PROSTHETIC LAB

Question 1

when do you start knee extension for transtibial amputations?
when do you start hip extension for transfemoral amputations?

Answer 1

as soon as possible

*transfemoral: NEED HIP EXTENSORS for prosthetic knee stability!

Question 2

strengthening which mm groups for patients with BELOW KNEE AMPUTATION?

Answer 2

-knee extensors
-knee flexors
-hip abductors
-hip extensors

need to be able to control!

Question 3

how do you strengthen below or above knee amputation with no lever arm?

Answer 3

CAT/CAM exercises!

Question 4

above knee amputation: strengthen which mm groups?

Answer 4

hip abductors
hip extensors

Question 5

What would CAT/CAM exercises for hip extension look like?

Answer 5

use towel roll under residual limb
use body weight–> lift hips, squeeze glutes, hold, isometric

Question 6

other than CAT/CAM exercises, what other strengthening?

Answer 6

1. CORE: hard exercises
2. transtibial amputation: tall kneeling
3. quadruped, sitting and standing balance, core strengthening

Question 7

avoid prolonged hip flexion, knee flexion positioning

Question 8

transtibial exercises

Answer 8

walking on knees
side stepping on mat
practice WB on knee

Question 9

transfemoral exercises: should you practice WB like transtibial?

Answer 9

NO *avoid direct WB through residual limb
you can use P-PAM devices for WB in a safe way

Question 10

order of pre gait training

Answer 10

1. standing balance
2. WS (side, forward/back, diagonal)
3. stool stepping (first stance on prosthetic)

Question 11

important stance cues for
transfemoral
transtibial

Answer 11

transfemoral: push back into socket
transtibial: soft knee

Question 12

how much weight needs to be on prosthetic foot to break the knee for swing?
*microprocessors, c-leg

Answer 12

70% weight
cue transverse pelvic rotation to unlock knee!

*dont need pelvic rotation for transtibial, just transfemoral

Question 13

stair/curb
ramp/hill
TRANSTIBIAL strategy

Answer 13

stairs: step over step, descending: let the toe hang off step to help knee bend

ramps: lean into hill up, tighten quad down

Question 14

stair/curb
ramp/hill
TRANSFEMORAL strategy

Answer 14

stairs:
up: step to
down: step over step (toe off step, ride hydraulic down)

ramps:
up: short steps, lean into hill
down: extend hip on way down or side step with prosthetic limb leading