PP06 - Week Four

Introduction

Knowledge of prosthetic components, alignment and function is important for Physiotherapists. During the rehabilitation process, it is likely that the Physiotherapist will spend many hours with the amputee, much of this spent on training them to walk with their prosthesis correctly.  This week we are going to learn about prosthetics and take a look at gait analysis.

You can see the online version of the week four email here.

Francois Friedel from the ICRC introduces this week's topics and stresses the importance of the role of the orthotists and prosthetists (Note - watching this video is optional).

To start watch this chat with Greg Halford from the ICRC where he highlights key points about biomechanics and prosthetics (Note - watching this video is optional).

Objectives for this week

At the end of this week you should:

  • Be familiar with the kinds of prostheses available and their component parts.
  • Have an understanding of prosthetic prescription including fabrication and fitting.
  • Have an understanding of and be able to assess normal and prosthetic gait.

Topic 1: Prosthetics

The aim of this topic is to familiarise you with prosthetic terminology, polypropelene technology, component parts, prosthetic selection, measurement and casting, fitting decisions, significance of weight distribution, donning and doffing.

  1. Find out why it is important for physiotherapists to be familiar with prosthetics by reading this page from AusPar
  2. Read the Physiopedia page Prosthetics to develop your understanding of general prosthrtics knowledge.
  3. The WHO Manual has a good overview of prosthetic fabrication - read chapter 4 on pages 77-89
  4. You should also be familiar with all the different kinds of prosthetics that are available - read pages 20-26 in the ICRC PGA Manual
  5. Alignment is one of the most important phases of the fabrication process as this will effect rehabilitation.  Read about the initial fitting with initial/bench alignment and static alignment in the ICRC manual - read pages 65-75 in the ICRC PGA Manual
  6. Polypropylene technology, developed and used by ICRC, is a low cost but reliable technology that uses inexpensive, easy to use and long life material - read about polypropylene technology
  7. Read about the good quality yet cost effective polypropelene prosthetic products that the sponsor of this course, CR Equipements, produce - CR Equipements

These two videos demonstrate how ICRC use polypropylene technology to fabricate and fit prostheses and they are an excellent overview of all that you have just learned about prosthetics:

Topic 2: Gait analysis

The aim of this topic is to provide you with knowledge to assess normal gait, prosthetic gait and gait deviations.

  1. Read the Physiopedia page Gait in prosthetic rehabilitation
  2. Read more about normal gait and prosthetic gait in the ICRC manual - read pages 75-85 from the ICRC PGA Manual
  3. It is important that you are able to assess gait deviations. Have a look at some common gait deviations on Physiopedia 
  4. (optional) Watch these videos and try to identify the gait deviation before the answer appears.  Take note of the prosthetic and amputee causes of each gait deviation.

Quiz

You are not assessed on this quiz, it is designed for you to test your knowledge on the topics this week.

Have a go at the quiz for week four

Case Study

Watch this video:


Find out more about Mary (alternative text document if you can't watch the video)

Discussion

Go to the Discussion Forum and add responses for the three discussion activities below. Please post your discussions as a comment in the relevant discussion thread that will be set up for you.

  1. The information that we have presented this week about prosthetics is orientated towards ICRC technology. How does the prosthetic service and how do the the prosthetics differ in your workplace? Don't forget to mention what your working environment is!
  2. Gait analysis is often done with one health care professional, do you think gait analysis might be better done as a interdisciplinary team? If yes, who should be involved and what will their roles be?
  3. In relation to the video case study, Mary walks with a right trans-femoral prosthesis. In the video, she was fitted recently with a new prosthesis after a re-amputation. You can see her walking in short sequences at the beginning of the video. What would you say about her gait? If you had the opportunity to help her perfect her gait, what type of exercises would you advise?

Optional: Explore other resources

The following resources are optional for you to read/view but will further expand your knowledge on this week's topics:

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The Rehabilitation Series for Lower Extremity Amputees

Free access to these three text books has kindly been provided by Robert and Ann Gailey for the duration of the course:

  1. Prosthetic Gait Training For Lower Extremity Amputees
  2. Balance, Agility, Coordination and Endurance For Lower Extremity Amputees
  3. Stretching and Strengthening For Lower Extremity Amputees

Alternatively you might be interested in having your own copy of the books.

Buy PDF version of all three books for £4.99 direct from Physiopedia

Additionally you might be interested to purchase the complementary DVDs direct from Robert and Ann Gailey.

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Prosthetic Gait Analysis for Physiotherapists

This is the course textbook from ICRC which will be available to all participants of the course.

Access the book here

Alternatively you might be interested in having your own copy of the book.

Download your own FREE copy here

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Therapy for Amputees

This course textbook has kindly been provided by Elsevier and will be available to all participants of the course for FREE for the duration of the course. Please bear in mind that this book is fairly old so use it critically in addition to all the other resources that we will point you at.

Access the book here

Alternatively you might be interested in having your own copy of the book.

Buy with 20% discount from your local online Elsevier store (not available in all regions)

Buy PDF version for £4.99 direct from Physiopedia