PTA 213 - Orthotics and Prosthetics

1. Describe pre-operative foot care.
   1. Identify areas susceptible to pressure sores.
   2. Educate patients in the prevention and management of an ulcerated foot.
   3. Describe a diabetic foot.
2. Describe the physical characteristics of upper and lower extremity amputations.
   1. Identify the causes of amputations and the percentage of occurrence of each.
   2. Describe the special precautions for an amputee patient due to Peripheral Vascular Disease.
   3. Define the possible limitations of the amputee patient with regard to pain, circulation, endurance, strength, sensation, and psychological stress.
   4. Describe volume control in regard to an amputee.
   5. Discuss the influence of the loss of a limb on a person’s social-emotional well-being and how this affects rehabilitation.
3. Discuss post-surgical management following an amputation.
   1. Define the purpose of a post-op dressing.
   2. List the most important factors to be considered in selecting the appropriate prosthesis.
   3. Identify the proper weight bearing and relief sites of the below-knee socket.
   4. Recognize and define abnormal weight bearing on the residual limb from the prosthetic socket and describe ways to decrease it.
   5. Define major complaints of early prosthetic users.
   6. List possible physical problems to watch for in a patient wearing a prosthesis.
   7. List the major advantages of a silicone suction device on a prosthesis.
   8. Discuss the general biomechanics of a BK/AK prosthesis.
   9. Compare and contrast the variety of prostheses, including partial foot, Syme-level, BK, AK, Bilateral BK or AK, and hip disarticulation/hemipelvectomy.
4. Discuss the information utilized by the PT to create a treatment program.
   1. Discuss all information relevant for the physical therapy evaluation of the amputee patient.
   2. Identify interventions for all levels of amputee mobility and function.
   3. Describe the importance of assessing the residual limb prior to and after treatment.
   4. Determine the appropriate amount of progression or regression after each treatment.
5. Review a progressive amputee treatment protocol.
   1. Define the principles and purposes of correct residual limb wrapping and consequences of improper wrapping.
   2. Define phantom sensations, phantom pains, and residual limb pain and define methods for decreasing this problem.
   3. List ways that a patient with a BKA can prevent contractures and decrease edema.
   4. List additional ways that a patient with an AKA can prevent contractures and decrease edema.
6. Discuss proper gait training procedures with a prosthesis as well as the proper assistive devices necessary to assist an amputee in mobility and function.
   1. Discuss the steps necessary to secure the purchase of applicable and appropriate assistive devices.
   2. Describe the major gait difficulty with prosthetics.
   3. Describe the major considerations for wheelchair use for patients with a LE amputation.
7. Communicate effectively regarding the amputee patient.
   1. Communicate verbally and in writing regarding amputee treatment using proper terminology.
8. Examine the role of orthotics for use with patient rehabilitation.
   1. Define the following: AFO, KAFO, HKAFO, TLSO, WHO.
   2. Define the main pressure areas to be aware of when wearing an AFO.
   3. List five purposes of orthotics.
   4. Discuss the main advantages of using a shoe insert.
   5. Compare and contrast a plastic AFO to an AFO with bilateral metal uprights.
   6. Discuss the proper procedure in fitting a lumbosacral corset.
   7. Describe reasons in which a doctor may order a jewett brace.
   8. Describe the advantages of using a ring collar over a miami j collar cervical brace.
   9. Describe the process of being fit for a custom molded AFO.
9. Discuss potential legal or ethical issues pertaining to orthotics or prothetics.
   1. Describe an appropriate response to each legal/ethical clinical issue discussed in class.