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Self-Assessment Examination

JPO SELF-ASSESSMENT EXAMINATION

JPO Journal of Prosthetics and Orthotics: July 2011 - Volume 23 - Issue 3 - p 141-143
doi: 10.1097/JPO.0b013e3182290902
  • Free

TO EARN TWO PCE CREDITS:

  1. Read the article on pages 124–140.
  2. Complete the examination.
  3. Submit your completed examination to the AAOP per the directions on the next page.

DIRECTIONS:

The following questions require short answers only; you do not have to use complete sentences. All questions refer to the article, “An Investigation of Comfort Level Trend Differences between the Hands-on Patellar Tendon Bearing and Hands-off Hydrocast Transtibial Prosthetic Sockets” by Stephan Manucharian, M A, MSc., CP, BOCO.

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Quiz – An Investigation of Comfort Level Trend Differences between the Hands-on Patellar Tendon Bearing and Hands-off Hydrocast Transtibial Prosthetic Sockets, Stephan Manucharian, M A, MSc., CP, BOCO.

Two prevalent and contrasting approaches to transtibial socket manufacture currently employed by prosthetists include the Patellar Tendon Bearing (PTB) and Hydrocast Total Surface Bearing designs. This study compared socket comfort levels for both socket types. The results revealed higher comfort levels for PTB socket users.

This study compares the comfort levels of each socket type at initial fitting and at a one month follow-up visit using the Socket Comfort Score outcome tool. The PTB socket users reported higher overall comfort scores at both intervals than the HCTSB users. Other clinically relevant findings were also reported. Change in prosthetic socket type for the user was strongly correlated with a decrease in comfort level for both groups. Additionally, less time since amputation resulted in decreased comfort scores for the PTB socket group and prosthetic adjustments resulted in decreased comfort scores for both groups.

1. The Symposium on Below Knee Prosthetics at the University of California Berkeley Biomechanics Laboratory in 1957, the subsequent introduction of the patellar tendon bearing socket design, and the introduction of a total contact theory changed the clinical approach of designing transtibial prostheses in all of the following ways except:

A. Sockets were designed with distal contact.

B. Joints and thigh lacers were used less frequently.

C. Primary weight distribution in the socket was transferred proximal to the knee.

D. Weight-tolerant areas of the residual limb were identified and preferentially utilized for weight-bearing.

2. The author reports many advantages of using a hydrostatic socket design process. Which of the following is not listed as a benefit of the hydrostatic socket design process?

A. The positive model has a high level of repeatability.

B. The technical skill of the practitioner is less important.

C. Less equipment is required than manual casting techniques.

D. The positive model normally does not require substantial rectification.

3. All of the following approaches of fabricating sockets represent an attempt at the direct method of designing a prosthetic socket except:

A. SocketCone™ technology

B. CIR sand casting system

C. Manual plaster casting of a negative model

D. ICECAST® and ICEX® casting and fabrication systems

4. Which of the following outcome measurement tools did the researcher deem most appropriate for evaluating socket comfort for this study?

A. Socket Comfort Score (SCS)

B. Satisfaction with Prosthesis (SATPRO)

C. Prosthesis Evaluation Questionnaire (PEQ)

D. Trinity Amputation and Prosthetic Experience Scales (TAPES)

5. Which of the following conditions would not have excluded a patient from this study?

A. Peripheral vascular disease

B. A contralateral Syme's amputation

C. An open lesion over the distal tibia

D. No prior experience with prosthetic use

6. Which of the following techniques deviates from the casting protocol outlined for use in this study?

A. Apply tube gauze around the patient's limb prior to casting.

B. Apply a silicone liner prior to inserting the limb into the pressure cast tank.

C. Ensure that right and left superior iliac spines are level while obtaining the plaster cast.

D. Obtain impression with patient standing and bearing 50% of body weight through the residual limb.

7. Which variable tested showed a significant relationship with socket comfort in the HCTSB socket group?

A. Activity level

B. Cause of amputation

C. Previous socket type

D. Time since amputation

8. Which statement best summarizes the results of this study regarding subjects whose socket type had not changed?

A. They reported higher initial and final socket comfort levels than participants who had changed sockets.

B. They reported socket comfort levels that were comparable to those of the subjects who changed sockets.

C. Initial socket comfort levels were lower, but final socket comfort levels were higher than subjects who changed sockets.

D. Their initial socket comfort levels were higher, but final socket comfort levels were comparable to subjects who changed sockets.

9. Which of the following groups showed a decrease in the mean socket comfort level from initial fitting to final assessment?

A. Only PTB socket users who received no adjustments.

B. Only HCTSB socket users who received no adjustments.

C. Both PTB socket users and HCTSB socket users who received no adjustments.

D. Both PTB socket users and HCTSB socket users who received one or more adjustments.

10. Which of the following statements accurately describes the results of this study with regard to the comfort level of the two socket types tested?

A. The PTB socket group reported higher comfort at both initial and final assessments.

B. The HTCSB socket group reported higher comfort at both the initial and final assessments.

C. The PTB socket group reported higher initial comfort, while the HCTSB group reported higher final comfort.

D. The HCTSB socket group reported higher initial comfort, while the PTB socket group reported higher final comfort.

Complete the JPO Self-Assessment Examination on the previous page and score a minimum of 75 percent to earn two PCE credits. Send the completed examination and payment in U.S. currency ($20/AAOP members, $50 nonmembers) to: AAOP, 1331 H Street, NW, Suite 501, Washington, DC 20005. The examination must be received by the AAOP within 3 years of the publication date for credit to be awarded.

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© 2011 American Academy of Orthotists & Prosthetists