1. Part 1: Assessment for Prosthetic Use & Stump Management

2.  Obtain pertinent subjective information from a patient with amputation  Perform stump assessment on a patient with amputation  Perform prosthetic check-out ◦ Static ◦ Dynamic ◦ Functional Ax

3. Patient information  Demographic data  Diagnosis  Subjective information  Personal / Social history

4.  Diabetes  Heart condition  High blood pressure  Medications

5.  Living Status  Living conditions  Profession  Normal Daily activities  Recreation activities

7.  Anthropometric measurements  Knee stability  Shape of the stump  Incision  Skin  Bones  Subcutaneous tissue  Sensation  Phantom sensation / pain  Condition of the remaining lower extremity

8.  Length Measurements  Girth Measurements

9.  Cylindrical  Conical  Bulbous

10.  Location  Condition ◦ Inflammation? Open area? Scabbed area? Adhesions? Blisters?

11.  Delicate  Average  Tough

12.  Heavy  Average  Light

13.  Light touch  Dull / Sharp pain  Visual skin inspection

14.  Vascularity  Sensation  Skin  ROM  Muscle strength

16. Below-knee prosthetic users  Is the prosthesis as prescribed?  Is the patient experiencing discomfort while standing with equal weight on each side with the feet 4-6 inches apart?  Is the length of the prosthesis correct?

17. Below-knee prosthetic users  Is the knee stable without feeling pushed into excessive flexion and extension?  Is suspension adequate?  Can the patient sit comfortably with the knee flexed 90deg and shoe flat on the floor?

18. Above-knee prosthetic users  Is the ischial tuberosity properly located within the socket?  Is adductor longus channel properly located in the socket?  Is the knee unit stable on weight bearing?

19. Above-knee prosthetic users  Is suspension adequate to minimize pistoning of the residual limb when prosthesis is raised off the floor  Does the socket maintain its position on the residual limb in sitting?  Do the lengths of the prosthetic leg and thigh section approximate those of the sound side?

20. Above-knee prosthetic users  Does the knee remain flexed in sitting?  Does the patient experience pressure on the posterior thigh?

21.  Are the forces appropriately distributed over the residual limb? ◦ Discoloration ◦ Skin breakdown

22.  Groin area  Distal end  Suspension system  Weight of the prosthesis  Donning and doffing  Fatigue

23.  Ability of prosthesis to keep up with activities  Balance  Transfers  Ambulation ◦ Indoor ◦ Outdoor ◦ Speed ◦ Stairs

24.  Evaluate skills that the patient need to have in order to perform daily tasks  Frequency of performance of said tasks  Measures and considerations with regards the environment ◦ Environmental Ax ◦ Barriers?

25.  Ask if patient can do the task and if he can demonstrate  Safety issues

26.  Confidence of patient in using the prosthesis  Resemblance to sound side  Use of other assistive device  Injuries acquired  Other patient concerns

27.  Other members of the prosthesis team

28.  O’ Sullivan, A. & Schmitz, T. (2007). Physical Rehabilitation: Assessment & Treatment 5 th Ed. Philadelphia, F.A. Davis Company.  Patrick, D.G. (1995). Prosthetics. In R.S. Myers (Ed.) Saunders Manual of Physical Practice. USA: WB Saunders Co.  Mariano, L.M.M.Jr. (2007). PT150 archives.