The Patient with Bilateral Lower Extremity Amputation Flashcards Preview

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Flashcards in The Patient with Bilateral Lower Extremity Amputation Deck (9)
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1

Pre-prosthetic interventions for patients with bilateral lower extremity amputations: [5]

  • Intensive strengthening of the upper and lower extremities
  • Sleeping in prone (or at least some time during the day in prone
    • because highly susceptible to hip contracture
  • Hip extension flexibility exercise
    • in prone or side-lying
  • Balance activities:
    • weight shifting, playing ball, rotation in sitting and kneeling
  • Residual lower extremity and upper extremity resistive exercises:
    • isotonic, isometric, PNF, isokinetic

2

Pre-prosthetic interventions for those who will not be functional ambulators:

  • Basic mobility
    • bed mobility while avoiding shear forces
    • rolling
    • supine or sidelying to sitting
    • weight shifting
    • scooting in sitting
    • transfers
    • wheelchair propulsion
  • Advanced wheelchair skills
    • independent wheelchair propulsion on:
      • level and uneven surfaces
      • navigation in tight spaces

3

Common socket and suspension for bilateral transtibial amputations (2):

  • Patellar tendon bearing socket with supracondylar cuff suspension
    • (PTB + supracondylar cuff suspension)
  • Total surface bearing socket with roll on silicone liner suction suspension
    • (TSB + silicone liner suction suspension)

4

Advantages of "stubbies" with bilateral transfemoral amputations:

  • Center of gravity lower to the base of support
  • Rocker bottoms prevent backward falls
    • also have no articulated knee joints
  • Require less energy output
  • less cumbersome
  • less fear of falling
  • Decrease risk for hip flexion contracture
  • Allows for physiologic effects of being upright

5

Disadvantages of "stubbies" with bilateral transfemoral amputations:

  • Slower ambulation
  • Psychological acceptance
    • resulting from shortened stature

6

Definitive prostheses that are (-----length in inches and cm----) shorter than preamputation legs result in improved balance by lowering the center of gravity.

  • 2-3 inches or 5-7 centimeters

7

Knee type that offers maximum stance phase stability for individuals with bilateral transfemoral amputations:

  • Bilateral Polycentric (four bar linkage)
    • Advantage of shortening during swing phase aiding in toe clearance

8

Knee type that offers maximum efficiency for individuals with bilateral transfemoral amputations:

  • Bilateral hydraulic
    • higher cost is a disadvantage

9

If one residual limb is longer than the other in a bilateral amputation, then to ascend stairs and/or ramps:

  • Longer limb ascends first
  • Shorter limb descends first