Integ > Prosthetic gait deviations > Flashcards

Prosthetic gait deviations Flashcards

(44 cards)

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1
Q

Eric Lieux:
TF IC to Midstance
Deviation: knee instability (flexion)

A

Causes:

  1. Knee Center Too far Anterior
  2. Excessive Resistance to Planter Flexion
  3. Weak Hip Extensors

Correction:
Strengthen hip extensors

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2
Q

Eric Lieux:
TF IC to Midstance
Deviation: Unequal stride

A

Cause:
Bad Gait Habit
NO TRUST

Correction:
- Work on equal stride length; put down tape to make them even

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3
Q

Eric Lieux:
TF IC to Midstance
Deviation: ER of the foot

A

Causes:

  1. Anterior Medial Brim
  2. Planter Flexion too Stiff
  3. R.O. M. Limited

Correction
Increase ROM
- want foot to hit ground, go to 5th met head, jump to first met he’d and out to big toe; need that transfer for normal gait!

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4
Q

Eric Lieux:
TF IC to Midstance
Deviation: Lateral trunk bending exceeds 1-2” at the head

A

Causes:

  1. Insufficient Adduction
  2. Foot out set too Far
  3. Prosthesis too Short
  4. Femur too Short
  5. Hip Pathology
  6. Weak Hip Abductors
  7. Painful Lateral Distal Femur Pressure

Correction:
Core strengthening with knee pain; for lateral distal femur pressure pain, scar tissue is a huge problem

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5
Q

Eric Lieux:
TF Midstance
Deviation: abducted gait

A

Causes:

  1. Medial Wall Problems
  2. Prosthesis too Long
  3. Poor Gait Habit
  4. Lateral Distal Femur Pressure
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6
Q

Eric Lieux:
TF Midstance
Deviation: Inversion or eversion of the foot

A

Causes:

  1. Improper Adduction or Abduction of Prosthetic Socket
  2. Loose Socket ML

Correction:
1st step if a prosthesis hurts, add a sock

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7
Q

Eric Lieux:
TF terminal stance
Deviation: Pelvic rise (vaulting)

A

Causes:

  1. Toe Lever too Long
  2. Shoe changed by amputee to lower heel

Correction:
Instruct amputee in regards to correct heel height

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8
Q

Eric Lieux:
TF terminal stance
Deviation: Drop off, torso lowers excessively

A

Cause:
1. Toe Lever arm Inadequate

Correction:
Gait training to achieve equal time on each leg and equal length of stride

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9
Q

Eric Lieux:
TF terminal stance
Deviation: Excessive lumbar lordosis

A

Cause of deviation:

  1. Insufficient socket Flexion
  2. Developing Hip Flexion contracture

Correction:
Stretch out contracture

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10
Q

Eric Lieux:
TF Pre-swing through initial swing
Deviation: Circumduction of the prosthesis

A

Causes:

  1. Medial Brim Problem
  2. Prosthesis too Long
  3. Inadequate Knee Flexion

Correction:
this is a habit, hard to break

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11
Q

Eric Lieux:
TF Pre-swing through initial swing
Deviation: Piston action

A

Cause:
inadequate fit and/or suspension
- should slip less than ¼ inch

Correction:
Check suspension

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12
Q

Eric Lieux:
TF Pre-swing through initial swing
Deviation: Medial whip; an abrupt medial moment of the heel as it raises from the floor, accompanied by a lateral movement of the knee and shank

A

Cause:

  1. Knee axis in excessive External Rotation
  2. Socket unstable on stump
  3. Muscular skeletal Pathology
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13
Q

Eric Lieux:
TF Pre-swing through initial swing
Deviation: Lateral whip; an abrupt lateral moment of the heel as it raises from the floor, accompanied by a medial movement of the knee and shank

A

Causes:

  1. Knee axis in excessive Internal Rotation
  2. Socket unstable on stump
  3. Muscular skeletal Pathology
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14
Q

Eric Lieux:
TF Mid-swing
Deviation: Vaulting on sound side

A

Causes:

  1. Prosthesis too long
  2. Prosthetic Knee too stiff
  3. Bad gait Habit
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15
Q

Eric Lieux:
TT IC
Deviation: Ball of the foot dorsiflexed more than 1.5”

A

Causes:

  1. Stride length too long
  2. Excessive socket flexion

Correction:
Train patient to maintain equal stride length

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16
Q

Eric Lieux:
TT IC
Deviation: Knee fully extended

A

Causes:

  1. Heel lever arm too short
  2. Heel Resistance too soft
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17
Q

Eric Lieux:
TT IC
Deviation: Excessive or insufficient compression

A

Cause:

heel resistance too soft or too firm

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18
Q

Eric Lieux:
TT
Deviation: continual anterior distal tibia pressure

Study These Flashcards
A

Cause:
Excessive use of knee extensors

Correction:
Teach amputee hamstring gait

19
Q

Eric Lieux:
TT Mid-stance
Deviation: Lateral trunk bending exceeds 1” at the head

Study These Flashcards
A

Causes:

  1. Hip pathology - IT band
  2. Foot outset too far
  3. Prosthesis too short
20
Q

Eric Lieux:
TT Mid-stance
Deviation: Gait base exceeds 2” - “wide base gait”

Study These Flashcards
A

Causes:

  1. Foot outset too far
  2. Prosthesis too long
  3. Hip pathology
21
Q

Eric Lieux:
TT Mid-stance
Deviation: Inversion or eversion of the foot; walking on lateral or medial edged

Study These Flashcards
A

Causes:

  1. Improper adduction or abduction
  2. Loose Socket M. L.
22
Q

Eric Lieux:
TT Mid-stance
Deviation: Lateral displacement exceeds ½”

Study These Flashcards
A

Causes:

  1. Foot outset too far
  2. Loose socket M. L.
23
Q

Eric Lieux:
TT Mid-stance
Deviation: No lateral displacement or any displacement medially

Study These Flashcards
A

Causes:

  1. Foot outset too far
  2. Pain in peroneal area
  3. Short stump
  4. Knee pathology
24
Q

Eric Lieux:
TT Terminal stance
Deviation: Knee goes into extension; pressure on anterior knee

Study These Flashcards
A

Causes:

  1. Toe lever arm too long
  2. Amputee changed shoe to lower heel
  3. Insufficient socket flexion
25
Eric Lieux: TT Weight transfer to pre-swing Deviation: Drop off; WB period shortened and knee flex accentuated
Cause: | Toe lever arm too short
26
Eric Lieux: TT swing phase Deviation: Whip; An abrupt lateral or medial movement of the heel as it raises from the floor, accompanied by a medial movement of the knee and shank
Causes: 1. Suspension incorrect 2. Hip and or knee pathology
27
Book TF Deviation: Lateral displacement, abduction in stance
Prosthetic causes: 1. Long prosthesis 2. Abducted hip joint 3. Inadequate lateral wall adduction 4. Sharp or high medial wall Anatomical causes: 1. Abduction contracture 2. weak abductors 3. lateral/distal pain 4. adductor redundancy instability
28
Book TF Deviation: Lateral displacement, Circumduction in swing
Prosthetic causes: 1. Long prosthesis 2. locked knee unit 3. loose friction 4. inadequate suspension 5. small socket 6. loose socket 7. foot PF'd Anatomical causes: 1. Abduction contracture 2. poor knee control
29
Book TF Deviation: Trunk shifts, lateral bend in stance
Prosthetic causes 1. short prosthesis 2. inadequate lateral wall adduction 3. sharp or high medial wall Anatomical causes: 1. Abduction contracture 2. Weak abductors 3. hip pain 4. instability 5. show amputation limb
30
Book TF Deviation: Trunk shifts, forward flexion in stance
Prosthetic causes: 1. unstable knee unit 2. Short walker or crutches Anatomical causes: 1. instability
31
Book TF Deviation: Trunk shifts, Lordosis in stance
Prosthetic causes: 1. inadequate socket flexion Anatomical causes: 1. hip flexion contracture 2. weak extensors
32
Book TF Deviation: Rotations, medial (or lateral ) whip at heel off
Prosthetic causes: 1. faulty socket contour 2. knee bolt externally (or internally) rotated 3. Foot malrotated 4. prosthesis donned in malrotation Anatomical causes: 1. with sliding friction unit, fast pace
33
Book TF Deviation: Rotations, Foot rotation at heel contact
Prosthetic causes: 1. Stiff heel cushion 2. malrotated foot no anatomical causes
34
Book TF Deviation: Excessive knee motion, heel high rise in early swing
Prosthetic causes: 1. Inadequate friction 2. Slack extension aid no anatomical causes
35
Book TF Deviation: Excessive knee motion, terminal impact at late swing
Prosthetic causes: 1. Inadequate friction 2. Taut extension aid Anatomical cause: 1. forceful hip flexion
36
Book TF Deviation: Reduced knee motion, vault during swing
Prosthetic causes: 1. Long prosthesis 2. locked knee unit 3. loose friction 4. inadequate suspension 5. small socket 6. loose socket 7. foot PF'd Anatomical cause: 1. with sliding friction unit, fast pace
37
Book TF Deviation: Reduced knee motion, hip hike in swing
Prosthetic causes: 1. Long prosthesis 2. locked knee unit 3. loose friction 4. inadequate suspension 5. small socket 6. loose socket 7. foot PF'd Anatomical causes: 1. Weak DFs 2. PF spasticity 3. pes equinus 4. weak hip flexors
38
Book TF Deviation: uneven step length
Prosthetic causes: 1. uncomfortable socket 2. insufficient socket flexion Anatomical causes: 1. hip flexion contracture 2. instability
39
Book TT Deviation: Early stance, excessive knee flexion
Prosthetic causes: 1. High shoe heel 2. insufficient PF 3. Stiff heel cushion 4. socket too far anterior 5. Socket excessively flexed 6. Cuff tabs too posterior Anatomical causes: 1. Flexion contracture 2. Weak quadriceps
40
Book TT Deviation: Early stance, insufficient knee flexion
Prosthetic causes: 1. Low shoe heel 2. Excessive PF 3. Soft heel cushion 4. Socket too far posterior 5. Socket insufficiently flexed Anatomical causes: 1. Extensor spasticity 2. Weak quadriceps 3. Anterior-distal pain 4. Arthritis
41
Book TT Deviation: Midstance, lateral thrust
Prosthetic cause: 1. excessive foot inset no anatomical causes
42
Book TT Deviation: Midstance, medial thrust
Prosthetic cause: 1. excessive foot outset no anatomical causes
43
Book TT Deviation: Late stance, early knee flexion (also referred to as "drop off")
Prosthetic cause: 1. High shoe heel 2. insufficient PF 3. Keel too short 4. DF stop too soft 5. Socket too far anterior 6. Socket excessively flexed 7. Cuff tabs too posterior Anatomical cause: 1. flexion contracture
44
Book TT Deviation: Late stance, delayed knee flexion (perception of walking uphill)
Prosthetic cause: 1. Low shoe heel 2. excessiv PF 3. Keel too long 4. DF stop too stiff 5. Socket too far posterior 6. Socket insufficiently flexed Anatomical cause: 1. extensor spasticity
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