AMPUTEE SELECTION-ASSESSMENT & EXAMINATION

SUMMARY

The decision to begin a prosthetic program is multi-disciplinary: vascular, rehabilitation medical specialists, PT/OT, prosthetist, nursing staff. Assess the following:

MEDICAL ISSUES
1. Length, shape & healing of the stump.
2. Health of the contralateral limb.
3. Ipsilateral, contralateral knee & hip ROM & strength, assess for contractures.
4. Stump & contralateral leg sensory examination.
5. Ability to STS on one leg with/without walking aid.
6. Comorbidities: patient does not have other conditions that may prevent prosthetic use or training such as poor cardiovascular function, severe PVD, ulcers on the intact foot that may prevent weight-bearing.

PT ISSUES
7. UL ROM & function: shoulder pathology, pain can interfere with mobility and transfers.
8. ROM in the residual limb: patient has sufficient ROM in the residual limb. For TTA < 20^o knee flexion contracture, TFA < 10^o hip flexion contracture.
9. Strength in the residual limb: patient has sufficient strength on the intact side to begin training, able to stand up with minimal assistance; ability to hop with a walking aid is advantageous but not essential.

OT ISSUES
10. Premorbid mobility levels: if the client could not walk prior to the amputation, then they may not be able to walk after the amputation. the exception being that they could not walk due to pain or deformity prior to the amputation.
11. Functional issues: premorbid ADLs (can’t go home without achieving these!); instrumental ADLs (can get others to do these!).

COGNITION/PSYCHOLOGICAL ISSUES
12. Cognitive function: the patient should be able to understand and learn tasks such as gait training and safety.
13. Vision: essential for ambulation.
14. Language barriers: can the patient understand instructions in English or require an interpreter?
15. Attitude and motivation: important for prosthetic use, training, care and safety.

SOCIAL ISSUES
16. Social support: ensure that the patient has sufficient support available for prosthetic use and training.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.