain regarding prosthetic fit?
Does prosthetic training increase demand on the body?
Yes. CV demands especially (be cautious with patients with DM or other co-morbidities, chemo, dialysis (swelling), etc)
Increased WB can also cause skin and/or musculoskeletal issues
In the post-prosthetic phase, do you want to still use shaping and shrinking devices?
Yes, continue use of shaping and shrinking devices when out of a prosthesis (sometimes use liner). Also continue use of protective devices outside of prosthesis
What are two factors that weight can have on someone with a prosthesis?
Affect on fit
Affect on success with mobility
How should you clean your prosthesis and its components (duration and solution)? (3)
Daily with soap and water and liners
Weekly with alcohol liner and socket
Hand or machine wash socks and change at least daily
4 Questions you must answer at the end of the initial prosthetic visit?
1. Is the prosthesis as prescribed and are all components working/made correctly?
2. Does it fit correctly and is it comfortable?
3. How is the patient's alignment in sitting, standing, and while moving?
4. Does the prosthesis function properly?
What are 4 factors that can affect donning and doffing?
Eyesight, hand function, balance, and cognition
*Design wear and use schedules
What is the difference between wear and use time?
Wear time - the time the prosthesis is on the limb
Use time - the time the patient is WEIGHT BEARING in the prosthesis
How long must you be able to tolerate wearing your prosthesis to be able to take it home?
Once you can tolerate 45 minutes of wear time during therapy, you will be taking your limb home and begin wear/use time according to schedule provided
When should you stop use of a prosthesis?
If redness does not fade after 20 mins
What should the initial wear and use time be when first receiving a prosthesis?
45 mins wear time and 20 mins use time
How should you increase wear and use time?
If tolerable, 15 mins of wear time each day.
For use time, add 10 mins after the first day (30 min total), then 15 mins each day up to 12 hours, if appropriate
What is the max use time according to the PPT?
If gait deviations appear when you advance their device, are they ready?
How do TT amputees transverse stairs?
Foot place is critical (essential dorsiflexion)
*Toe of foot off of step (otherwise, prosthetic knee would hyper-extend)
Start with step-to, but majority of TT amputees can progress to step-over-step gait on stairs
How do TF amputees transverse stairs?
Usually step-to gait. Few TF amputees are able to perform step-over-step up the stairs without a microprocessor. Those with hydraulic or microporcessor knees are often able to descend step-over-step
How do TT amputees transverse ramps?
May start with side-stepping or step-to gait
Typically able to ascend and descend with a typical gait eventually
Decreased available DF will result in increased difficulty
How do TF amputees transverse ramps?
Traditionally start with side-step
May be able to ascend and descent with a more typical gait with microprocessor technology
What are 4 different types of floor transfers?
1. Bump up
2. Push-up from a surface (chair, couch, etc)
3. Push-up from the floor, intact limb forward
4. Push-up from floor (teepee)
Varies significantly depending on level, bilaterally and functional limitations