Lec 3 - Amputee Rehab and Prosthetics

amputation

born with a limb and then lose it

limb difference

born without a limb

neuroma

 thickening or enlargement of nerve tissue that can cause sharp burning or stinging with pressure.

nearly half of the individuals who have an amputation due to vascular disease will die within ____ years.

5

of people with diabetes who have a lower extremity amputation up to 55% will require. . ..

amputation of the second leg within 2-3 years

what is the most common lower limb amputation

toe!

_____% of people had pre-existing diagnosis of diabetes militis

57

____% of people experience an infection prior to their amputation

43

____% of people have amputations due to vascular issues (PAD, DM, DVT)

54

osteomyelitis

infection and inflammation of the bone marrow

what contracture is most common in transtiibial amputations?

knee flexor fractures

disarticulation

separation of a bone or limb from the body directly through a joint space rather than cutting through a bone

IPOP - immediate post op prosthesis good for . . .

decreases edema, earlier ambulation and increases motivation.

what is the disadvantage of having an immediate post op prosthesis?

cannot monitor wound healing

immediate post op prosthesis is a ____ dressing

rigid

semi-rigid dressings provide what benefit?

improved healing and edema control compared to soft dressings

T/F: soft dressings have relatively have poor control of edema

T

what is a lanyard

liner with a strap on front so they can pull strap to put it on

socks fxn

fills space as limb loses volume

non-articulated foot

does not move. most common, lighter weight, more durable

articulated feet

move, heavier, less durable (more moving parts)

what foot is most common?

SACH foot

SACH foot stands for

solid ankle cushion heel

SACH foot is articulated or non articulated?

non-articulated

SAFE foot stands for

stationary attatchment flexible endoskeleton

safe foot is articulated or non articulated?

non-articulated

weigh the pros and cons of a SAFE foot

heavier, more costly, easier to use on uneven terrain, energy storing foot

dynamic response feet/energy storing and return (ESR)

designed for active users in moderate to high activity, varied speed and demands.

microprocessor feet

◦uses various sensors to continuously monitor the user’s movement and adjust both the angle and stiffness of the hydraulic ankle in real-time.

patellar tendon bearing socket purpose

pressure is distributed to few other area

total surface bearing socket

pressure is distributed through the residual limb

ischial containment socket

ischial tuberosity is contained inside the socket, which limits rotation of the socket on the limb

quadrilaterla socket

ischial tuberosity sits on a “shelf”, less rotational control

ischial containment is good for ____ limbs, and quadrilateral socket is good for _____ limbs.

shorter, longer

sail or parachute socket

has a soft back os when people sit their leg goes all the way down

osseointegration

screw the prosthetic into the bone

polycentric knees

use multiple aces of rotation as opposed to a single hinge

why do polycentric knees provide superior stability?

the center of rotation stays being the load line during standing, prevents buckling

single axis kne benefit

great ability to lock in extension due to fatigue or prolonged standing

socket designs are also called a ______

lamination

if the prosthetic is too tight, what should you check first?

check shrinker usage, salt intake, and fluid retention

what is the first action if the prosthetic is too loose?

prosthetic socks

K levels

rating system used to determine a patient’s expected level of function and ideal prosthesis

what are the two classifications for K Levels?

AMP PRO, AMP no PRO 9 (no prosthesis)

K Level 0

no ability or potential to ambulate/transfer safely with ot without assistance.

K Level 1

has potential to use prosthesis for transfers or ambulation in level surfaces at a fixed cadence. household ambulator

K Level 2

ability for ambulation, transverse low-level environment barriers such as curbs, stairs, or uneven surfaces. limited community ambulator

K Level 3

ability for ambulation with variable cadnece. community ambulator, who can traverse most environmental barriers and may have exercise that demands prosthetics neyond locomotion

K level 4

ability for prosthetic ambulation that exceeds basic ambulation skills, high impact, or energy levels.

passive upper extremity prosthetic

can be used for all levels of amputation, is used to replace the body part that is missing, can assist the sound side arm in activities like holding or placing objects

mechanical arm prosthesis

this prosthesis uses body movements to operate the terminal device

myoelectric (externally powered) prosthesis UE

uses signals from muscles of the residual limb to control the opening and closing of the terminal device (hook or hand) or elbow depending on the level of amputation

terminal device

the outermost, functional component at the end of an upper-limb prosthesis that interacts directly with the environment. ex golf hand, hammer,