Prescription Topic #1BK
Description
Collection
Title:
Prescription Topic #1BK
Text:
I am a CP in a VA hospital setting trying to establish and bring progressive
prescription criteria to our clinic and several others in our VISN (a three
state multi-clinic group) I have a SEVERAL topics in mind but will introduce
them one at a time over the next couple of months.
We know that you can give a peg leg to somebody and they can make it work.
I am looking for prescriptions that OPTIMIZE a persons ability to
successfully ambulate.
I am looking for progressive prosthetists' considered opinions and experience
about several topics which I will be posting. I would like your name and, if
available, any references you might site for additional justification.
These are my (current) opinions and I am soliciting support as well as a
difference of opinion.
I would like to present proposals that reflect more than my PERSONAL opinion.
Topic #1 BK
It is my belief that the only time a sach foot should be given is for a
patient that
is using a leg to transfer or to ambulate a few steps within the house. I
question whether you have real plantarflexion with the soft heel, and the
hard keel does not make for the smoothest rollover.
If the patient is a bilateral they should have two, not just one, to make
transferring easier.
If the patient is ambulatory we should, at the very least, give them a
flexible keel and OPTIMALLY give a foot that has ankle motion.
I think ankle motion is more important than dynamic response although both
would be preferable to the person capable of loading the keel.
A single axis foot which INCLUDES front bumpers can be considered for a BK
but multiaxial is preferred.
The first dynamic response feet were the created in response to the sach
foot and should be limited to those requiring a zero maintenance foot and are
capable of loading the foot.
The more modern dynamic response feet with ankle motion should be the
preferred foot for most reasonably active people.
We should be using shock pylons on most new ambulating amputees if the foot
doesn't incorporate sufficient shock absorption and the patient doesn't have
much tissue to pad his limb.
I prescribe like it was for my relative. I would like to establish what is
optimal and then factor in patient's compliance, and then cost limitations.
Thank you for your opinions and help in clarifying my thoughts
Respectfully,
Mark Benveniste CP
prescription criteria to our clinic and several others in our VISN (a three
state multi-clinic group) I have a SEVERAL topics in mind but will introduce
them one at a time over the next couple of months.
We know that you can give a peg leg to somebody and they can make it work.
I am looking for prescriptions that OPTIMIZE a persons ability to
successfully ambulate.
I am looking for progressive prosthetists' considered opinions and experience
about several topics which I will be posting. I would like your name and, if
available, any references you might site for additional justification.
These are my (current) opinions and I am soliciting support as well as a
difference of opinion.
I would like to present proposals that reflect more than my PERSONAL opinion.
Topic #1 BK
It is my belief that the only time a sach foot should be given is for a
patient that
is using a leg to transfer or to ambulate a few steps within the house. I
question whether you have real plantarflexion with the soft heel, and the
hard keel does not make for the smoothest rollover.
If the patient is a bilateral they should have two, not just one, to make
transferring easier.
If the patient is ambulatory we should, at the very least, give them a
flexible keel and OPTIMALLY give a foot that has ankle motion.
I think ankle motion is more important than dynamic response although both
would be preferable to the person capable of loading the keel.
A single axis foot which INCLUDES front bumpers can be considered for a BK
but multiaxial is preferred.
The first dynamic response feet were the created in response to the sach
foot and should be limited to those requiring a zero maintenance foot and are
capable of loading the foot.
The more modern dynamic response feet with ankle motion should be the
preferred foot for most reasonably active people.
We should be using shock pylons on most new ambulating amputees if the foot
doesn't incorporate sufficient shock absorption and the patient doesn't have
much tissue to pad his limb.
I prescribe like it was for my relative. I would like to establish what is
optimal and then factor in patient's compliance, and then cost limitations.
Thank you for your opinions and help in clarifying my thoughts
Respectfully,
Mark Benveniste CP
Citation
“Prescription Topic #1BK,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/211646.
