Take Home Extra Credit Work

Name: Yosheph Yosheph

ID : 1702364
It is stated in the problem that a patient who has had a below-the knee amputation (BKA) of the left leg
and has been fitted with prosthetic is ready to start balance training, transfers training (e.g., to the car),
and gait training.
1. As expected, the patient is not going to progress as fast as what had been assumed in the first place.
The patient may have high frustration. The frustration may lead to a loss motivation. Therefore, some
strategies can be made to increase the motivational level as follows:
Explaining to the patient benefits that can be gained by being able to walk properly such as:
playing sports, going to picnic with family members, and etc.
Creating a positive, supportive learning environment that is challenging but realistic. This can
made by giving the learning environment which consists different steps starting from the easiest
to the most challenging like: walking with stick, and etc.
Introducing the patient to the other patients who had experienced the same condition and been
able to overcome the difficulty. By knowing this person, the patient may think that if this person
can overcome this difficulty, I should be able to do the same as well.
Involving the patient in the goal-learning process. This can be done by setting the goal together
with patient. For example: be able to walk in 1 week training, etc.
2. The main overcome of the patient is the fear of the falling.
a. The arousal level that might be associated with the fear of falling is categorized to be a high level
arousal.
b. The fear of the falling may somehow affected the patiences training since the patience is too
focus only a few environmental issues and ignore the important ones. This may affected the
patience in daily live. For example: The patience will focus on his les in such a way that he may
not consider that there is something in front of him or somebody is calling his name.
c. In order to reduce the fear of falling in the patients mind, it can be done by commanding the
patient to stand for a while. While standing, the patient already performed the hyper vigilance.
The patient can also be trained with a blinded eye and let him to walk there by some instructions
given from somebody. By doing this, the patient will focus on the other information given besides
the fear of falling inside his mind.
3. The goal setting can be implemented into the rehabilitation process directly. The patient can be told:
what an outcome that he might have such as: the feeling of family member seeing that he can
overcome this difficulty,.
performace goals: being able to walk properly in one week
process goals: by being able to walk properly without fear of the falling (not letting the arm spread
open).
4. In general the patients with BKA will have difficulty learning to equalize stride length. In order to
compensate this issue, some feedback mechanisms can be applied as follows:
By providing the floor where the patient learn how to walk with some tiles or meters. By doing
this, the patient can easily measure whether he has an equal stride length.
In each of the walking training, provide the patient with the information whether he has
performed an equal stride length in each step with some precisions.
5. Doing variable practices may somehow enhances the learning process of the patient. The variations
can be introduced in each category as follows:
a. Learning to fall safely
The variable practice for this process could be as follows:
Learning to fall safely while standing on the floor
Learning to fall safely while using a stick
Learning to fall safely while walking slowly
Learning to fall safely while walking fast
b. transfers (e.g., to the car)
The variable practice for this process could be as follows:
Learning how to sit in the car
Learning how to press pedals inside a car.
c. Gait (both indoors and outdoors)
The variable practice for this learning could be as follows:
Learning how to walk in 10 meters, 50 meters
Learning how to walk inside a room, in a field