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A 34-year-old female undergoes open reduction and internal fixation (ORIF) for the left lower extremity injury shown in Figures A-C. Her postoperative weight bearing protocol includes touch down weight bearing to the left lower extremity. Which of the following ambulatory support devices is most appropriate for this patient?
Double axillary crutch
Single forearm (Lofstrand) crutch
Single axillary crutch
Single platform crutch
Select Answer to see Preferred Response
A 32-year-old man has difficulty walking 5 months after having an amputation as shown in Figure A. Gait analysis reveals a shortened stance phase and irregular toe off on the operative extremity. Which of the following would most likely improve his ambulation?
Solid ankle ankle-foot orthosis
University of California Biomechanics Laboratory (UCBL) insert
Full-length steel shank shoe modification
Full-length steel shank and rocker sole shoe modification
The pattern of ambulation shown with the assistive device in Video A is most appropriately described as which of the following?
Which of the following is an example of an antalgic gait pattern not typically seen in clinical practice?
Patient's knee is maintained in slight flexion throughout the stance period for ipsilateral knee arthritis
Patient's contralateral step length is shortened with ipsilateral ankle arthritis
Patient leans their trunk laterally over the painful leg during stance phase with ipsilateral hip arthritis
Patient ambulates on their toes with an ipsilateral calcaneal stress fracture
Patient ambulates predominately through the heel for ipsilateral knee arthritis
A prosthetic polycentric knee with hydraulic swing control is chosen for a very active 63-year-old transfemoral amputee. All of the following appropriately describe the features of this prosthesis EXCEPT:
Flexes in a controlled manner
Ability to walk at a moderately fast pace
Knee center of rotation is fixed anterior to the line of weight bearing
Weighs more than a constant friction knee that has a manual extension locking mechanism
Patients with transradial amputations are considered the best candidates for a myoelectric prosthesis. Each of the following are advantages of a myoelectric device compared to a body controlled device EXCEPT:
Provide more proximal function
More sensory feedback
Can be used in any position including overhead activities
Require less gross limb movement
A 34-year-old male is an inpatient at a rehabilitation hospital after sustaining severe lower extremity injuries in a motor vehicle collision. As a result, his energy expenditure while ambulating is 40% above baseline after being fitted with an appropriate prosthetic prescription. What is this patient's most likely lower extremity amputation level?
Unilateral long transtibial
Unilateral average transtibial
All of the following are advantages of a body-controlled prosthesis compared to a myoelectric prosthesis for patients with upper extremity amputations EXCEPT:
Better for heavy labor activities
Decreased amount of harnessing
Decreased amount of therapy for training
Less prosthetic maintenance
In consideration of a prosthetic knee, each of the following are advantages of choosing a polycentric knee with fluid control over a constant friction knee EXCEPT:
Allows variations in cadence
Flexes in a more controlled manner
Lighter in weight
Improved stance control allows less energy expenditure
Overall length of the limb is shortened during initiation of a step reducing the risk of stumbling
A 45-year-old patient with a below knee amputation is interested in hiking as a hobby. He would like to know more about his SACH foot before selecting a different terminal device. A SACH foot or non-dynamic response (non-energy storing) foot, as compared to the dynamic response foot (energy storing) demonstrates all of the the following EXCEPT:
Less frequent replacement
Longer duration midstance of gait
Increased ground reaction forces to the contralateral limb
Diminished maximal gait velocity
Which of the following amputations has the LEAST increase in metabolic demand for walking compared to a healthy patient without amputation?
Traumatic transtibial amputation
Vascular transtibial amputation
Vascular thru-knee amputation
Traumatic transfemoral amputation
Vascular transfemoral amputation
Closed-chain exercise differs from open-chain exercise in which of the following ways?
Distal portion of the extremity is free during exercise
More commonly used in upper extremity exercise
Predictable movement is produced by co-contraction of muscles
Joint compression is decreased
Usually involves a single joint
What type of exercise is used early in the rehabilitation process to safely stimulate co-contraction of the scapular and rotator cuff muscles?
Resistive active motion
Facilitated active motion
Open kinetic chain
Closed kinetic chain
A 44-year-old male with transtibial amputation is interested in doing more hiking as a hobby, however he has had difficulty negotiating uneven terrain with a solid-ankle, cushioned-heel (SACH) prosthetic foot. Which of the following modifications to the new prosthesis is most appropriate?
Single axis foot
Shortened keel articulated dynamic-response foot
Lengthened keel articulated dynamic-response foot
Sagittal split keel articulated dynamic-response foot
Rigid keel nonarticulated dynamic-response foot
A 35-year-old woman with a transtibial prosthesis is seen to have knee buckling (i.e "drop-off") during terminal stance. What prosthetic modification would correct this problem?
Dorsiflex prosthetic foot
Move foot more posterior
Increase flexibility/softness of keel
Move toe break of prosthesis more posterior
Move foot more anterior
A 27-year-old patient comes in for a new prescription for his below knee amputation prosthesis because it is not fitting properly. All of the following are complaints and examination findings consistent with a prosthetic foot that is placed too far inset EXCEPT:
Socket pain located medial and proximal
Increased knee extension during stance
Socket pain located lateral and distal
A prosthetic foot which incorporates a multi-axis articulated foot assembly is recommended for which of the following amputees?
Low functioning diabetic who needs to transfer bed to chair
Long distance runner with below knee amputation
Elderly male with above knee amputation
Below knee amputee who needs to regularly walk on uneven ground
10-year-old male with above knee amputation from osteosarcoma
What is the most important factor when choosing an optimal lower limb prosthesis for an adult patient?
Patient functional status