Phantom Limb Pain Insights
45 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is Phantom Limb Pain primarily described as?

  • An inability to move the remaining limb
  • A painful sensation in an amputated body part (correct)
  • A numb feeling in the opposite limb
  • A dull ache in the remaining limb

    • Which of the following is a commonly reported figure for the percentage of patients affected by Phantom Limb Pain after amputation?

  • 75 - 90%
  • 25 - 50%
  • 15 - 30%
  • 50 - 85% (correct)

    • What is suggested as a potential risk factor for developing Phantom Limb Pain?

  • Frequent use of pain medication
  • Low physical activity
  • Psychological distress (correct)
  • Advanced age

    • What type of therapy has been shown to potentially reduce Phantom Limb Pain?

    <p>Mirror Therapy</p> Signup and view all the answers

    What was a key observation in a case study regarding Mirror Therapy and Phantom Limb Pain?

    <p>It led to significant relief and increased motor control</p> Signup and view all the answers

    What was the main outcome measured after the intervention for Jim?

    <p>Improved range of motion</p> Signup and view all the answers

    What contributed to Jim's difficulties in completing tasks?

    <p>Limited range of motion</p> Signup and view all the answers

    Which of the following was NOT mentioned as a benefit Jim experienced post-intervention?

    <p>Enhanced wheelchair dependence</p> Signup and view all the answers

    What was noted as a crucial factor for Jim's safety during exercise?

    <p>Access to a walker</p> Signup and view all the answers

    What change in mental health aspect was observed in Jim after the intervention?

    <p>Positive shift in mental health</p> Signup and view all the answers

    What exercise technique was employed to address Jim's fitness post-amputation?

    <p>Detailed fitness plan with slow progression</p> Signup and view all the answers

    What remained a significant consideration when prescribing exercises for Jim?

    <p>Continual safety considerations due to his amputation</p> Signup and view all the answers

    Which of the following factors contributed most significantly to Jim's progress?

    <p>Improvement in muscle strength across all categories</p> Signup and view all the answers

    What is a primary goal for individuals using a transtibial prosthesis?

    <p>Achieve independence in daily tasks</p> Signup and view all the answers

    Which factor can impede Jim's ability to fully engage in his rehabilitation program?

    <p>Fear of reintegrating activities</p> Signup and view all the answers

    What ongoing education is essential for managing diabetes and PAD?

    <p>Diet and glucose control</p> Signup and view all the answers

    What kind of training does the advanced mobility section focus on?

    <p>Advanced gait training</p> Signup and view all the answers

    What is one challenge associated with adapting to a transtibial prosthesis?

    <p>Limited mobility and daily task difficulties</p> Signup and view all the answers

    What are the recommended physical activities during advanced mobility stages?

    <p>Obstacle course practice</p> Signup and view all the answers

    What personal factor is crucial for Jim's success in rehabilitation?

    <p>Desire for higher levels of independence</p> Signup and view all the answers

    What specific health consideration should be monitored to manage PAD progression?

    <p>Vascular health through check-ups</p> Signup and view all the answers

    What is the suggested duration for stationary cycling during cardiovascular training?

    <p>10–15 minutes</p> Signup and view all the answers

    How often should single-leg balance exercises on a prosthetic leg be performed each week?

    <p>3 times per week</p> Signup and view all the answers

    Which exercise is recommended for upper body strength training?

    <p>Resistance Band Rows</p> Signup and view all the answers

    What is the recommended approach to improve stability on uneven surfaces?

    <p>Walking on uneven surfaces for 5–10 minutes, 3 times per week</p> Signup and view all the answers

    What type of therapy is suggested for low-impact cardiovascular conditioning?

    <p>Swimming or Aquatic Therapy</p> Signup and view all the answers

    What is a common requirement for an individual who can independently perform daily tasks?

    <p>They require occasional assistance with complex tasks</p> Signup and view all the answers

    How many sets and repetitions are recommended for lunges in strength training?

    <p>2 sets of 10 reps</p> Signup and view all the answers

    What is one goal of joining an amputee support group?

    <p>To build social connections and reinforce motivation</p> Signup and view all the answers

    What contributes significantly to improved functional performance in patients with lower limb issues?

    <p>Weight bearing and walking training</p> Signup and view all the answers

    What is a noted benefit of prosthetic use in unstable conditions?

    <p>Improvement in reactive balance</p> Signup and view all the answers

    Which statement accurately reflects mental health improvements post-rehabilitation?

    <p>Significant improvement in mental health correlates with motivation enhancements.</p> Signup and view all the answers

    How are community programs beneficial for individuals with mobility issues?

    <p>They provide resources for adaptive sports and social networks.</p> Signup and view all the answers

    What does a complete rehabilitation plan aim to restore?

    <p>Comprehensive functionality and strength across systems</p> Signup and view all the answers

    Which mobility skill can an individual attain through successful rehabilitation?

    <p>Walking independently on varying surfaces</p> Signup and view all the answers

    What aspect of rehabilitation is highlighted in relation to the core and upper body?

    <p>Increased stability and strength enhancement</p> Signup and view all the answers

    Which of these accurately describes advanced mobility tasks post-rehabilitation?

    <p>They demonstrate independence in various environments.</p> Signup and view all the answers

    What is one of the key therapies mentioned for managing phantom limb pain?

    <p>Mirror Therapy</p> Signup and view all the answers

    Which of the following conditions is most commonly related to the need for bilateral lower limb amputations in the discussed case report?

    <p>Dry gangrene</p> Signup and view all the answers

    During which activity was energy expenditure of below-knee amputees studied?

    <p>Harness-Supported Treadmill Ambulation</p> Signup and view all the answers

    What type of rehabilitation information does the Merck Manual provide about limb amputation?

    <p>Post-amputation rehabilitation</p> Signup and view all the answers

    In recent trends of limb amputation, which factors were assessed in relation to amputations in Saskatchewan, Canada?

    <p>Type and level of amputation</p> Signup and view all the answers

    What advantage does harness-supported treadmill training have over conventional training methods for amputees?

    <p>Enhanced mobility and balance</p> Signup and view all the answers

    What is a common psychological benefit of mirror therapy for amputees?

    <p>Improved body image</p> Signup and view all the answers

    Which study predominantly looks into the factors related to lower extremity prosthesis use?

    <p>Duration and frequency of prosthesis use</p> Signup and view all the answers

    Study Notes

    Amputations

    • Amputation is surgery to remove all or part of a body appendage, commonly a limb or extremity (arm, leg, hand, or foot).

    Types of Amputations

    • Upper Body: Shoulder disarticulation, elbow disarticulation, hip disarticulation, knee disarticulation, ankle disarticulation, partial foot.
    • Lower Body: Forequarter, above elbow, below elbow, partial hand (transcarpal), hand and wrist disarticulation, hemipelvectomy, above knee (transfemoral), below knee (transtobial), Syme's.

    Etiology

    • Diabetes and other vascular diseases (peripheral artery disease)
    • Traumatic incidents
    • Congenital limb deformities
    • Cancer (bone cancer)
    • In Canada, diabetes is the primary cause of lower limb amputations.

    Prevalence of Lower Limb Amputations (LLA)

    • Between 2006 and 2011, 44,430 amputations were performed in Canada.
    • Little variation in LLA numbers year to year.
    • Average age of LLA patients is 65, with 54.9% between 50 and 74 years old
    • 68.8% of those undergoing LLA were male.
    • Transtibial amputations make up 30.9% of all LLA.
    • LLA in BC represent 10% of all cases in Canada.
    • Upper limb amputations are much less prevalent and studied compared to lower limb amputations.

    Case Study: Jim

    • 68-year-old African American male
    • Low-income, limited access to healthcare
    • Diagnosed with Type 2 diabetes
    • Peripheral artery disease
    • Peripheral neuropathy
    • Long history of smoking
    • Minimal physical activity
    • Infected ulcer
    • Undergone surgical removal

    Research Informed Timeline

    • Rehabilitation stages are broken down into weeks based on research.
    • The ICF model, exercise interventions, physical, mental, and social characteristics are addressed according to their prominence at each stage.
    •  Stages: Acute post-operative, pre-prosthetic phase, prosthetic training phase, and advanced mobility/community reintegration.

    Stage 1: Acute Post-Operative

    • Focuses on the immediate recovery period immediately after amputation.
    • Identifying goals for this stage is important.
    • Time line is crucial.

    Medications

    • Various medications are applied for pain relief, including NMDA-antagonists, antidepressants, opioids, anticonvulsants, hormones, and antihypertensives.
    • Different mechanisms of actions and potential benefits and side effects are described.
    • Medications specific for Jim are explored.
    • Types of pain experienced are noted

    Stage 2: Pre-Prosthetic Training (Weeks 4 - 8)

    • Communication, goal planning, teamwork with the patient
    • Specific, tested training plans aimed at improving muscle strength and range of motion.
    • Preparing the patient for prosthesis use.
    • Improving capacity for day-to-day tasks.
    • Goals, expectations and anticipated difficulties are laid out.

    Exercises

    • Many different exercises are listed for strengthening muscles, promoting mobility and balance, performing gait training, maintaining posture and increasing endurance.
    • Detailed procedures for many exercises.

    ICF Model

    • A model for understanding how health conditions affect activities and participation.
    • The model is applied to help Jim with his amputation.
    • Includes health conditions, body functions, activities and participation, environmental and personal factors relevant to his case.
    • Onset of depression, low self-esteem, decreasing motivation, hopelessness and other mental factors.
    • Associated with: prosthesis use/availability, perceived social support, and functionality levels

    Duration, Frequency and Factors Associated With Prosthesis Use

    • Decreased symptoms of depression.
    • Improved self-esteem.
    • Beliefs that physical symptoms are stable, and treatment will be successful.
    • Better prosthesis use scores relate to better mental health.
    • Stronger positive correlation between mobility and well-being.
    • Prosthesis use can prevent sedentary lifestyle and obesity.

    Quality of Life Following a Lower Limb Amputation in Diabetic Patients

    • 86-person study group, with diabetes and a diabetic foot ulcer
    • 73.3% male patients, mean age of 63
    • Hospital Anxiety and Depression Scale, Barthel Index, Satisfaction with Social Support Scale, and Short Form Health Survey results used to evaluate quality of life after amputation.
    • Perceived social support and functionality have effects on patients.
    • Early untreated anxiety can impact rehabilitation.
    • Trauma can affect the physical component score.
    • Appropriate psychological support from professionals in the area with amputees is crucial.
    • Exercise interventions should be goal-oriented.

    Stage 3: Initial Prosthetic Training (Weeks 8-12)

    • Gait training, weight-bearing, functional movement.
    • Mirror therapy to treat phantom limb pain.
    • Client gains additional independence and incorporates prosthesis into daily life.
    • Different types of lower limb prostheses are listed, including hemipelvectomy, hip disarticulation, transfemoral, transtibial and Syme's.

    Transtibial or Below-Knee Prosthesis

    •  Image of a transtibial or below-knee prosthesis is included.

    Strengthening, Gait and Balance, and Functional Mobility and Endurance

    • Detailed description of strengthening exercises (core, oblique twists, lower body, etc.).
    • Detailed description of gait and balance training (weight shifting, heel-to-toe walking, uneven surfaces etc).
    • Detailed description of functional mobility and endurance (walking with assistive devices, stair climbing, etc.).

    Phantom Limb Pain

    • Phantom Limb Pain is a type of pain felt in a limb that's been amputated, with sensations described as crushing, burning, tingling, or shooting.

    Mirror Therapy and Phantom Limb Pain

    • Mirror therapy can help reduce phantom limb pain, by giving a low cost, alternative form of pain relief.
    • There is a lack of understanding of the mechanisms underlying the therapy.
    • Significant relief from phantom limb pain, and increased motor control is noted in some case studies.

    Stage 4: Advanced Mobility and Community Reintegration (Weeks 17+)

    • Achieves independence in daily tasks.
    • Enhances community participation.
    • Continues long-term health management.

    Advanced Rehabilitation

    • Lifestyle adjustments, emphasizing diabetes and PAD management, and seeking support from community.
    • Advanced gait training involving obstacle courses, uneven surfaces.
    • Cardiovascular and endurance training (stationary cycling, swimming).
    • Strength training for core, legs, and upper body.

    ICF Model Development

    • Muscle atrophy has improved considerably.
    • Significant improvement in mobility, activities, participation and independent living in many ways.

    Research

    • Weight-bearing and walking training improves functional performance.
    • Dynamic activities with prosthesis improve balance reaction.
    • Physiotherapy rehabilitation plans restore strength, range of motion and improved surrounding systems.

    Continual Safety Considerations

    • Cardiovascular endurance, pain, and balance remain limitations despite functional progress, hence safety measures may need to be considered.
    • Alternative exercise methods (harness-supported treadmills) provide safer cardiovascular option compared to unsupervised methods.

    Physiotherapy Intervention

    • Explains the holistic treatment approach for patients.
    • Programs focus on strengthening exercises, gait training, and functional activities.

    Stage 3: Initial Prosthetic Training (Weeks 8-12)

    • Focused on gait, weight bearing, and functional movement
    • Mirror Therapy for Phantom Limb Pain
    • Develops independence and incorporates prosthesis into daily activities

    Other Important Considerations

    • Manual muscle testing results showing improved strength in the affected limb.
    • Significant improvements in range of motion in the affected limb.
    • Describes practical applications and specific exercises for these phases.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Amputations Slides (Spencer et al, 2024) PDF

    Description

    Test your knowledge on Phantom Limb Pain, including its definition, occurrence rates, risk factors, and therapeutic approaches. This quiz also explores findings from case studies, such as the effects of Mirror Therapy on management of this condition.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser