Prosthetic info
What are the 3 aspects a prosthetic has to have? (in general- not specific)
Comfortable, Functional, Cosmetic (in that order)
Explain a K0 level patient.
Non-ambulatory
Does not warrant a prescription of a prosthesis
What are some benefits for a SACH foot? What are some disadvantages?
Benefits: inexpensive, low maintenance, may increase PF at initial contact
Disadvantages: no energy return, abrupt DF, no adjustment for different surfaces, may maintain stance phase too long
What is a single axis knee used for? What are benefits/disadvantages?
Single speed swing phase control ONLY
Benefits: inexpensive, durable, used mainly with children
Disadvantages: no variation in swing with gait speed changes, no stance control
What are socks used for with an amputee?
Socks provide additional space for a limb that is constantly changing
Explain a K1 level patient.
Household ambulator or a person who can only walk in the home
What are the benefits of a single axis prosthetic foot? Disadvantages?
Advantages: fast flat foot enhances knee stability
Disadvantages: no energy return, increases knee extension moment at midstance, NOT for transtibial, requires maintenance
When would a stance-phase control prosthetic knee be used? What are the benefits and disadvantages?
Weight activated friction brake stabilizes knee even if slightly flexed, limits swing phase control
Benefits: good knee stability, surable, indicated mainly for debilitated pts using slow walking speeds
Disadvantages: weight has to be totally off prosthesis to initiate swing, no adjustments to gait speed changes, requires mostly SLOW walking
What happens if there are not enough socks? What about too many?
Too few: The patient reports distal patella and end pressure
Too many: not able to get into the prosthetic
Explain a K2 level patient.
Limited community ambulator
Can traverse low level barriers like curbs, stairs, or uneven surfaces
Only walks at one speed
What are some actions a dynamic response foot (multi axis) can perform?
DF/PF, inversion/eversion with carbon fiber energy return
What are Polycentric prosthetic knees used for? What are the benefits and disadvantages?
Four bar system provides for moving knee axis
Benefits: gives some stance and swing phase control, good for long residual limbs, moving knee axis gives higher toe clearance on swing
Disadvantages: increased weight, needs food voluntary knee control
If the prosthetic leg is hurting the patient, what should we do before calling the prosthitist?
Take the leg off and put on again, identify where in gait they are having pain, look for pressure areas
Explain a K3 level patient.
Community ambulator
Can walk at variable cadence, can transverse most barrieres and may have a job
Therapeutic or exercises that demands prosthetic use beyond simple locomotion
What are the advantages and disadvantages of a dynamic response foot?
Advantages: varying levels of energy return, can go on varying surfaces, may allow heel height adjustment
Disadvantages: heavier than non-articulated, more expensive, more maintenance
What are the benefits and disadvantages of a microprocessor knee (computer driven control)?
Benefits: variable cadence, allows for easy descent of stairs and hills, closest to normal knee motion
Disadvantages: expensive, responsive only
What are some landmarks/body structures you should observe to see if a transfemoral prosthetic fits the patient correctly?
Rotational positioning- identify where adductor longus tendon should fit
Medial brim- no pressure on pubic ramus
Anterior brim- ample ASIS clearance
Lateral brim- trochanter free of pressure
Posterior brim- ischial tuberosity support, gluteal muscles support and loading
Explain a K4 level patient.
Exceeds needs for basic ambulation
Activities that require high impact, stress or energy levels
Child, active adult or athlete
What is a microprocessor foot and what are the benefits?
It provides positive push off in terminal stance and lifting activities- some battey and some robotic designs
Benefits: smooth computer controlled response to different surfaces
What are the benefits/disadvantages for a manual locking knee?
Benefits: total knee stability
Disadvantages: stiff knee with gait requires considerable energy, used very limitedly