Special Populations - high level amputee rehab

Question 1

goal

Answer 1

• allow for participation in exercise or/and sport

- maintain or ehance physical conditioning gained during functional rehab

Question 2

team responsibility

Answer 2

injury prevention
motivation
education

Question 3

considerations for high level rehab

Answer 3

• acceptable gait
• stable volume
• skin condition
• baseline health
• reason for amp

Question 4

ideal team

Answer 4

patient
coach
prosthetist
strength and conditioning coach
PT

Question 5

prosthetists role

Answer 5

• design based on athlete
• modifies componentry to maximize fxn and reduce injury risk
• communication

Question 6

coach’s role

Answer 6

• must understand muscle fxn, imbalance and injury risk concepts
• tailored individualized program
• careful monitoring
• communication

Question 7

strength and conditioning specialists role

Answer 7

• develops optimal conditioning for the specific sport or activity
• individualized plan for all aspects
• communication
• monitoring

Question 8

PT assessmnet

Answer 8

• determines readiness

Question 9

readiness assessment by PT

Answer 9

• gait, CV fitness, core strength, balance, proprioception, muscle imbalance
• hx of previous participation
• hx of previous injury
• communication

Question 10

PT intervention: basic strength and conditioning

Answer 10

• UE/LE
• injury prevention
• coordination with CSCS

Question 11

PT intervention: core stability

Answer 11

• improve power output
• provide for stable base
• sport specific

Question 12

PT intervention: gait training

Answer 12

• idnetify deviations
• to correct or not correct
• running assessment

Question 13

muscle strength and imbalances: what is the difference of strength between the limbs

Answer 13

• intact limb stronger than amputated leg

- less difference in amputee athletes

Question 14

muscle strength and imbalances: what happens to hip musculature

Answer 14

• can be overactive
• increased energy absorption and generation at the hip of the amputated leg
• compensates for lack of PF

Question 15

muscle strength and imbalances: what is unique about eccentric power in LE

Answer 15

• eccentric HS power is increased in sound limb

- eccentric quad power is greater in amputated limb

Question 16

CV impact

Answer 16

• lower VO2 max
• lower anaerobic thresholds
• comorbidities with dysvascular

Question 17

mechanical overload

Answer 17

• since you already have non-optimal biomechanics, overload can happen quicker
• compensatory mechanisms
• over-reliance on sound limb

Question 18

what is important for these pt’s

Answer 18

recovery time

Question 19

compensatory mechanisms

Answer 19

• asymmetrical overload of sound limb during gait
• knee total work less on amputated side vs. intact
• increased hip energy generation on amp side
• all increased if residual limb is painful

Question 20

physiological overload

Answer 20

higher energy demand + less muscle to generate force = increased recovery `

Question 21

what is overload dependent on

Answer 21

the pt

the amputation level

Question 22

strengthening interventions

Answer 22

• address compensatory movements first
• should be sport specific
• same as able bodied individuals
• increase load appropriately

Question 23

endurance training interventions

Answer 23

• variety of forms
• sport specific
• same principles as able bodied
• be careful with sweating
• amputated limb may fatigue faster than sound limb or CV system