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----- Original Message -----
From: Anna <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, January 08, 2001 7:04 AM
Subject: Re: Partial weight bearing
> Hello Linda,
>
> Sorry !!! Don't know how I made that mistake with your name must have
taken
> it from McLaren.
>
> thanks you have sort of - I guess I was curious as to whether standing on
> the unstable surface actually affects the amount that they are willing to
> put on the affected side and whether comparing it with force plate would
> make a difference to amount of weight put on the affected side (forceplate
> being steady but impractical in a rehab setting). ie do they "hold back"
> when on the e scales and put more weight on the non affected side?
>
>
>
> Cheers,
>
> Anna.
>
>
> Anna Lee
> Principal,
> Work Ready Industrial Athlete Centre
>
> Write to me at: [log in to unmask]
>
> Visit me at: www.workready.com.au
>
> Snail mail:
> Suite 3, 82 Enmore Road,
> Newtown NSW 2042
> Australia
>
> Phone: (612) 95197436
> Fax: (612) 95197439
> Mob: 0412 33 43 98
>
>
>
> ----- Original Message -----
> From: "McLaren, L" <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Monday, 8 January 2001 9:57
> Subject: Re: Partial weight bearing
>
>
> > Anna,
> > Sorry was confused at first as you've addressed this to Karen.
> >
> > Yes I use the two bathroom scales to quantify how much wt bearing an
> amputee
> > is putting through their residual limb, in all phases of their rehab,
> until
> > they are 100% full wt bearing on their prosthesis at the end of phase 3
> (of
> > 3).
> >
> > I use the scales as their balance exercises are progressed from level
> > surfaces to incline surfaces to unstable surfaces (unstable surface = a
> > trampoline, although standing on a scale on a trampoline is not as
> unstable
> > as just standing on the trampoline itself; if safety is an issue then I
> use
> > the scale under the sound limb and simple math then tells me the
> percentage
> > wt bearing through the residual limb or prosthesis).
> >
> > My ability to quantify the wt bearing, however grossly with the scales,
is
> > better in my humble opinion, than trying to guess or by asking the
> patient.
> > It provides valuable feedback to the rest of team, particularly the
> > prosthetists. I hope I answered your question/comment.
> > Linda McLaren, B.Sc. PT
> > Physiotherapist, Amputee Team
> > GF Strong Rehab Center
> > 4255 Laurel Street
> > Vancouver, B.C. V5Z 2G9
> > [log in to unmask] (work)
> > [log in to unmask] (home)
> >
> > ----- Original Message -----
> > From: Anna <[log in to unmask]>
> > To: <[log in to unmask]>
> > Sent: Sunday, January 07, 2001 1:55 PM
> > Subject: Re: Partial weight bearing
> >
> >
> > > Hello Karen,
> > >
> > > This sounds great - have you quantified the amount or difference in
> weight
> > > when standing with both feet on unsteady surface such as two bathroom
> > > scales - does that have an effect on the amount that is placed through
> the
> > > less effective limb?
> > >
> > >
> > > Cheers,
> > >
> > > Anna.
> > >
> > >
> > > Anna Lee
> > > Principal,
> > > Work Ready Industrial Athlete Centre
> > >
> > > Write to me at: [log in to unmask]
> > >
> > > Visit me at: www.workready.com.au
> > >
> > > Snail mail:
> > > Suite 3, 82 Enmore Road,
> > > Newtown NSW 2042
> > > Australia
> > >
> > > Phone: (612) 95197436
> > > Fax: (612) 95197439
> > > Mob: 0412 33 43 98
> > >
> > >
> > >
> > > ----- Original Message -----
> > > From: "McLaren, L" <[log in to unmask]>
> > > To: <[log in to unmask]>
> > > Sent: Sunday, 7 January 2001 4:38
> > > Subject: Re: Partial weight bearing
> > >
> > >
> > > > Partial wt bearing in my area of interest (amputee rehabilitation)
is
> a
> > > > specific clinical tool, and I use two bathroom scales to quantify
> > exactly
> > > > how much wt an amuptee is taking through their residual limb, as a
> > > > percentage of total body weight. Often amputees have had
orthopaedic
> > > trauma
> > > > in addition to their amputation.
> > > >
> > > > When amputees are first given their prosthesis in the initial
fitting
> > apt.
> > > > the prosthetist oftens asks them 'how much wt are you taking through
> the
> > > > artificial limb'. The client's response varies, but is often as
much
> as
> > > > 50%; given that this is often the first time they have stood up and
> > > 'walked'
> > > > in the parallel bars, I often wondered how accurate the patient was,
> and
> > > how
> > > > precise the prosthetist was in 'guessing' with their eyes, how much
wt
> > was
> > > > being taken through the artificial limb. And so started my attempts
> at
> > > > quantifying this and the most practical tool was two bathroom
scales.
> > > >
> > > > I now measure on a biweekly basis how the numbers change, the wt
> bearing
> > > > tolerance on the prosthetic side as a percentage of total body
weight.
> > > This
> > > > number is useful to the team, when it suddently changes for no
> apparent
> > > > reason; something is going on within the socket-residual limb
> interface
> > > that
> > > > causes pain to prevent wt bearing.
> > > >
> > > > Can patient's wt bear to a specific percentage of body wt?
> Absolutely,
> > > when
> > > > they are given feedback that quantifies the amount of wt. For an
> > amputee
> > > > they learn that the amount of pressure they feel coming up through
> their
> > > > prosthesis onto their residual limb, and the position of their body
> > > relative
> > > > to that constitutes midline or 50% of their body weight on each
limb.
> > For
> > > > patients who have spent a period of time on crutches, due to ortho
> > trauma,
> > > > amputation, etc the shift in midline to their 'new normal' can be a
> > > > frustrating thing for a physiotherapist to treat.
> > > > Linda McLaren, B.Sc. PT
> > > > Physiotherapist, Amputee Team
> > > > GF Strong Rehab Center
> > > > 4255 Laurel Street
> > > > Vancouver, B.C. V5Z 2G9
> > > > [log in to unmask] (work)
> > > > [log in to unmask] (home)
> > > >
> > > > ----- Original Message -----
> > > > From: <[log in to unmask]>
> > > > To: <[log in to unmask]>
> > > > Sent: Saturday, January 06, 2001 3:43 AM
> > > > Subject: Partial weight bearing
> > > >
> > > >
> > > > > A student was talking to me the other day about partial weight
> > bearing.
> > > As
> > > > a
> > > > > consequence of our discussion the following issues arose, and I
> would
> > be
> > > > > interested to hear your views. If you are aware of any research in
> the
> > > > area
> > > > > I would also be interested as the student has not (so far) managed
> to
> > > find
> > > > > anything relevant.
> > > > >
> > > > > It appears that some therapists give quite specific instructions
> about
> > > how
> > > > > much weight should be taken through a limb when a patient is
partial
> > > > weight
> > > > > bearing. For example the patient should only take 50% of body
> weight.
> > > But
> > > > do
> > > > > we have any evidence to support this level of precision?
> > > > >
> > > > > Is there any research into how strong (perhaps as a percentage of
> > > original
> > > > > 'strength') a bone is in the later stages of healing (union and
> > > > > consolidation)?
> > > > >
> > > > > Does anyone know of any evidence that patients are able to weight
> bear
> > > to
> > > > a
> > > > > specified level or is it rather a nonsense to tell a patient to
take
> > 50%
> > > > of
> > > > > his/her weight?
> > > > >
> > > > > Just out of curiosity I wonder what sort of instructions clinical
> > > > > colleagues give when trying to convey the concept of partial
weight
> > > > bearing
> > > > > to a patient. Obviously some use a percentage of body weight,
others
> > > > appear
> > > > > to suggest to patients that there is a tomato or an egg under the
> sole
> > > of
> > > > > the foot and it should not be squashed!
> > > > >
> > > > > Marion Trew
> > > > > University of Brighton
> > > > > UK
> > > > >
> > > >
> > >
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