Prosthetic Phase (1)

Question 1

how do we determine K level

Answer 1

objective measures and outcome measures

Question 2

scores of K level

Answer 2

range of scores across K-levels overlap

Question 3

overlaping scores –> K level

Answer 3

mean scores do not overlap

range overlap makes determination difficult

allows for more flexibility

Question 4

K1

Answer 4

slow walker

Question 5

K2

Answer 5

intermediate walker

Question 6

K3

Answer 6

fast walker

Question 7

K4

Answer 7

fast walker and athletic activity

Question 8

K1 and K2

Answer 8

stance control (single axis) and polycenturic knees

Foot: SACH or low level dynamic feet

Question 9

K3 and K4

Answer 9

hydraulic and micropressor knees

higher energy storing dynamic feet

Question 10

what are independent of K level

Answer 10

socket suspension and interface

bilateral

Question 11

prosthetic check out

Answer 11

static

dynamic

Question 12

static –> prosthetic check out

Answer 12

prosthesis

donning

check w/ pt sitting

check w/ pt standing

check doffing/inspection

Question 13

prosthesis –> static

Answer 13

check prosthetic prescription

Question 14

donning –> static

Answer 14

does the prosthesis fit

check insert/socks/interface

check ability to don

Question 15

check insert/socks/interface –> donning –> static

Answer 15

measured in ply (cotton 2 ply/wool 3-5 ply)

insert 15 ply

Question 16

check w/ pt sitting –> static

Answer 16

pressures

TT –> posterior, liner, knee flexion, RL

TF –> easy flexion, amount of flexion

Question 17

check w/ pt standing –> static

Answer 17

pain/sensations

tissue rolls

foot position (shoe contact)

knee stability (TT/TF)

pistoning

leg length

suspension

total contact

Question 18

checking doffing/inspection –> static

Answer 18

ability to doff

skin inspection = redness in appropriate areas

Question 19

dynamic check out

Answer 19

gait eval

stair climbing

training v. problem

Question 20

training v. problem –> dynamic

Answer 20

do they need more training

is this a problem

Question 21

prosthetic rehab

Answer 21

prosthetic adjustment

RL

sound side

endurance

ADL

Question 22

begin with –> prosthetic adjustment –> prosthetic rehab

Answer 22

1/2 hour to 1 hour per day

Question 23

prosthetic adjustment –> prosthetic rehab

Answer 23

AM/PM

check RL skin before and after

gradual increase WBing

increase to 2-3 hours a day

progress until weaking prosthesis all day

Question 24

RL–> prosthetic rehab

Answer 24

advanced rehab

exercises w/ prosthesis on and off

Question 25

ADL --> prosthetic rehab

Answer 25

rising from floor, transfers, ramps

Question 26

characteristics of gait for individuals w/ limb loss

Answer 26

asymmetrical decreased self-selected walking speed (SSW) increased energy consumption

Question 27

what happens to SSW w/ limb loss

Answer 27

choice is slower still most efficient but higher energy

Question 28

able bodied SSW

Answer 28

120-140 cm/s

Question 29

TT SSW

Answer 29

70-120 cm/s

Question 30

TF SSW

Answer 30

60-80 cm/s

Question 31

what step length is longer

Answer 31

prosthetic step length is longer than sound limb

Question 32

prosthetic side --> step length

Answer 32

less time in stance = more in swing less weight on prosthetic limb

Question 33

sound side --> step length

Answer 33

more time in stance = less in swing more weight on sound limb

Question 34

divisions of gait

Answer 34

gait initiation --> quiet walking --> gait termination

Question 35

initiation of gait

Answer 35

the phase when we go from static standing to starting to walk

Question 36

what is the most problematic phase of gait

Answer 36

initiation regardless of which foot is used (sound or prosthetic)

Question 37

how long does initiation take

Answer 37

longer than able bodied part of the cause is decreased walking speed

Question 38

other issues with gait --> TT & TF

Answer 38

decreased shock absorption at HS decreased propulsion at PO

Question 39

other issues w/ gait --> TF

Answer 39

decreased knee control (flexion) @ HS decreased propulsion at PO decreased knee control during swing increased muscle activity around the hip

Question 40

TT compensations --> gait

Answer 40

increased hip and knee movement and force (muscle activity)

Question 41

TF compensations --> gait

Answer 41

increased hip movements and force (muscle activity)

Question 42

effects on sound limb

Answer 42

increase stress trauma and degenerative changes

Question 43

general considerations for prosthetic gait

Answer 43

more available movement in prosthetic joint --> more control needed must consider mobility v. stability (always compromise) safety first = most important consideration