Prosthetic Fit & Training

Question 1

what are four negative prognostic indicators of prosthetic use

Answer 1

1. old age
2. co-morbidities
3. high level amputations
4. cognitive impairment

Question 2

what is the single best predictor of post amputation mobility

Answer 2

pre-amputation mobility/fitness (Kahle et al 2016)

Question 3

what is K0

Answer 3

nonambulatory with or without prosthesis

Question 4

what is K1

Answer 4

household ambulator

Question 5

what is K2

Answer 5

limited community ambulator

Question 6

what is K3

Answer 6

community ambulator and capable of various cadence

Question 7

what is K4

Answer 7

exceeding basic ambulation - active adult or athlete

Question 8

when is a patient fitted for their first socket (temp prosthesis)

Answer 8

6-12 wks post amputation

Question 9

what are the four prerequisites for prosthesis fittting

Answer 9

1. sutures removed
2. incisions healed/healing
3. edema controlled
4. distal measurements < proximal

Question 10

how long before a patient gets comfortable enough to wear their prosthesis throughout the day

Answer 10

2-4 months from fitting

Question 11

when should you consider replacing the socket

Answer 11

> 15 ply sock fit

Question 12

how long does shrinkage of the RL typically take

Answer 12

6-12 months post amputation

Question 13

what qualifies a patient to recieve a definitive socket and when does it usually occur

Answer 13

stable ply fit over 2-3 month period (usually happens around 6-12 months)

Question 14

what are typical sock ply thickness levels and how does this relate to donning socks

Answer 14

1, 3, 5 - we’d prefer a patient wear one 5-ply sock instead of five 1-ply socks

Question 15

how long should a patient wear their prosthesis at the first session?

Answer 15

5-10 min at a time with frequent skin checks - a lot of practice donning/doffing in the early weeks

Question 16

what is reactive vasodilation/hyperemia

Answer 16

redness that occurs after weightbearing and resolves within 10 min

Question 17

what does it mean if reactive vasodilation redness persists after 10 min?

Answer 17

if it persists OR doesn’t blanch - tissue damage has occurred

Question 18

how can you cue your patient to target their weightbearing in their prosthesis?

Answer 18

target their weight through the heels and toes to feel that experience in the socket

Question 19

where should the patient direct their focus when moving in a prosthesis

Answer 19

cue the focus to the pelvis as amputees tend to retract the pelvis on the prosthetic side