A physical therapist works with a patient with a transfemoral amputation on controlled fall training. The patient ambulates with a single axillary crutch. What controlled falling technique is the MOST appropriate to teach the patient in an anterior loss of balance?

1.    Pull the crutch close to the body to absorb the impact
2.    Discard the crutch and land on slightly flexed arms
3.    Turn the body to absorb the fall on the back of the trunk and legs
4.    Land on the elbows and prosthesis to absorb the impact

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist works with a patient with a transfemoral amputation on controlled fall training. The patient ambulates with a single axillary crutch. What controlled falling technique is the MOST appropriate to teach the patient in an anterior loss of balance?

1.    Pull the crutch close to the body to absorb the impact
2.    Discard the crutch and land on slightly flexed arms
3.    Turn the body to absorb the fall on the back of the trunk and legs
4.    Land on the elbows and prosthesis to absorb the impact

Fall Training

Controlled falling is a desirable training technique for patients following amputation. If they are ambulating using an assistive device, the first step is to discard it and prepare for the fall. Discarding the assistive device whenever possible allows the patient to absorb the fall on slightly flexed arms, decreasing the impact to any one specific segment of the body. 

When answering this question, it is critical recognize that the therapist is instructing the patient how to fall in the event of an anterior loss of balance.

Let’s explore each of the options:

Option 1 - Pull the crutch close to the body to absorb the impact

Pulling the crutch close to the body will prevent the upper extremities from absorbing the impact of the fall once contact is made. The crutch should be discarded to allow the arms to perform their role in shock absorption.

Option 2 – Discard the crutch and land on slightly flexed arms

Discarding the crutch and landing on slightly flexed arms allows for significant force absorption. Once impact has occurred, the elbow extensors function to eccentrically lower the body to the floor. 

Option 3 – Turn the body to absorb the fall on the back of the trunk and legs

Turning the body to absorb the fall on the back of the trunk and legs is not a viable option for absorbing the forces. Even though the gluteal muscles have a large amount of adipose tissue, the risk of injury to the head exceeds the potential benefit.

Option 4 – Land on the elbows and prosthesis to absorb the impact

Landing on bony prominences or the prosthetic limb is undesirable, as neither are designed to absorb forces and could result in fractures.

The correct answer is Option 2.

Let’s explore the all student data:

7% of students selected Option 1 - Pull the crutch close to the body to absorb the impact
56% of students selected Option 2 – Discard the crutch and land on slightly flexed arms – the correct response
32% of students selected Option 3 - Turn the body to absorb the fall on the back of the trunk and legs
5% of students selected Option 4 - Land on the elbows and prosthesis to absorb the impact

System Classification
This question is a Non-Systems question which represents approximately 14% of all exam items.

Content Outline Classification
This question is a Safety and Protection; Professional Responsibilities; Research question which represents approximately 8% of all exam items.

Level Classification
This question is a Level 2 question since the question requires students to integrate numerous pieces of information or to apply knowledge in a given clinical scenario. Remediation of Level 2 questions occurs by increasing flexibility with academic content and by carefully analyzing decision making processes when answering applied examination questions.

Academic Focus Area
Looking to review related academic content? Check out page 706 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!