Prosthetic Training

How should first-time & friction knee users approach stairs & curbs?

Sound up first, down last

What is the most challenging gait task?

Slopes

How do you turn with the sound side first, 2-step pattern?

Plant prosthetic foot at 45º

Rotate sound limb 180º

Step w/ prosthesis

How do you turn with the prosthetic side first, 3-step pattern?

Plant sound foot at 45º

Rotate prosthetic foot maximally (135º)

Full turn with sound foot

What are interventions for increasing step length?

Hip extension joint mobility

Glute max strength *WB

Exaggerate neuromotor control patterns

What is involved in advanced balance training?

BBS Top 3 → Tandem, Stepping, Turn 360º

Heel-toe pivot

Single-limb squat

Avoiding obstacles

Why is it important to train how to fall?

20-32% fall during rehab

>50% fall per year in the community

80% of elderly fall in the community

With a microprocessor knee, how can you train lack of "eccentric" knee flexion in loading?

Sit and "ride socket down"

Lean into lunge against wall = To show that knee will bend

Ramp descents

With a microprocessor knee, how can you train difficult stance-swing transitions?

Note: Forefoot WB needed for swing phase resistance

Lean against wall to bounce on toes = To promote forefoot WB

→ Can then transition to lunge & practice push-off

With a microprocessor knee, what are tips for stair training?

Descent heel placement = > ½ anterior foot off step

Ascent tricks - Angle swing diagonally for tight spaces

How do you sit with a constant friction knee?

Shift weight posterior to the knee to flex