Clinical reasoning (temp only)

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Amputee

D1 Co-morbitity

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? No = D1

D1 treatment
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amputee

D2 Query ability to use prothesis

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? No = D2


D2 treatment
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amputee

D3 Unhealthy Stump

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection No = D3

D3 treatment
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amputee

D4 Oedematous Stump

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? Yes = D4

D4 treatment
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amputee

D5 Unheathy Scar

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? No = D5

D5 treatment
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amputee

D6 Painful stump

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? Yes = D6

D6 treatment
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amputee

D7 Reduced Hip Range of movement

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? Yes = D7

D7 treatment
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amputee

D8 Reduced hip strength

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? Yes = D8

D8 treatment
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amputee

D9 Reduced knee Range of movement

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? Yes = D9

D9 treatment
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amputee

D10 Reduced knee strength

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? Yes = D10

D10 treatment
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amputee

D11 Reduced Ankle Range of movement

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? No = go 12


test

12: Does the ankle have reduced ROM? Yes = D11

D11 treatment
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amputee

D12 Reduced ankle strength

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? No = go 12


test

12: Does the ankle have reduced ROM? No = go 13


test

13: Does the ankle have reduced power? Yes = D12

D12 treatment
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amputee

D13 Reduced range of movement upper limb

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? No = go 12


test

12: Does the ankle have reduced ROM? No = go 13


test

13: Does the ankle have reduced power? No = go 14


test

14: Does either arm have reduced ROM at either shoulder, elbow, wrist or hand? Yes = D13

D13 treatment
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amputee

D14 Reduced upper limb strength

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? No = go 12


test

12: Does the ankle have reduced ROM? No = go 13


test

13: Does the ankle have reduced power? No = go 14


test

14: Does either arm have reduced ROM at either shoulder, elbow, wrist or hand? No = go 15


test

15: Does either arm have reduced power at the shoulder, elbow, wrist or hand? Yes = D14

D14 treatment
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amputee

D15 Poor dexterity

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? No = go 12


test

12: Does the ankle have reduced ROM? No = go 13


test

13: Does the ankle have reduced power? No = go 14


test

14: Does either arm have reduced ROM at either shoulder, elbow, wrist or hand? No = go 15


test

15: Does either arm have reduced power at the shoulder, elbow, wrist or hand? No = go 16


test

16: Does the patient have good hand dexterity? No = D15

D15 treatment
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amputee

D16 Poor foot health contralateral health

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? No = go 12


test

12: Does the ankle have reduced ROM? No = go 13


test

13: Does the ankle have reduced power? No = go 14


test

14: Does either arm have reduced ROM at either shoulder, elbow, wrist or hand? No = go 15


test

15: Does either arm have reduced power at the shoulder, elbow, wrist or hand? No = go 16


test

16: Does the patient have good hand dexterity? Yes = go 17


test

17: Is the contra-lateral foot healthy? No = D16

D16 treatment
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amputee

D17 Suitable for prothesis if available

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? No = go 12


test

12: Does the ankle have reduced ROM? No = go 13


test

13: Does the ankle have reduced power? No = go 14


test

14: Does either arm have reduced ROM at either shoulder, elbow, wrist or hand? No = go 15


test

15: Does either arm have reduced power at the shoulder, elbow, wrist or hand? No = go 16


test

16: Does the patient have good hand dexterity? Yes = go 17


test

17: Is the contra-lateral foot healthy? Yes = go 18


test

18: Based on this on-going assessment Is a prosthesis suitable for the patient?? Yes = D17

D17 treatment
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amputee

D18 Not ready for prosthesis yet, to be re-assessed

main

1: Do you know the cause of the amputation? Yes = go 2


2: Is the patient free of co-morbidities? Yes = go 3


3: Does the patient understand and retain new information? a friend may be necessary or a relative may be vital? Yes = go 4


test

4: Is the stump healthy? check for signs of vascular disease or infection Yes = go 5


test

5: Is the stump oedematous? check for signs of oedema by pressing gently with flat of thumb? No = go 6


test

6: Is the scar healthy? Yes = go 7


test

7: Is the stump painful? No = go 8


test

8: Does either hip have reduced active/passive ROM? No = go 9


test

9: Does either hip have reduced muscle power? No = go 10


test

10: Does either knee have reduced active/passive ROM? No = go 11


test

11: Does either knee have reduced power? No = go 12


test

12: Does the ankle have reduced ROM? No = go 13


test

13: Does the ankle have reduced power? No = go 14


test

14: Does either arm have reduced ROM at either shoulder, elbow, wrist or hand? No = go 15


test

15: Does either arm have reduced power at the shoulder, elbow, wrist or hand? No = go 16


test

16: Does the patient have good hand dexterity? Yes = go 17


test

17: Is the contra-lateral foot healthy? Yes = go 18


test

18: Based on this on-going assessment, is a prosthesis suitable for the patient? No = D18

D18 treatment
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