Patient Management & Follow-Up Flashcards

A bilateral lower limb amputee returns for a follow-up reporting fatigue during ambulation. Which energy expenditure factor should the practitioner evaluate first?

Answer: Prosthetic foot category and dynamic response

Prosthetic foot selection directly influences energy return and metabolic cost of ambulation in bilateral amputees.

Which patient complaint during follow-up most strongly indicates the need for a complete socket replacement rather than a modification?

Answer: Total contact loss with >6 socks needed for fit

Requiring more than 5 ply of socks indicates significant volume loss that warrants fabricating a new socket rather than temporary accommodation.

During a follow-up with a patient using a myoelectric upper limb prosthesis, the practitioner observes delayed terminal device response. The most likely cause is:

Answer: Inadequate electrode contact with skin

Poor electrode-skin contact is the most common cause of delayed or inconsistent myoelectric signal response.

A patient at a 12-month follow-up reports phantom limb pain that has worsened since initial fitting. The appropriate practitioner response is:

Answer: Document the complaint and refer to the treating physician

Worsening phantom limb pain requires physician referral for medical management, as it falls outside the prosthetist's scope to treat.

When conducting a follow-up gait analysis for a patient with a transtibial prosthesis, a shortened step length on the sound side is most likely caused by:

Answer: Excessive prosthetic foot plantarflexion resistance

Excessive plantarflexion resistance at the prosthetic ankle limits forward progression, causing a shortened contralateral step.

A patient who is a K2 ambulator presents at follow-up requesting a microprocessor knee. The practitioner's most appropriate action is:

Answer: Explain that K2 functional level does not meet criteria for microprocessor knees

Microprocessor knees are indicated for K3/K4 ambulators; a K2 classification does not meet the clinical criteria for this technology.

During a upper limb prosthesis follow-up, a patient using a body-powered hook reports difficulty with fine motor tasks. The first adjustment to evaluate is:

Answer: Terminal device opening force via rubber band count

The number of rubber bands on a voluntary-opening hook directly determines the pinch force and precision of grip.