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Flashcards in Special Populations Deck (27)
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what is important for bilateral TTA components?

  1. tend to have the same foot/ankle on each limb
  2. absorbing shock
  3. protect the limb
  4. suspension
    • decrease pistoning
    • vacuum/suction is preferred



list some rehab considerations for bilateral TTA

  1. gait
  2. balance
  3. falling
  4. W/C and assistive device use, associated transfers
  5. UE strength
  6. Progress as normal



list some considerations for bilateral TFA components

  1. need to have reliable stance and swing phase control from the knee unit
  2. stability from the ankle/foot 
  3. ischial containment socket
  4. suction suspension with appropriate liner
  5. may use Stubbies



list some rehab considerations for bilateral TFA

  1. Balance
  2. transfers
  3. W/C skills
  4. falling and recovery
  5. UE strength
  6. gait



what are stubbies?

bilateraly TFA sockets with no knee joint only pylons

amputee is very short but these can be really functional


T/F: a TFA and a TTA is more functional than bilateral TFA


preserve the knee joint


list some general gait characteristics for bilateral amputees

  1. wide based with decreased speed
  2. typically use some AD
  3. very taxing
  4. community barriers



list some main take aways for bilateral LE amputees

  1. gait with bilateral prostheses increase energy expenditure
  2. even if ambulatory ALL B LE amputees need to have proficient WC skills
  3. although slower, general progression is still the same
  4. increased likelihood of gait deviations



what types of unique challenges do pediatric amputees face?

  1. motor development and milestones
  2. learning
  3. psychosocial
  4. skeletal issues
  5. neuromuscular issues



list some considerations for pediatric amputee components

  1. basic components are the same, but smaller
  2. durability is an issue
  3. less choices available
  4. age appropriateness 



how can a prosthetist account for growth in children, relating to sockets

build the child a socket that is bigger than they need so that they can grow into it


what are rotationplasties?

the knee joint is removed, lower leg is turned and attached to the femur - the ankle now functions as the knee

used for tumors of the distal femur or proximal tibia (typically in peds)


what is the benefit of a rotationplasty?

no phantom limb

quick return to function


list some main takeaways for pediatric amputees

  1. rehabilitation:
    • ROM > strength
    • AD use
  2. educate parents on:
    • skin care
    • device function
    • donning/doffing
  3. make therapy age appropriate
  4. encourage use
  5. encourage adaptive sports
  6. be realistic



what factors/things should be considered for high-level rehab in amputees?

  1. acceptable gait - walking and runing
  2. stable volume
  3. skin condition
  4. baseline health
  5. reason for amputation



list members of the rehab team for high level amputees

  1. patient
  2. coach
  3. prosthetist
  4. strength and conditioning coach
  5. PT



what goes into a readiness assessment conducted by a PT?

  1. gait, CV fitness, core strength, balance, proprioception, muscle imbalances
  2. history of previous participation
  3. history of previous injury
  4. frequent communication



UE amputations are most commonly caused by _________

industrial accidents or combat injuries

60% of congenital amputations are UE

70% of traumatic amputations are UE



list some surgical considerations for UE amputations

  1. scar placement not critical
  2. levels of amputation:
    • wrist disarticulation
    • forearm
      • lose pro/sup
      • as distal as possible
    • elbow disarticulation
    • above elbow
      • as distal as possible



describe the prosthetic fit for UE prosthetics

  1. prosthetic arm may be left slightly shorter
  2. bony landmarks:
    • C7 → harness ring below 
    • clavicle → site of breakdown
    • Acromion → to measure length of residuum
    • Scapula → need good mobility



describe the below elbow harness system

  1. shoulder flex tightens cable and operates terminal device
  2. shoulder extension relaxes cable and closes terminal device
  3. abduction augments flexion



T/F: most amputees prefer prosthetic hands over hooks


hook is more functional and durable and the pt can easily see through it (helps compenstate for lack of sensation at the hand)


describe how an amputee operates a below elbow harness

they move the scapula or go into shoulder flexion/abduction creates tension on the cable heading to the terminal device which opens the device


describe the above elbow harness system

  1. main suspension over the deltoid
  2. shoulder flexion operates terminal device
  3. elbow lock through depression of shoulder with humeral abduction and extension and then operates terminal device
  4. elbow must be locked to operate terminal device



describe a myoelectric system for UE prosthetics

  1. suspended through pin and lock system, suction or supracondylar
  2. operated via EMG-like activity
  3. electrodes sense muscle contraction to control terminal device
  4. flexion closes terminal device
  5. if damage to mm or nn in UE can use chest or back muscles to control



what is targeted muscle reinnervation?

nerves in residuum are transferred to target mm that no longer perform function. Augments signal to muscle for easier and enhanced prosthetic control 

nerves grow into new target tissue

enhances control of myoelectric arm


how many surgeries are generally required for osseointegration in UE amputees?

2 surgeries 6 months apart