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What may a pre-op exers program involve?
deep breathing and coughing
increase proximal m strength
What are some goals of rehab?
regain pre-surgical function
help function at higher level
What are some goals of the post-surgical program?
promote healing of residual limb
maintain mobility of all proximal jts
maintain/regain strength of all proximal jts
increase/maintain strength in remaining limbs
learn proper care of remaining limb
achieve max independence with ADLs
assist with adjustment to the loss of a body part
determine feasibility of prosthetic fitting
What are the 3 types of dressings post-op?
What are the advantages of a rigid dressing (cast)?
controls edema the best
can serve as a foundation for immediate post-op prosthesis (IPOP) for early weight bearing
pt can use the limb for function soon after surgery
early prosthetic use is associated with a greater likelyhood of eventual acceptance of final prosthesis
protects limb from trauma
What are the disadvantages of a rigid dressing?
need trained personnel to appy
cant check suture line
not removable or adjustable
What are the advantages of a removeable rigid dressing (RRD)?
can be removed to check wound/incision healing
gives immediate post op fit for prothesis for early WBing
What is a disadvantage of a removable rigid dressing?
physician applies and must closely supervise
What are the advantages of a semirigid dressing?
semirigid unna dressing (not as hard as regular cast..type of medication in dressing)
limits edema formation
increase healing, decrease pain
limb can be placed in a temp prosthesis for earling WBing
protects against trauma
What are the disadvantages of a semirigid dressing?
need trained personnel to apply and reapply
cant check suture line
cant be done by pt/pta
What are the advantages of a soft dressing?
easy to remove for wound/incision inspection
mid-mod edema control
shapes the limb
can be done by pt/pta
What are some disadvantages of a soft dressing?
least amt of edema control
doesnt allow for attachment of a temp prosthesis
must reapply every 3-4 hours
no protection of limb
must use proper technique
no contracture prevention
What are the advantages of shrinker socks?
better with edema control than ace wraps
easier to apply
What are disadvantages of shrinker socks?
need new socks with edema changes
no prevention for contractures
What are the advantages of an air splint?
same advantages as removable rigid dressing
allows for early amb (can be used for attachment for prosthesis
provides uniform pressure
What are disadvantages of an air splint?
can be hot and increase moisture against skin
can be cumbersome
What will the post op therapist measure the residual limb for?
measurements taken as soon as the dressing allows
What is important for residual limb care?
What can pot begin to do once sutures are removed?
begin bathing normally
begin friction massage
inspect limb with mirror daily
What is the proper skin care for the residual limb?
promote soft pliable skin
decrease use of home remedies
pt should never shave the residual limb
should not use lotions unless directed by physician
How should an effective bandage wrap be?
smooth and wrinkle free
has angular turns (figure 8)
encourages proximal jt extension
ends are fastened with tape
if incision is ant-attempt to bring bandage from post-ant over the distal end
limbs should be rewrapped at least every 4 hours
How should you take care of the elastic bands and shrinkers?
hand wash daily with mild soap and wring out
lay flat to dry on clean towel
should be allowed to dry for 12 hrs overnight
alternate between 2 sets of bandages
never dry elastic bandages or shrinkers on a radiator or in a dryer
What is good positioning techniques for prosthetic pts?
goal is to prevent secondary complications like contractures
avoid prolonged sitting
pt should lie in prone for some each day
do not position limb over a pillow to elevate it
What types of ROM should you perform?
What types of strengthening should you perform?
involved LE when healing allows
For effective prosthetic ambulation, pts need good strength in the involved LE consisting of what? (most important)
What type of general strengthening/conditioning should you perform?
What types of gait patterns should a prosthetic pt use?
3 point with crutches
What types of mobility should you work on?
What are some advantaged of a temp prosthesis?
can enhance post op program
can be fit as soon as the wound is healed
What do you need to increase with bilateral amputation pts?
more mat activities to increase a sense of body position and balance
more UE strength
independent in bed mobility, transfers, and w/c mobility
Why would a pt not be appropriate for a prosthetic?
amb was contraindicated prior to surgery
transfemoral amputees that lack the balance/strength/energy reserves required
those that lack the mental facilities to follow the limb and prosthetic care required
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