Partial preview of the text
Download BRACING, PROSTHETICS, ORTHOTICS 100% DETAILED VERIFIED CORRECT ANSWERS 2025/2026 STUDY SET and more Exams Health sciences in PDF only on Docsity!
BRACING, PROSTHETICS, ORTHOTICS
100% DETAILED VERIFIED CORRECT
ANSWERS 2025/2026 STUDY SET
CLASSIFICATION OF BRACES AND SPLINTS
1. RESTING: PROTECT JOINT (ACUTE INFLAMMATION), MINIMIZE MOTION (EXTERNAL
SUPPORT SO MUSCLES CAN RELAX)
2. ASSISTIVE: AUGMENT WEAKNESS, FACILITATE MOVEMENT
3. FUNCTIONAL: PROTECT JOINT DURING ADL'S OR SPORT
4. CORRECTIVE: IMPROVE ROM, DECREASE TONE/CONTRACTURE (LLLD STRETCH TO
IMPROVE ROM)
BRACING OF THE AXIAL SPINE
- LUMBOPELVIC: CORSETS AND ABDOMINAL BINDERS, RIGID LUMBOSACRAL BRACING,
SACROILIAC BELT
- THORACIC: BOSTON BRACE
- CERVICAL: SOFT COLLAR
LUMBOSACRAL CORSET: INDICATIONS AND MECHANICS
- FABRIC ORTHOSES, NO HORIZONTAL RIGID STRUCTURES
- GOAL: ABDOMINAL COMPRESSION (IMPROVE ABDOMINAL PRESSURE, WILL INHIBIT
SOME TRUNK MOTION)
- INDICATIONS: FOLLOWING LUMBAR SURGERY OR VERTEBRAL FX
- MECHANICS: RESTRICTS LUMBAR ROM IN FRONTAL AND SAGITTAL PLANES
ABDOMINAL BINDER: INDICATIONS, MECHANICS, SPECIAL CONSIDERATIONS
- INDICATIONS: SPINAL CORD INJURIES, IMPAIRED ABDOMINALS, REDUCED LUNG VOLUME
OR VOICE
- MECHANICS: INCREASED INTRAABDOOMINAL PRESSURE
- SPECIAL CONSIDERATIONS: DOFFING PROCEDURE (TAKE OFF SLOWLY SO NOT TO DROP BP
TOO QUICKLY AND LEAD TO AUTONOMIC DYSREFLEXIA OR ORTHOSTATIC HYPOTENSION
MOMENT)
LUMBOSACRAL FLEX-EXT LATERAL ORTHOSIS: INDICATIONS, MECHANICS AND SPECIAL
CONSIDERATIONS
- AKA KNIGHT SPINAL ORTHOSIS
- DIFFERS FROM LUMBOSACRAL CORSET IN THAT ITS A RIGID ORTHOSES
- PELVIC BAND USED TO PROVIDE FIRM ANCHORAGE OVER THE MIDSECTION OF THE
BUTTOCKS; THORACIC BAND (LIES HORIZONTALLY OVER LOWER THORAX): TWO BANDS
GOING BY A PAIR OF POSTERIOR UPRIGHTS ON EITHER SIDE OF THE SPINE AND A PAIR OF
LATERAL UPRIGHTS PLACED AT THE R AND L LATERAL MIDLINE OF THE TORSO
- INDICATIONS: RESTRICT SAGITTAL PLANE MOVEMENT
- MECHANICS: 3-PT SYSTEM ANTERIOR AND POSTERIOR
- SPECIAL CONSIDERATIONS: LIMITED ABILITY PREVENT ROTATION
KNIGHT SPINAL ORTHOSIS: HOW DOES IT RESIST FLEXION, EXTENSION AND LATERAL
MOVEMENTS
- FLEXION: CONTROLLED BY A POSTERIOR DIRECTED FORCE FROM TOP AND BOTTOM OF
ABDOMINAL FRONT; ANTERIORLY DIRECT FORCE AT THE MIDPORTION OF THE POSTERIOR
CERVICAL SOFT COLLAR: INDICATIONS, MECHANICS, SPECIAL CONSIDERATIONS
- INDICATIONS: ACUTE CERVICAL INJURY (I.E. WHIPLASH)
- MECHANICS: RESTING SPLINT, LIMITS FRONTAL AND SAGITTAL ROM (ALLOWS MUSCLES
TO RELAX AND HEAL)
- SPECIAL CONSIDERATIONS: SHOULD BE USED SHORT TERM, WEANING PROCESS
CERVICAL PHILADELPHIA COLLAR: INDICATIONS, MECHANICS, SPECIAL CONSIDERATIONS
- INDICATIONS: CERVICAL FX, POST-OPERATIVELY
- MECHANICS: LIMITS 3 PLANES OF MOVEMENT
- SPECIAL CONSIDERATIONS: TEMPOROMANDIBULAR PAIN; PT MAY FEEL
CLAUSTROPHOBIC
- MANDIBULAR AND OCCIPITAL EXTENSION (MORE ROBUST THAN SOFT COLLAR)
HALO AND MINERVA ORTHOSES: INDICATIONS, MECHANICS, SPECIAL CONSIDERATIONS
- INDICATIONS: REQUIRES MAXIMUM PROTECTION, UPPER CERVICAL FX (NO CERVICAL
MOVEMENT WHATSOEVER)
- MECHANICS: HALO (EXTERNAL FIXATION), MINERVA (RIGID POSTERIOR SECTION FROM
HEAD TO MID-TRUNK, NON-INVASIVE, FOREHEAD BAND HOLDS ORTHOSES IN PLACE)
- SPECIAL CONSIDERATIONS: HALO (WOUND MANAGEMENT, FIXED TO SKULL BY 4 SCREWS,
UPRIGHTS CONNECT HALO TO THORACIC VEST, MOST RESTRICTIVE NECK BRACE)
BRACING OF THE PERIPHERAL JOINTS
- HIP: POST-OPERATIVE
- KNEE: IMMOBILIZER, NEOPRENE SLEEVE, PATELLOFEMORAL, UNLOADER, CHO-PAT,
FUNCTIONAL COLLATERAL, FUNCTIONAL CRUCIATE
- ANKLE: INVERSION CONTROL
- SHOULDER: SLING, IMMOBILIZER, SULLY
POST-OPERATIVE HIP BRACE: INDICATIONS, MECHANICS
- MOST COMMON TYPE
- INDICATIONS: POST-OP HIP ARTHROSCOPY, DISLOCATION
- MECHANICS: LIMIT ROM (MAINTAIN ONLY SAGITTAL PLANE MOTION)
KNEE IMMOBILIZER: INDICATIONS, MECHANICS
- INDICATIONS: ACUTE KNEE INJURY, POST-OPERATIVE
- MECHANICS: ALLOW JOINT TO REST, PROVIDE STABILITY FOR GAIT
*CAN BEAR WEIGHT WITH THIS BRACE, PEG-LEG GAIT
KNEE NEOPRENE SLEEVE: INDICATIONS, MECHANICS, EVIDENCE
KNEE CHO-PAT: INDICATIONS, MECHANICS, EVIDENCE
- INDICATIONS: TIBIAL APOPHYSITIS, DISTAL PATELLAR APOPHYSITIS
- MECHANICS: FORCE DISTRIBUTION
- EVIDENCE: LIMITS PATELLAR TENDON STRAIN
*INEXPENSIVE DEVICE, TRIAL AND ERROR
KNEE FUNCTIONAL COLLATERAL BRACE: INDICATIONS, MECHANICS, EVIDENCE
- INDICATIONS: FOLLOWING MCL/LCL INJURY, PROPHYLAXIS (PREVENT INJURY)
- MECHANICS: PREVENT MEDIAL OR LATERAL GAPPING
- EVIDENCE: 20-30% GREATER RESISTANCE TO VALGUS FORCE; FOOTBALL LINEMAN (AT
HIGH RISK FOR MCL TEAR AND STRAIN)
KNEE FUNCTIONAL CRUCIATE BRACE: INDICATIONS, MECHANICS, EVIDENCE
- INDICATIONS: FOLLOWING ACL/PCL SURGERY, NON-OPERATIVE ACL INJURY
- MECHANICS: PREVENTS ANTERIOR AND POSTERIOR TIBIAL TRANSLATION
- EVIDENCE: NO EVIDENCE THAT PAIN, ROM, GRAFT STABILITY, OR PROTECTION FROM
SUBSEQUENT INJURY WERE AFFECTED BY BRACE USE
*DOESN'T WORK WELL AT ALL, MOST ACL INJURIES ARE TORSIONAL IN NATURE AND THIS
BRACE DOESN'T PREVENT THAT MOTION
ANKLE INVERSION CONTROL: INDICATIONS, MECHANICS, EVIDENCE
- INDICATIONS: FOLLOWING INVERSION ANKLE SPRAIN
- MECHANICS: LACES, LATERAL STAY, FIGURE 8 STRAPS, PREVENTS INVERSION MOMENT
- EVIDENCE: AFFECTIVE AT PREVENTING FIRST AND SUBSEQUENT ANKLE SPRAINS
*AKA ASO BRACE
SHOULDER SLING: INDICATIONS, MECHANICS, EVIDENCE
- INDICATIONS: FOLLOWING ACUTE EVENT: DISLOCATION, ACJ SPRAIN, LABRAL REPAIR,
"MINOR" SURGERY
- MECHANICS: RESTING SPLINT
- EVIDENCE: NO CORRELATION WITH RATES OF RE-DISLOCATION IF WORN >1 WEEK
*SLING AFTER DISLOCATION IS APPROPRIATE AFTER FIRST 2 DAYS, AFTER THAT IT'S NOT
HELPFUL IN HEALING OR PREVENTING FUTURE DISLOCATION
SHOULDER IMMOBILIZER: INDICATIONS, MECHANICS
- INDICATIONS: POST-OPERATIVE, FOLLOWING JOINT REPLACEMENT, ROTATOR CUFF
REPAIR
- MECHANICS: RESTING SPLINT WITH OR W/O ABDUCTION PILLOW
SULLY BRACE: INDICATIONS, MECHANICS
- INDICATIONS: NON-OPERATIVE SHOULDER INSTABILITY (ACUTE OR CHRONIC)
- MECHANICS: PREVENTS 90/90 POSITION
*FUNCTIONAL BRACE: CAN FXN IN ATHLETICS WITH THIS BRACE, CAN LIMIT
PERFORMANCE
WITH BRACES, REMEMBER...
THE JOINT ROM
*DON'T FORCE JOINT INTO AN ORTHOSIS
PRESSURE TOLERANCE OF TISSUES
- ORTHOSES MUST EXERT FORCES TO CORRECT OR IMPROVE FUNCTION
- LOW PRESSURE: <2 PPSI (TOO TIGHT SHOES)
- MODERATE PRESSURE: 2-25 PPSI (REPETITIVE LOADING)
- HIGH PRESSURE >25 PPSI (TRAUMA)
- CONSIDER LOCAL CAPILLARY BLOOD SUPPLY
PLASTIC ORTHOSES: ADVANTAGE AND DISADVANTAGE
- TOTAL CONTACT ORTHOSIS
- ADVANTAGE: CLOSE FIT PROVIDES GREATER CONTROL AND DISTRIBUTION OF PRESSURE,
CAN BE WORN WITH >1 PAIR OF SHOES, EASY TO CLEAN, LIGHT WEIGHT, MORE
COSMETICALLY APPEALING
- DISADVANTAGE: CONTRAINDICATED W/ EDEMA/FLUCTUATING EDEMA, MINIMAL
ADJUSTMENT (DOESN'T ACCOMMODATE GROWTH OR MUSCLE FLUCTUATION), NOT
GOOD FOR RAPIDLY CHANGING CONDITIONS
METAL ORTHOSES: ADVANTAGES AND DISADVANTAGES
- METAL=CONVENTIONAL
- ADVANTAGE: STRENGTH, RIGIDITY AND EASE OF FABRICATION/ADJUSTING; PRESENCE OF
EDEMA (GOLD STANDARD FOR EDEMA)
- DISADVANTAGE: HEAVY, BULK, POINT OF CONTACT LIMITED TO STRAPS AND CUFFS
(LIMITED IN CONTROLLING THE JOINT), COSMESIS
ORTHOTIC PRESCRIPTION SHOULD BE A ________________PROCESS.
DYNAMIC
- REFLECTS PATIENT'S CHANGING NEEDS AND FUNCTIONAL STATUS
PURPOSE OF AFO
- SWING: PROMOTE FOOT CLEARANCE DURING THE SWING PHASES
- WEIGHT ACCEPTANCE AND STANCE: PROMOTE SHOCK ABSORPTION, PROVIDE MEDIAL-
LATERAL STABILITY, PROVIDE KNEE STABILITY
AFO AFFECTS NOT ONLY THE ANKLE BUT ALSO THE NEXT MOST ________________ JOINT.
PROXIMAL
*THE KNEE
JOINT CONTROL POSSIBILITIES OF AFOS
- FREE: ALLOWS DIRECTION SPECIFIC TO NORMAL MOTION
- ASSIST: APPLIES EXTERNAL FORCE TO ASSIST ROM INTO SPECIFIED DIRECTION (DF ASSIST
USUALLY)
- STOP: LIMIT MOTION IN SPECIFIED DIRECTION
- LOCK: PREVENTS MOVEMENTS IN ALL DIRECTIONS
STOPS AND LOCKS
- ANTERIOR STOP (DF STOP): LIMITS DF, USED WITH WEAK PF CONTROL IN STANCE OR DF
PAIN
- POSTERIOR STOP: LIMIT PF, USED WITH WEAK DF, SPASTIC PFS AND/OR POORLY
TIMED/SEQUENCED DF/PF
- LOCKED/RIGID: COMBINED PF AND DF WEAKNESS AND/OR SPASTICITY
PRIMARY GOALS OF THE DF STOP
- PAIN CONTROL IN TERMINAL STANCE
- RESIST DF PRIOR TO INITIATION OF PAIN
- FACILITATE FOREFOOT ROCKER AND TIBIAL PROGRESSION
FLOOR REACTION AFO
- PURPOSE: TO INCREASE KNEE CONTROL DURING STANCE AND WB
- INDICATIONS: EXCESSIVE KNEE FLEXION IN WB, EXCESSIVE ANKLE DF IN WB
- DESIGN: ENSURE THE GRF IS ANTERIOR TO THE KNEE AT MID-LATE STANCE TO HELP
GENERATE A KNEE EXTENSION MOMENT; SUFFICIENTLY STIFF TO RESIST THE DF MOMENT;
2. IMPAIRED PROPRIOCEPTION AT THE ANKLE OR KNEE
3. LE SPASTICITY
KAFO (KNEE ANKLE FOOT ORTHOSIS): TOTAL CONTACT AND CONVENTIONAL
- PROVIDES SUPPORT AND STABILITY TO THE KNEE AND ANKLE.
- TOTAL CONTACT: ADVANTAGES IS THE REDUCED WEIGHT OF BRACE, MORE CONTACT,
BETTER CONTROL OF JOINTS IN WB ACTIVITIES
- CONVENTIONAL: ADVANTAGE IS THAT IT CAN BE ACCOMMODATED FOR QUICK CHANGES
RGO (RECIPROCATING GAIT ORTHOSIS)
- PELVIC BANDS AND AFO COMPONENTS
- CABLE EXTENDS BTW R AND L SIDES; CABLE DEVICE IS TRIGGERED WHEN ANTERIOR
LATERAL WEIGHT SHIFT (WALKING)
- FACILITATES ASSIST WITH SWING PHASE OF OPPOSITE LIMB
THIGH COMPONENT OF AFOS
- METAL UPRIGHTS WITH LEATHER AT KNEE/THIGH (CONVENTIONAL)
- METAL UPRIGHTS WITH PLASTIC AT KNEE/THIGH (TOTAL CONTACT)
LOCKED KNEE JOINT
- INDICATED FOR INDIVIDUALS W/O KNEE HYPEREXTENSION MOTION
- MANUALLY OR MECHANICALLY LOCKS WHEN INDIVIDUAL FULLY EXTENDS THE KNEE
- REQUIRES MANUAL UNLOCKING TO FLEX KNEE
- BAIL LOCK: SEMI-CIRCLE THAT EXTENDS POSTERIOR TO KNEE JOINT, WHEN PERSON GOES
TO SIT DOWN, OR HITS EDGE OF SEAT AND HELPS BEND THE KNEE
- DROP LOCK: PERSON HAS TO MANUALLY DROP THE LOCK TO LOCK THE KNEE OUT
OFFSET KNEE JOINT
- INDICATED FOR INDIVIDUAL WITH KNEE HYPEREXTENSION MOTION
- EXTENSOR MOMENT LOCKS KNEE WHEN KNEE IS EXTENDED AS KNEE AXIS IS ANTERIOR
TO JOINT LINE
- IF PERSON'S BW FALLS BEHIND OR POSTERIOR TO THE LOCKED KNEE JOINT, THE FORCES
CREATED FROM THE FLEXION MOMENT PRODUCED MAY BE SO LARGE THAT THEY
FRACTURE THE JOINT OR DEFORM THE UPRIGHTS
FREE KNEE
- INDICATED FOR INDIVIDUALS WITH ADEQUATE STABILITY IN STANCE W/O SUPPORT
- NO LOCKING MECHANISM
- USER'S WEIGHT LINE FALLS IN FRONT OR ANTERIOR TO THE KNEE JOINT CENTER->FORCES
THE JOINT TO REMAIN IN EXTENSION WITH MINIMAL USE OF MUSCULAR ACTIVITY
- WHEN WEIGHT FALLS BEHIND OR POSTERIOR TO THE KNEE JOINT, CREATES A FLEXION
MOMENT AROUND THE JOINT AXIS->INDUCES THE KNEE JOINT TO FLEX->USER MUST FIRE
QUADS OR KNEE EXTENSORS TO LIMIT OR STOP THE FLEXING OF THEIR KNEE
WHAT IS CONSIDERED A SUCCESSFUL AMBULATION TRIAL
- INDIVIDUAL CAN TRANSITION INTO STANDING WITH THE AD OVER 3 SEPARATE SESSIONS
- INDIVIDUAL CAN WALK THROUGH PARALLEL BARS W/ OPEN HANDS INDEPENDENTLY
- INDIVIDUAL CAN WALK WITH AD 20 CONSECUTIVE STEPS WITH SUPERVISION
REASONS FOR AMPUTATIONS
- PERIPHERAL VASCULAR DISEASE (PVD) ASSOCIATED WITH DIABETES
- TRAUMA (BLAST INJURIES, MVA/MOTORCYCLE, BOATING ACCIDENTS, TRAIN ACCIDENTS)
- OSTEOGENIC SARCOMA: DECREASED LIMB LOSS SECONDARY TO MEDICAL
INTO MUSCLE BELLY)
- FLAPS SHOULD BE CUT TO AVOID AREAS OF INCREASED PRESSURE
- SCAR MASSAGE IS IMPERATIVE TO POSTOPERATIVE MOBILITY
_________________: SEEN IN BLAST INJURIES; AN OVERGROWTH OF BONE WHEN TRYING
TO HEAL; PROBLEMATIC IF PUSHING INTO MUSCLE-> PAIN WITH PROSTHESIS; MAY NEED
SURGICAL INVOLVEMENT
HETEROTROPHIC OSSIFICANS
_________________: PROCEDURE IN WHICH THE DISTAL FIBULA IS TAKEN AND MADE
INTO A BONE BRIDGE BTW TIBIA AND LEFTOVER FIBULA; IF HAVE SHORTER FIBULA, MIGHT
ABDUCT FROM LIMB AND CAUSE PAIN WHEN PLACED IN A SOCKET; THIS PROCEDURE
INCREASES THE STABILIZATION IN THE PROSTHESIS; MORE CONTROL WITH AMBULATION,
POST-OP IMPLICATIONS (REFRAIN FROM WB ACTIVITIES FOR AT LEAST 6 WKS TO ALLOW
BONE BRIDGE TO HEAL COMPLETELY)
ERTLE PROCEDURE
AMPUTATIONS: FLAPS
- SHOULD BE CUT TO AVOID AREAS OF INCREASED PRESSURE
- LONG POSTERIOR FLAPS ARE USED TO ALLOW FOR INCREASED DISTAL PADDING OF THE
LIMB, RECOMMENDED BC POSTERIOR TISSUES HAVE INCREASED VASCULARIZATION;
ALLOWS FOR SUTURE LINE TO BE PLACED ON THE ANT. TIBIA OR FEMUR WHICH REMOVES
IT FROM A WB AREA AND ALLOWS FOR IMPROVED HEALING
WHY IS SCAR MASSAGE SO IMPERATIVE FOR AMPUTEES?
- AFFECTS HOW THE LIMB WILL FIT IN SOCKET AND AMBULATION
- IF SCAR ADHERES, WON'T ALLOW SKIN/MUSCLE TO MOVE AROUND BONE IN PROSTHEIS
THE WAY IT SHOULD-> WILL CAUSE PAIN AND AFFECT GAIT
POST-OPERATIVE SURGICAL DRESSINGS
- RIGID DRESSINGS: IMMEDIATE POST OPERATIVE PROSTHESIS (CAST PROSTHESIS),
REMOVABLE RIGID DRESSINGS, COMMONLY SEEN IN PEDIATRIC POPULATIONS
- SEMIRIGID: UNNA'S DRESSING GAUZE (ZINC OXIDE, GELATIN, GLYCERIN, CALAMINE)
WHAT IS THE BEST INDICATOR OF PROSTHETIC SUCCESS?
PRIOR LEVEL OF ACTIVITY
NEUROLOGICAL IMPLICATIONS FOR AMPUTATIONS
- HOMUNCULUS MAN: SENSORY NERVES IN BRAIN REROUTE AFTER AMPUTATION BC THEY
HAVE LOST THEIR DISTAL INPUT
- BC SENSORY LOCATIONS OF THE FEET AND GENITALS ARE SO CLOSE, PTS MAY EXPERIENCE
INCREASED PHANTOM PAINS AND/OR SENSATIONS WHEN DEFECATING OR SEXUALLY
AROUSED-> THIS IS NORMAL
- TAKES ABOUT A YEAR FOR THE BRAIN TO ACCOMMODATE TO A NEW "NORMAL"
- CHILDREN MAY EXPERIENCE A REGRESSION IN POTTY TRAINING BC CAN'T COMMUNICATE
THAT IT HURTS WHEN VOIDING/DEFECATING
DESENSITIZATION/DECREASING PHANTOM PAIN TREATMENTS
- FEELS LIKE LIMB IS STILL THERE OR IS ON FIRE/IN PAIN; FOOT MAY FEEL LIKE IT'S IN THE
POSITION IT WAS IN B4 AMPUTATION, MAY THINK LIMB IS ASLEEP
TREATMENTS
- COMPRESSION, TAPING, MASSAGE, USE OF TEXTURES
- PROGRESSIVE WEIGHT BEARING
- MIRROR BOX: LOOK AT OTHER LIMB IN MIRROR
- CATALOG OF LIMBS: LOOK AT CATALOG OF L AND R LIMBS IN MULTIPLE PLANES
- TIME: TAKES ABOUT A YEAR FOR BRAIN TO DISCOVER NEW NORMAL
- MEDICATIONS
- PERSONALIZED BF RESTRICTION TRAINING
_________________: CURLED UP NERVE, MAY BECOME PROMINENT AS MUSCLES
ATROPHY, POTENTIALLY CAUSING PAIN; TREATED BY GOING BACK IN AND CUTTING THE
FROM USING PROSTHESIS DOWN THE ROAD
- TUMMY TIME IS IMPERATIVE FOR ALL LE LEVELS OF AMPUTATION, BUILD IT INTO THEIR
TYPICALLY SCHEDULED DAY
PRINCIPLES TO BEGIN FITTING
- FIT TOO SOON: TISSUE DAMAGE, LESS THAN OPTIMAL RESULT THAT CAN DISCOURAGE
PATIENT
- WAIT TOO LONG: PT MAY BECOME WEAKER, TIGHTER, INCREASINGLY ACCUSTOMED TO
USING A WHEELCHAIR
PERFECT TIMING:
- WOUND CLOSURE
- WOUND TOLERANT TO FORCE COUPLE PRESSURES
- CIRCUMFERENCE REDUCTION (GET RID OF POST-OP EDEMA)
- SOUND SIDE WB ABILITY
- CONTRACTURE <25 DEG
PREPPING FOR THE FIRST PROSTHESIS
- DON'T DENY BASED ON CURRENT PRESENTATION
- SET GOALS OF INDEPENDENCE W/O A PROSTHESIS
- PRIMARY FACTORS THAT CAN BE OVERCOME WITH PT: CONTRACTURE REDUCTION,
SOUND SIDE WEAKNESS, UE WEAKNESS, EXCESS WEIGHT
PREP FOR 1ST PROSTHESIS: CONTRACTURE REDUCTION
- PROGRESS SLOWLY
- MEASURE AND GIVE PT A GOAL
- PASSIVE STRETCHING
- ACTIVE STRETCHING WHEN AMBULATING WITH A PROSTHESIS
- >25 DEG OF CONTRACTURE: NOT ADVISED TO FIT/DELAY FITTING OF PROSTHESIS
IF INITIALLY THE PT IS NOT A GOOD CANDIDATE FOR PROSTHESIS FITTING......
SET MEASURABLE PERFORMANCE GOALS
- INDEPENDENT USE OF WALKER FOR A STATED DISTANCE (100 FEET)
- MUST INCORPORATE GOOD MECHANICS IN PREPARATION FOR THE PROSTHESIS
OTHER FACTORS TO PREP FOR 1ST PROSTHESIS
- WANT THE PELVIS TO BE LEVEL (STRONG, PROPERLY TRAINED HIP ABDUCTORS)
- FOOT SHOULD BE MORE OUTSET (WIDE BOS-PREP FOR POSTHETIC USE AND CONTROL)
- ASSISTED DEVICE: START CONTACT GUARD/MIN ASSIST->SBA-STAND BY ASSIST-
>SUPERVISION->MODIFIED INDEPENDENT
NON-IDEAL FUNCTIONAL PRESENTATION FOR AMPUTEES
- PROSTHESIS FOR HOUSEHOLD AMBULATION OR TRANSFERS ONLY
- BK (TRANSTIBIAL) PROSTHESIS CAN HELP TRANSFERS (AK GETS IN THE WAY)
- AK (TRANSFEMORAL) PROSTHESIS CAN BE USED FOR HOUSEHOLD AMBULATION; USE A
LOCKING KNEE, MAY FREE UP THEIR HANDS FOR CERTAIN ACTIVITIES
GOALS OF THE 1ST PT SESSIONS AFTER GETTING PROSTHETIC
GOAL 1: DON'T COMPROMISE YOUR PT SESSION WITH POOR FITTING LIMBS THAT CAUSE
YOU MORE PROBLEMS
GOAL 2: SOLVE ISSUES WITHIN YOUR SCOPE W/O THE PROSTHETIST
BK (TRANSTIBIAL) LEG COMPONENTS
- SOCKET: WEIGHT SUPPORT DURING WB CONDITIONS
- INNER LINER: PROTECT SKIN, ABSORB SHOCK
- SUSPENSION: SECURES PROSTHESIS TO LIMB
- FOOT/ANKLE: TRANSFERS WEIGHT TO THE GROUND, ACCOMMODATE VARIOUS SURFACES
DURING AMBULATION
BEFORE PUTTING THE PROSTHESIS ON....
- VISUALIZE SKIN CONDITION IN WB REGION (BASELINE COMPARISON), INSPECT AGAIN
AFTER PROSTHESIS USE
- EVALUATED WB : PATELLA TENDON, MEDIAL TIBIAL FLARE, PRE-TIBIAL MUSCULATURE,
GASTROC MUSCLE BELLY, FIBULAR SHAFT
