Test Information

Hallo All,,

Would u plz be so kind and answer with justification the following questions:

1-u are treated a patient to use a pick up walker with partial weight bearing on right lower extremity .which gait sequence would u use?
a.walker pushed forwrad,right lower extremity moved forword ,left lower extremity moved forward .
b. walker picked up and moved forward ,right lower extremity moved forword ,left lower extremity moved forword.
c.walker picked up and moved forward ,left lower extermity moved forward ,right lower extrimity moved forward .
d.right lower extremiy moved forward,walker piked up and moved forward ,left lower extermity moved forward.

2-U are treating a 32 yr. old male with left above knee amputation who is full weight bearing and u are giving instructions on the proper stair climbing method for ascending while using axillary crutches,which of the following climbing seqences is correct for this patient?
a.right LE up ,left LE up ,RE crutch up ,leftcrutch up
b.left LE up ,right LE up ,left crutch up,right crutch up
c.right LE up,left LE UP,LEFT CREUTCH UP, RIGHR CRUTYCH UP
d.left LE up,right LEup,RIGHT CRUTCH UP,LEFT CRUTCH UP.

3-Post operative edema is one of the complications that may occur following an amputation .one of the ways to treating this problem is by the rigid derssing.Although this method is effective it does have certain disadvantages compared to more traditional soft dressing ,All of the following are disadvantages of rigid dressing except:
a.requires close supervision during healing stage
b.daily wound inspection not possiblec.
c.causes delayed ambulation
d.requires technical skills to apply

4-When u are working with geriatric patients,it's important to keep in mind that certain exercises don't need to be focused on,ALL of the following exercises should be focused on with geriatric patients except:
a.hip flexion
b.hip extension
c.knee extension
d.kee flexion

Any notes greatly appreciated...:rolleyes:

Regards

hi, studying sometimes helps!!:-))

joke, cruches always assist the injured leg (or the missing)!

question 4 is hip flexion.

cheers

Hi.

1 a or b is ok - the purpose of a support is to protect the limb involved. Therefore any combination where the frame/crutches then the right leg (affected one) in the middle of the sequence is usually correct during walking.

2 - Good foot goes to heaven, bad foot goes to hell. Crutches stay with the bad foot. Therefore to ascend stairs, it is good foot first (to heaven), then bad foot (always in the middle) then crutches. Descending is the reverse order...

3. ?? - Don't do amputees

4. a - Hip flexion if i had to answer but hip flexor strength is useful for improving walking and ground clearance i would have thought. hoever, if they were elderly and sitting around all day, then it is not so important...

Good luck - are you a student or a qualified physio??

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Originally Posted by alophysio

Hi.

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1 a or b is ok - the purpose of a support is to protect the limb involved. Therefore any combination where the frame/crutches then the right leg (affected one) in the middle of the sequence is usually correct during walking.

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Sir Thanks for ur intersts
Now,the problem here is to pick up or to push is there is a differnce!!!

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3. ?? - Don't do amputees

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What did u mean??? supose working at in patient physiotherapy ,i think this question need an answer...right!

Good luck - are you a student or a qualified physio??

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Once again thanks sir,and i'm a physiotherpaist
Please send my greetings to ur wife!

Hi Juniorphysiotherapist,

I don't do amputees so i can't help with your answer. I understand what i am good at and i do it very well. I also understand what i am not good at and so i either choose to learn it so i do it very well or i ask someone else to do it. In the case of amputees, i have only treated one in my 7 years of private practice and his problems were not to do with his amputation (although it has some bearing on it of course).

I hope someone can provide you the answer for the dressings - i would have thought a specialist nurse would know more about that...

As for pushing or lifting a PUF, i presonally prefer the frames that have wheels on the front and sliders on the back because it promotes a more normal walking pattern - the patient doesn't have to stop walking to pick up a frame.

However, like everything in life, there is a trade-off - these frames are less stable than normal 4 point pick up frames. Therefore it depends on the ability of the patient and how much they can do. i would use a 4 point PUF for NWB and touch weight bearing and progress them to rollator PUF and progress onto FWB from there. But that is an opinion only fom someone who is no longer in inpatient care... ;)

Hope that helps!

Hi Junior_physiotherapist,:)

answer for number 3 is C.

For rigid dressings, the advantages of this technique would be:
1. It greatly limits the development of post-op edema in the residual limb, thereby reducing post-pain and enhancing wound healing.
2. It allows earlier ambulation with the attachment of a pylon and foot.
3. It allows for earlier fitting of the definitive prosthesis by reducing the length of the time needed for the shrinking of the residual limb.
4. It is configured to each individual residual limb.

The rest that you have mentioned are the disadvantages.

Regards,
Charlize29:D

Hi PB,

i know it looks like a student assignment but i think it is simply her language. She is a physio. Also her range of questions suggests it is not an assignment...

thanks anyway

Hi Junior_physiotherapist,

"The Assessment and Treatment of Individuals following Lower Extremity Amputation" Chapter 19, pages 375-395 by Susan B O' Sullivan will provide you the answers to your questions about post-operative dressings, levels of amputation etc.


:D

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Originally Posted by alophysio

Therefore it depends on the ability of the patient and how much they can do.

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i would use a 4 point PUF for NWB and touch weight bearing and progress them to rollator PUF and progress onto FWB from there. But that is an opinion only fom someone who is no longer in inpatient care... ;)

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Hope that helps!

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Hi alophysio

would u please be so kind and rewrite the abbreviations above,also please if u have an effective websites/recommended books related to learning a normal pattern of gait mechanism provide me please!!!

Thanks

with Regards

Hallo All

Regarding dude physio,this is not an assignment even it may look like it.

Any way i think the goal here to gain a useful information ,may i can guess that student,teacher ,professional man,adult,children ...all have a right to ask,discuss then gain what they have already searching about!!!:cool:

Regards

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Originally Posted by junior_physiotherapist

Regarding dude physio,this is not an assignment even it may look like it.

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OK, if you say so. I have removed the admin posting that I made above :)

Hi

PUF = Pick Up Frame
NWB = Non Weight Bearing
FWB = Full Weight Bearing

My apologies

As for a normal gait pattern - it is simple - walking is heel strike, hip extension through to toe off then swing phase back to heel strike.

I am not sure where to find a textbook on that. Google might have something. It is basic undergrad level stuff so an undergrad textbook or a sports med textbook might have it. It applies to orthopaedics, neuro, musculoskeletal, paediatrics so i am sure you will find it somewhere...

Thanks

Hi All

Thanks Mr Alophysio for going back quickly to me,No thing to apologize for.

Regards

hi junior physiotherapist
u can go through the gait analysis book which u can lend in british council library.u will get all info reg gait.
thanks.
rajasd.

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Originally Posted by rajasd

hi junior physiotherapist
u can go through the gait analysis book which u can lend in british council library.u will get all info reg gait.
thanks.
rajasd.

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Hallo rajasad


Thanks alot of ,but where dose it locate??
e.i.(brithich council liberary)

Regards

It might be in Britain junior_physio!!

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Originally Posted by alophysio

It might be in Britain junior_physio!!

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It's OK sir,thanks

Regards