Module Group 3

Occupational therapist to visit and to advise on minimising obstacles.

To increase balance, tolerance and weight transference; To increase shoulder and elbow movement and lateral trunk rotation; To develop bilateral hand/eye co-ordination; To develop upper body strength; To maintain or regain interactive group skills

Woodwork; gardening; stool seating; kitchen activities; darts & snooker; using a printing press or sewing machine

By domiciliary visits by the occupational therapist, patient and community occupational therapist

Ensuring a contract point is in place at time of discharge. To organise home adaption prior to discharge

For lower limb amputee with trans-tibial amputation the PTB is normaly prescribed. This design permits full weight bearing upon the socket, is often self suspending and is reasonably lightweight and cosmetic in appearance.

Externally applied device used to replace wholly, or part, an absent or deficient limb segment

Comfortable waist belt and socket. A mechanical knee that will lock to provide stability, altough it requires more energy to walk than with a flexible knee, and early mobilisation.

Hook, hands, terminal devices such as tools, eating utensils etc.

Cord operated myoelectric devices, hybrid devices, electrical devices.

To reduce feelings of isolation and handicap

When a prosthesis has been fitted, and the patient's home has been assessed

For maintanance and provision of prosthesis, for stump and prosthetic review and for assessment and monitoring of how a patient is managing at home.

Comfort; Function; Cosmesis

shaoe and color also feel or texture of the surface of the prosthesis

The principal objective to conceal the disability of the patient's gait-pattern.

Interface components; functional components; alignment components; structural components; cosmetic components

Comfort; Function; Cosmesis

Interface components; functional components; alignment components; structural components; cosmetic components

socket and the suspensory components

support; stabilisation; suspension

Anchoring the socket to the underlying anatomy and this may require the socket shape to be adjustable by means of removable sections or splits to permit doffing and donning. Often in knee disarticulation

Creating a socket with a closed end which will resist removal by virtue of the pressure diffential which would result from such action. More common in shaft amputations. Adhesion between the stump and the inner socket wall may contribute additionally to suspension.

Support; stabilisation; suspension

Proximal support Distal support

Silicon; Urethane or Polymer gel

a= Reduced magnitude of forces b= Wide based gait

Substitute for some of the dynamic and sensory attributes of the normal limb. The need to bear the weight and to allow controll movement.

Ankle-foot devices; knee units; hip units

To bear the weight of the amputee and to allow controlled movement of the joints

simplest articulated ankle foot design. The normal ankle joint motion is replaced with a simple hinge joint allowing rotation in the sagittal plane only and control is achieved by rubber bumpers. The shock loads at heel contact are reduced by allowing some plantarflexion resisted by the plantarflexion bumper. The movement at roll over is allowed by movement of the joint. Dorsiflexion is resisted during push off by the dorsiflexion stop.

more complex mechanical joint which, as well as permitting dorsiflesxion/plantarflexion, allows for some inversion/eversion and interal/external rotation.

can be divided into those with a rigid ankle and those with a flexible ankle.

Ankle mechanism is made of a flexible material which deforms to replicate ankle movement