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Flashcards in Amputation Rehab Deck (27)
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1

Evaluation

Residual Limb Length and Shape
Vascularity
ROM
Muscle Strength
Neuro
Transfers
Balance
Mobility

2

ABI (ankle-brachial index)

Non-invasive measure of peripheral tissue perfusion
Used to rule out arterial disease
Should not be more than 10 mmHg difference in R to L sides

3

ABI: 1.1 -1.3

Vessel Calcification

4

ABI: 1.1 - 0.90:

Normal

5

ABI: 0.9-0.70:

Mild arterial insufficiency

6

ABI: 0.70-0.50:

Moderate arterial insufficiency, intermittent claudication

7

ABI: < 0.5:

Severe arterial insufficiency resting pain

8

ABI: < 0.3:

Ischemic or gangrenous extremity, Resting pain

9

Post-Operative Care

Reduce edema and promote healing
Prevent contractures
Increase UE and LE strength
Increase mobility and self care
Promote sound limb care
Assist with limb loss adjustment

10

Soft dressing advantages:

ease of application
ability to monitor wound
ability to change wound environment as necessary

11

Soft dressing disadvantages:

application of elastic wrap may create varied pressure to limb creating a tourniquet effect
manipulation of soft tissue may promote prolonged and deep seated pain patterns

12

Positioning:

Most important to maintain neutral hip and knee extension for optimal prosthetic fit and ambulation
AVOID HIP FLEXION AND ABDUCTION

13

Phantom Sensation

Non-painful sensation or awareness experienced that gives form to a body part with specific dimensions, weight, or ROM

14

Categories of phantom sensation:

1. Kinesthetic sensation
2. Kinetic sensation
3. Extroceptive sensation

15

Kinesthetic Sensation

posture
length
volume

16

Kinetic sensations

willed movements
spontaneous movements
associated movements

17

Extroceptive Sensations

touch
temperature
pressure
other (eg:coldness of limb in OR)

18

Phantom Pain

A painful sensation experienced within the limb that is now not part of the body.

19

Onset of phantom pain:

Onset=1 week to several months
Usually decreases within 6 months

20

What is phantom pain provoked and relieved by?

Provoked by emotional stress, cold, local irritants.
Relieved by wearing prosthesis, stroking,
heat, mental distraction

21

Residual Limb Pain

Pain arising in the residual limb from a specific anatomical structure that can be identified

22

Functional Level 0

no ability or potential for weight bearing or transfer

23

Functional Level 1

Ability or potential to transfer and ambulate within the household with an assistive device

24

Functional level 2

Community ambulator with the ability or potential to traverse minor environmental barriers, fixed cadence

25

Functional Level 3

Community ambulator with the ability or potential to traverse all environmental barriers with a variable cadence

26

Functional Level 4:

Exceeds basic ambulation, high impact, energy levels. Child, active adult or athlete.

27

Five Staged of Grief:

Denial
Anger
Bargaining
Depression
Acceptance