Prosthetic gait deviation

Question 1

excessive bending lateral from the midline (usually to prosthetic side)

Answer 1

Lateral bending of the trunk

Question 2

Prosthetic causes for Lateral bending

Answer 2

• Prosthesis too short
• An improperly shaped lateral wall may fail to provide adequate support for the femur
• High medial wall may cause lean away to minimize discomfort
• A prosthesis aligned in abduction may cause a wide-based gait, resulting in lat lean

Question 3

Amputee causes for Lateral bending

Answer 3

• inadequate balance
• abduction contracture
• residual limb over-sensitive & painful
• very short limb may fail to provide a sufficient lever arm for the pelvis
• habit pattern

Question 4

very wide base w/ prosthesis held away from the midline at all times

Answer 4

Abducted gait

Question 5

Prosthetic causes for Abducted gait

Answer 5

• prosthesis too long
• too much abduction built into prosthesis
• high medial wall–> pressure on ramus
• improperly shaped lateral wall doesn’t support the femur well
• pelvic band positioned too far away from pt body

Question 6

Amputee causes for Abducted gait

Answer 6

• abduction contracture

- habit pattern

Question 7

swing prosthesis laterally in a wide arch during swing phase

Answer 7

Circumducted gait

Question 8

Prosthetic causes for circumducted gait

Answer 8

• too long prosthetic

- too much alignment stability/friction the knee–> difficult for knee flex

Question 9

Amputee causes for circumdected gait

Answer 9

• abd contracture of residal limb
• lack confidence for fllexing the prosthetic knee bc of mm weakness/fear of stubbing toe
• habit pattern

Question 10

rising on the toe of the normal foot permitting the amputee to swing the prosthesis through with little knee flexion

Answer 10

vaulting

Question 11

Prosthetic causes for vaulting

Answer 11

• too long
• inadequate socket suspension
• limb discomfort

Question 12

Amputee causes for vaulting

Answer 12

• habit pattern
• fear of stubbing toe
• limb discomfort

Question 13

Prosthetic causes for Rotation of the prosthetic foot on heel strike

Answer 13

• too much resistance t lantar flexing by thePF bumper/ heel wedge
• too much toe-out built in
• loosely fitting socket

Question 14

Amputee causes for Rotation of the prosthetic foot

Answer 14

• pt extend the residual limb too vigorously at heel strike

- poor mm control of residual heel

Question 15

Prosthetic causes for Uneven arm swing on prosthetic side

Answer 15

-improperly fitting socket–> limb discomfort

Question 16

Amputee causes for Uneven arm swing on prosthetic side

Answer 16

• bad balance
• fear/insecurity w/ uneven timing
• habit pattern

Question 17

Prosthetic causes for Uneven timing of steps

Answer 17

• improperly fitting socket causing pain & desire to shorten stance phase on prosthetic side
• weak extension aid/insufficient friction in prosthetic knee causes excessive heel rise–> prolonged swing-through
• alignment stability

Question 18

Amputee causes for Uneven arm swing on prosthetic side

Answer 18

• mm weakness
• bad balance
• fear/insecurity

Question 19

Prosthetic causes for Uneven heel rise

Answer 19

• knee joint have insufficient friction

- inadequate extension aid

Question 20

Amputee causes for Uneven heel rise

Answer 20

-amputee using more power than needed for knee flex

Question 21

Rapid forward movement of that shank allowing the knee to reach maximum ext w/ too much force before heel strike

Answer 21

Terminal swing impact

Question 22

Prosthetic causes for Terminal swing impact

Answer 22

• insufficient knee friction

- too strong knee extension

Question 23

Amputee causes for Terminal swing impact

Answer 23

-Amputee makes sure of full knee extension by deliberalty and forcibly extending residual limb

Question 24

Prosthetic causes for Instability of prosthetic knee

Answer 24

• knee jn too far ahead of the TKA line
• insufficient initial flex built into socket
• PF resistance too great–> knee buckling at heel strike
• failure to limit DF leads to incomplete knee control

Question 25

Amputee causes for Terminal swing impact

Answer 25

- hip extensor weakness | - severe hip flex contracture

Question 26

Prosthetic cause for Lateral whips

Answer 26

- excessive IR of prosthetic knee - too tight socket fit - excessive valgus in prosthetic knee - badly aligned toe-break in a conventional foot--> twisting on toe-off

Question 27

Prosthetic cause for Medial whips

Answer 27

- excessive ER of prosthetic knee - too tight socket fit - excessive valgus in prosthetic knee - badly aligned toe-break in a conventional foot--> twisting on toe-off

Question 28

Amputee causes for Medial/Lateral whips

Answer 28

-Faulty walking habits

Question 29

Prosthetic causes for Foot Slap

Answer 29

-PF resistance is too soft

Question 30

Amputee causes for Foot Slap

Answer 30

-amputee may be driving the prosthesis into the walking surface too forcibly to assure knee extension

Question 31

Downward movement of the trunk as the body moves forward over the prosthesis

Answer 31

Drop off at the end of stance phase

Question 32

Prosthetic cause of Drop off at the end of stance phase

Answer 32

- inadequate limitation of DF - too short keel of SACH-type foot - too far posterior toe break of a conventional foot - too far anterior socket (when related to the foot)

Question 33

Amputee cause of Drop off at the end of stance phase

Answer 33

-no specific medical causes

Question 34

Prosthetic cause for Long prosthetic step

Answer 34

-insufficient initial flexion in the socket when an irreducible residual limb flexion contractor is present

Question 35

Amputee cause for Long prosthetic step

Answer 35

-Flexion contracture un-accommodated prosthetically

Question 36

Prosthetic causes for Excessive trunk extension

Answer 36

- improperly shaped posterior wall--> forward rot of pelvis to avoid full wt bearing on ischium - insufficient initial flexion build into the socket

Question 37

Amputee causes for Excessive trunk extension

Answer 37

- hip flexor tightness - wk hip extensor--> lumbar substitution - wk abdominal mm - habit pattern - shoulders moving backward for better balance