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Prosthetic CPM Study Guide Questions with Solutions
1. What measurements for a TT Patient need to be collected for casting?: AP(at PTB), M/L (at condyles),
PML,
Residual Length MTP- Floor Foot Size Circumferences every 2"
2. What questions should you ask at evaluation for a prosthetics: Cause and date of amputation
Comorbidities (DM, kidney, hypertension0 Contralateral Limb integrity Skin Integrity Hand Dexterity/strength Vocational/Recreational Activities Goals Assistive Devices Used MMT/ROM (Thomas test)
3. What are the advantages to a PTB style socket?: Rotational Control, Relief over bony
prominences
4. What are the advantages to a TSB style socket: Equal distribution of pressure over entire limb, use
of liner to reduce shear forces and skin irritation, decreased pistoning
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5. What are the disadvantages to a PTB style socket?: Concentrated pressures on select few areas,
high pressure on patellar tendon
6. What are the disadvantages to a TSB style socket: Requires the use of liners patient must be able
to don liner, lack of rotational control
7. What are the advantages to locking liner suspension: Auditory confirmation of lock increase
confidence, can have patient start to don and engage lock while seated, easy to manage volume with socks
8. What are the disadvantages to a locking liner suspension: Pistoning/milking of the limb, can be
difficult for patient to align pin and lock must be consistent, lack of a rotational control
9. What are the advantages to a cushion liner/sleeve suspension: Reduced pistoning of prosthesis,
easy volume management, secure suspension, benefits of liner
10. What are the disadvantages to a cushion liner/sleeve suspension: In- creased bulk around the
knee that can reduce knee flexion, can be hot (extra layer), requires dexterity to use liner
11. What are the advantages to a seal in system for suspension: Decreased pistoning, increased
proprioception, decreased apparent weight of prosthesis
12. What are the disadvantages to a a seal in system for suspension?: More difficult to control
volume with socks, must have good balance to don prosthesis, requires exact fit
13. What are the advantages to an elevated vacuum system: Promotes limb health, decreases
pistoning, increased proprioception, decreased sweating, de- creased apparent weight
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25. What are the advantages to a multiaxial foot: Accommodates uneven terrain, decreases stress on
skin and proximal joint
26. What are the disadvantages to a multiaxial foot: Expensive, heavier
27. What are the advantages to a flexible keel foot: Smooth rollover to mimic natural gait, reduces
socket forces on limb
28. What the disadvantages to a flexible keel foot: No energy return, limited push off on foot
29. What are the advantages to a dynamic response foot: Energy storage, reduces impact on
proximal joints, decreases energy consumption while walking
30. What are the disadvantages to a a dynamic response foot: Expensive, weighs more, may
require a higher build height
31. Define a K0 patient?: No ability/potential to ambulate. Not indicated for a prosthesis for
ambulating or transferring
32. Define a K1 patient and the available componentry: Ability/potential to am- bulate over event
terrain at a fixed cadence, household ambulator Feet= Single axis, SACH Knee= Single axis, constant friction, locked
33. Define a K2 patient and the available componentry: Ability/potential to am- bulate over uneven
terrain at a fixed cadence Feet: Multiaxial, flexible keel, single axis with multi-axial Knee= Single axis,
5 / weight activated stance control
34. Define a K3 patient and available componentry: Ability/potential to ambulate over mixed terrain at
a varying cadence, unlimited community ambulator Foot: Dynamic Response with multi-axial components Knee- pneumatic, hydraulic, microprocessor
35. What is the issue and solution to a medial leaning pylon: *Socket is too adducted foot is to
Outset Solution- abduct the socket, inset foot
36. What is the issue solution to a lateral leaning pylon: Socket is too abducted or foot is to inset
Solution= outset foot adduct socket
37. What is the issue/solution to excessive anterior leaning pylon: Socket is too flexed, foot is too
dorsiflexed, foot is too far posterior Solution- move foot further anterior, extend socket
38. What is the issue/solution to posterior leaning pylon: Foot to anterior, socket too extended
Solution - move foot posterior, flex socket
39. What is the bench alignment for a TT patient: Sagittal= 5 degrees of socket flexion, Socket
Bisection 37mm anterior to foot bolt/ posterior third of foot Coronal= match sound side adduction, 12mm inset Transverse= 5-7 degrees of toe out, in line with 2nd ray
40. What are the measurements necessary for a Transfemoral amputees cast- ing: IT- to distal end
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49. What are the advantages and advantages to a Silesian/tes belt: Good auxil- iary suspension for
patients with fluctuating volume or very short limbs, can provide rotational control
50. What are the disadvantages to a Silesian/Tes belt: Positioning, bulky, extra layer, adds another
step to donning process
51. What are the advantages to a pelvic band and hip joint?: Maximum M/L stability, rotational
control
52. What are the disadvantages to a pelvic band and hip joint?: Heavy, bulky, difficult to don,
pistoning
53. What are the advantages to a single axis knee: Adv: inexpensive, durable
54. What are the disadvantages to a single axis knee: Fixed cadence, decreased stability
55. What are the advantages to a weight activated stance control knee: Stable during stance, and
allowing for swing limb for more natural gait, good for new amputees, allows for easier sitting
56. What are the disadvantages to a weight activated stance control knee: Must fully unload knee to
sit, a lot of stress on contralateral limb, single speed cadence
57. What are the advantages to a polycentric knee: More stable, Instantaneous center of rotation is
more superior and posterior make knee inherently stable, knee center folds up under socket shortening limb in swing making good for longer limbs
58. What are the disadvantages to a polycentric knee: Increased weight, more maintenance
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59. What are the advantages to a manual lock knee: Most stable, simple
60. What are the disadvantages to a manual lock knee: Abnormal gait, difficult to sit with
61. What are the advantages to a hydraulic/pneumatic knee: Ambulate with varied cadence,
adjustable resistances, more stance stability
62. What are the disadvantages to a hydraulic/pneumatic knee: Costly, more expensive
63. What are the advantages to an MPK: Varied resistances depending on situa- tion/speed/incline,
various different modes for different situations, most natural gait
64. What are the disadvantages to a an MPK: Heavy/bulky, expensive, not always covered by insurance
65. What are the measurement that will be given for a the TF bench alignment task: KC-floor, IT to
floor, heel height, flexion contracture. Note whether KC-floor and IT-floor include shoe or not
66. What is the bench alignment for a TF prosthesis: Sagittal= 5 degrees of socket flexion plus
contracture, 5-15 mm (1/4"-1/2") TKA anterior to knee center Coronal= foot(center of heel) 30-50mm outset from ischium, socket adducted 6-8 degrees, 2-4" base of support Transverse= Knee externally rotated 3-5 degrees, foot externally rotated 5-7 de- grees, medial wall in line of progression
67. What are some questions to always ask during the trouble shooting sec- tion: Gained lost
weight? Activity level changed? Limb
10 / Solution: Move EFA proximal, Move PBPR Distal, Medial Posterior, remove rubber band, check housing clearance, add z strap, tighten CAS, add dual NW ring
71. What is the cause and solution to a patient with: Lack of ischial containment, lack of proximal
control causing femur to adduct in socket Solution- pad medially, until ischium is contained and if this is not possible, re make socket
72. What is the cause and solution to a patient with: Pushing through narrow socket, add a
window door Solution" pad proximal to malleoli to offload, remake socket
73. What is the cause and solution to a patient with transtibial pain/redness on bottom, distal Patel,
and fibular head: Bottoming out- solution add sock, pad pretibial and popliteal area
74. What is the cause and solution to a knee disarticulation with pain on very bottom/condyles: Using
too many socks/ not reaching the bottom
75. What is the cause of anterior proximal redness with a BK and solution: -
Socket is too extended , flex socket Shoes were changed to lower heel height
76. What is the cause of anterior distal redness: Socket too flexed- extend socket Socket to anterior to
foot- use offset plate to reverse Shoe heel to height AP too large- pad popliteal
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77. What is the cause of tibial tubercle/proximal fibular head redness: Too many socks- reduce sock ply
78. What is the cause of verrucous hyperplasia: Lack of distal contact, reduce sock ply and use clay
ball to ensure distal contact
79. What is the cause of distal lateral and proximal medial pressure: Socket to abducted, adduct
socket
80. What is the cause of distal medial and proximal lateral pressure: Socket too adducted
81. What is the cause of redness on distal end, fibular head, distal end of fibula: Loss of volume
making socket too large, add socks or pad socket
82. What is the cause of proximal lateral and distal medial redness?: Socket too adducted, medially
leaning pylon, outset foot. Patient walking on inside of foot Solution abduct socket
83. What is the cause of proximal medial and distal lateral redness for a BK: Socket too
abducted, foot too inset, walking on outside of foot Adduct socket
84. What is the difference between a figure of 8 and figure 9 harness: Figure 8 will have triceps cuff
and be used for suspension (shoulder strap) and cabling Figure 9 is used for cabling/control only
85. Where does the Control attachment strap sit on an upper limb patient.: In- ferior to C7 and towers
the sound side
13 / proximal Add NW ring
91. What does a force problem in a transradial prosthesis look like, what are the solutions?: Too
much force in system can not open TD Remove rubber bands, add teflon to reduce friction, remove sharp corners in cabling
92. What does an excursion problem look like in a transradial system: CAS too loose-tighten
CAS to high- lower to capture more excursion Too much slack in axilla loop- tighten
