CPO Patient Management & Follow-Up 2 — Questions and Answers
Question 1: During a follow-up visit, a transtibial amputee reports that their residual limb has decreased in volume since fitting. What is the most appropriate initial intervention?
- Fabricate a new socket immediately
- Add prosthetic socks to accommodate volume loss (Correct answer)
- Refer the patient to a physician for evaluation
- Discontinue prosthetic use until limb stabilizes
Correct answer: Add prosthetic socks to accommodate volume loss
Adding prosthetic socks is the standard first-line approach to compensate for residual limb volume reduction and restore proper fit.
Question 2: A patient with a below-knee prosthesis presents with a pistoning gait pattern. Which follow-up assessment is most critical?
- Evaluate suspension mechanism integrity (Correct answer)
- Check pylon alignment
- Assess foot dorsiflexion range
- Measure socket brim height
Correct answer: Evaluate suspension mechanism integrity
Pistoning is primarily caused by inadequate suspension, so evaluating the suspension system is the priority assessment.
Question 3: When documenting a patient's functional outcome at a 6-month follow-up, which standardized tool is most appropriate for lower limb prosthetic users?
- Barthel Index
- Timed Up and Go (TUG) test (Correct answer)
- Berg Balance Scale only
- SF-36 alone
Correct answer: Timed Up and Go (TUG) test
The Timed Up and Go test is a validated, widely used functional mobility assessment appropriate for prosthetic users.
Question 4: A pediatric prosthetic patient's parent reports the child has outgrown the socket after 3 months. What growth accommodation strategy should be employed?
- Wait until growth stabilizes before refitting
- Use a flexible inner socket with adjustable frame (Correct answer)
- Prescribe the largest adult size available
- Apply additional padding to the existing socket
Correct answer: Use a flexible inner socket with adjustable frame
A flexible inner socket with an adjustable frame allows for periodic adjustments to accommodate rapid pediatric growth.
Question 5: At a 3-month follow-up, a transfemoral amputee reports knee instability during stance phase. The most likely cause is:
- Excessive knee flexion moment from socket alignment (Correct answer)
- Weakness of the contralateral hip abductors
- Prosthetic foot dorsiflexion stiffness
- Excessive socket adduction angle
Correct answer: Excessive knee flexion moment from socket alignment
Knee instability during stance in a transfemoral amputee is most commonly related to alignment creating excessive knee flexion moment.
Question 6: During a follow-up session, a patient indicates they cannot don their prosthesis independently. Which intervention addresses this issue most directly?
- Modify the socket trim lines
- Provide dressing aids and repeated donning training (Correct answer)
- Recommend a different suspension system
- Refer immediately to occupational therapy without further assessment
Correct answer: Provide dressing aids and repeated donning training
Providing dressing aids and repeated donning training directly addresses independence in prosthesis application.
Question 7: A patient presents at a follow-up with skin breakdown at the distal tibia. The practitioner notes the socket has a hard distal end. The appropriate modification is:
- Trim the socket brim proximally
- Add distal cushioning or fabricate a cushion liner (Correct answer)
- Increase suspension suction
- Shorten the pylon by 5 mm
Correct answer: Add distal cushioning or fabricate a cushion liner
Distal tibial skin breakdown from a hard socket end is addressed by adding cushioning material or a cushioned liner to distribute pressure.
CPO Patient Management & Follow-Up 2
During a follow-up visit, a transtibial amputee reports that their residual limb has decreased in volume since fitting.
What is the most appropriate initial intervention?