Flashcards in Pre-Prosthetic Deck (15)
When does the pre-prosthetic phase occur?
6-8 weeks after surgery; but there is a lot of grey and overlapping
When does the pre-prosthetic phase begin?
When the limb is fully healed. (the process at this stage is more and more PATIENT-DRIVEN)
What are the primary goals for the pre-prosthetic phase?
1. Determining prosthetic potential
2. Get patient ready for the prosthesis
What co-morbidities can have an impact on prosthetic potential? (6)
1. CV disease and impairment (inc energy demand)
2. Dysvascular amputations (DM, PVD, PAD) (considerations for circulation, healing, and sensation)
3. Traumatic amputations (TBI, potential skin grafts!, burns, MS injuries)
4. Ca related amputation (stability of weight, treatments, lymphedema)
6. Congenital (all other developmental issues)
What are behavioral / emotional preparation for prosthetic?
1. Provide support but avoid overwhelming the patient (introduce new info in stages, assure for retention)
2. Support (groups, 1:1 peer visits, written material)
3. Age considerations
4. Prosthetic interviews
5. Motivation and compliance (clarify pt's goals - they should drive the rehab program)
What is the formula for motivation?
(Wants * Beliefs * Rewards) / Costs
How do you prepare the residual limb in the pre-prosthetic phase?
Move to AGGRESSIVE SHAPING and shrinkage of the residual limb
Make the patient more responsible for their limb
Manage scars, prevent contractures, assess for PROTECTIVE SENSATION
Where do you test for protection sensation for a BKA (TT)? (5)
Medial tibial plateau
Where do you test for protective sensation for AKA (TF)? (4)
Lateral hip / greater troch area
Should you use lengthy and "canned" HEPs?
What are three examples of rehab interventions learned in class in pre-prosthetic phase?
Balance, core strength, and retraining the COG.
(body blade, sit on ball, turn to side, kneel on stool)
Should you go into the community without your prosthesis?
Yes, and train for recreational activities without a prosthesis too
What does the end of the pre-prosthesis stage bring?
Brings initial prosthetic prescription generation, if applicable.
What factor influences the type of prosthesis prescribed?