Gait Deviations

Question 1

Abducted Gait

Answer 1

• Width of the walking base is significantly greater than the normal range of 2-4 inches
• Exaggerated lateral displacement of the pelvis
• Lateral Bending

Question 2

When does abducted gait occur?

Answer 2

• Period of double limb support

Question 3

Where should you observe Abducted Gait?

Answer 3

• Behind the patient

Question 4

Causes of Abducted Gait

Answer 4

• Pain or discomfort in crotch area, possibly due to Skin infection, adductor roll, pressure from the brim of the medial socket wall
• Contracted abductors of the residual limb
• Prosthesis alignment
• Improper prosthesis alignment
• Amputee feels insecure and compensates by widening the walking base

Question 5

Lateral Bending of the Trunk

Answer 5

• Trunk bends towards the amputated side when the prosthesis is in stance phase

Question 6

When does Lateral bending of the trunk occur?

Answer 6

• Just after heel strike to mid-stance

Question 7

Where should you observe lateral bending from?

Answer 7

• Behind the patient

Question 8

Causes for Lateral bending of the trunk?

Answer 8

• Abducted Gait pattern
• Insufficient support by lateral socket wall
• Abducted socket
• Weak abductors
• Short Prosthesis

Question 9

Circumducted Gait

Answer 9

• The prosthesis follows a laterally curved line as it swings through

Question 10

When does circumducted gait occur?

Answer 10

• Thoughout swing phase

Question 11

Where should you observe circumducted gait from?

Answer 11

• Behind the patient

Question 12

Causes of circumducted gait pattern?

Answer 12

• Prosthesis is too long
• Amputee uses little or no knee flexion because of insecurity or fear
• Manual knee lock, excessive friction, or a tight extension aid may prevent the knee from bending
• Inadequate suspension alloing the prosthesis to slip off the residual limb (pistol action)
• Too small of a socket, The ischial tuberosity is above the ischial seat
• Foot set in plantar flexion

Question 13

Sing Phase Whips

Answer 13

• Medial whip: Toe off the heel moves medially

- Lateral Whip: Toe off the heel moves laterally

Question 14

When does Swing phase whips occur?

Answer 14

• during or just after toe-off

Question 15

Where should you observe Swing phase whips?

Answer 15

• From behind the patient

Question 16

Causes of Swing Phase Whips

Answer 16

• Residual limb with weak, loose musculature in which tissues rotate freely around femur
• Socket too tight or insufficiently contoured to accommodate muscles.
• Pressure from contracting muscle bellies causes the prosthesis to rotate around its long axis
• Toe break not set a right angle to the line of progression
• Improper alignment of knee bolt in the transverse plane

Question 17

Rotation of the foot on heel strike

Answer 17

• As the heel contacts the ground, the foot rotates laterally, sometimes with a vibratory motion

Question 18

When does rotation of the foot occur?

Answer 18

• Heel strike

Question 19

• Where should you observe rotation of the foot?

Answer 19

• From behind the patient

Question 20

Causes of Rotation of the foot on heel strike?

Answer 20

• Too hard of a plantar flexion bumper or heel cushion
• Correction after a lateral whip
• With a suction socket wearer, the foot rotation may be due to poor control of the socket by the residual limb

Question 21

Terminal Swing Impact

Answer 21

• The prosthetic shank comes to a sudden stop with forcible impact as the knee goes into extension

Question 22

When does Terminal Swing impact occur?

Answer 22

• At the end of Swing phase

Question 23

Where should you observe Terminal swing impact from?

Answer 23

• From the side of the Patient

Question 24

Causes of Terminal Swing impact

Answer 24

• Insufficient friction on the prosthetic knee
• Too much tension on the extension aid
• Amputee’s fear of the knee buckling

Question 25

Foot Slap

Answer 25

- The foot plantarflexes too rapidly and strikes the floor with a slap

Question 26

When does Foot slap occur?

Answer 26

- Just after heel strike

Question 27

Where should you observe foot slap from?

Answer 27

- Side of patient, listen for slap

Question 28

Causes of foot slap

Answer 28

- Plantar flexion bumper or heel cushio is too soft

Question 29

Uneven Step Length

Answer 29

- The length of the step taken with the prosthesis differs from the length of the step taken with the sound foot

Question 30

When does Uneven step length occur?

Answer 30

- Throughout the gait cycle

Question 31

Where should you observe Uneven step length from?

Answer 31

- The side of the patient

Question 32

Causes of Uneven Step Length

Answer 32

- Pain or fear, causes the amputee to shift weight off the prosthesis and onto the sound leg as quickly as possible - Insufficient friction on the prosthetic knee - Flexion contracture of the hip or insufficient flexion of the socket

Question 33

Flexion contracture of the hip or insufficient flexion of the socket causes?

Answer 33

- Restricts hip extension range - Decreased stance time on prosthetic limb - Shorter step length on the sound side

Question 34

Lordotic Gait

Answer 34

- Exaggerated Lordosis

Question 35

- When does lordotic gait occur?

Answer 35

- Throughout stance phase

Question 36

Where should you observe lordotic gait from?

Answer 36

- From the side of the patient

Question 37

Causes of Lodotic Gait?

Answer 37

- Flexion contracture of the hip (produces anterior pelvic tilt, the amputee throws shoulders back to compensate) - Insufficient initial flexion of socket - Weak hip extensors ( Produces anterior pelvic tilt) - Weak abdominal muscles (Abdominal mm's restrain the tendency of the pelvis to tilt forward) - Painful ischial bearing (The amputee may roll the pelvis forward, attempting to relieve pressure on the ischium)

Question 38

Vaulting

Answer 38

- The amputee bobs up and down excessively during gait due to excessive plantar flexion of the sound foot during stance

Question 39

When does Vaulting occur?

Answer 39

- During swing phase of the prosthesis

Question 40

Where should you observe Vaulting gait from?

Answer 40

- Behind the patient or from the side

Question 41

Causes of Vaulting gait?

Answer 41

- Excessive length of the prosthesis