TF Gait Deviations

Question 1

Describe terminal impact during IC->LR of TF gait:

Answer 1

forceful and excessive knee extension, usually audible

Question 2

What prosthetic causes of terminal impact during IC->LR of TF gait?

Answer 2

Inadequate knee friction (won’t slow leg down)

Question 3

What user causes of terminal impact during IC->LR of TF gait?

Answer 3

1. Fear of knee giving way

2. Forceful hip flexion

Question 4

Describe foot slap during IC->LR of TF gait:

Answer 4

Accelerated PF at heel strike resulting in the foot getting flat to the floor too soon

Question 5

What prosthetic causes of foot slap during IC->LR of TF gait?

Answer 5

PF bumper too soft

Question 6

What user causes of foot slap during IC->LR of TF gait?

Answer 6

Increased hip extension force at IC

Question 7

Describe knee instability during IC->LR of TF gait:

Answer 7

Knee giving way in early stance phase

Question 8

What prosthetic causes of knee instability during IC->LR of TF gait?

Answer 8

1. Knee axis too far anterior
2. Socket too far posterior
   - > Gravity line falls posterior to knee causing flexor moment
3. Lack of socket flexion

Question 9

What user causes of knee instability during IC->LR of TF gait?

Answer 9

1. Inadequate hip extension ROM

2. Hip flexion contracture

Question 10

T/F Knee instability during IC->LR of TF gait is major cause of concern in the transfemoral amputee as it can lead to falls

Answer 10

True

Question 11

Describe lateral trunk bend during MSt of TF gait:

Answer 11

• Excessive lateral lean during stance phase
• this deviation is seen when there is inadequate contact between the residuum and the lateral wall of the socket, thus limiting the action of gluteus medius

Question 12

What prosthetic causes of lateral trunk bend during MSt of TF gait?

Answer 12

1. Socket too abducted (shift body over it)
2. Prosthesis too short
3. Medial socket wall too high (dig into groin -> lean away from medial wall)

Question 13

What user causes of lateral trunk bend during MSt of TF gait?

Answer 13

1. Pain
2. Glute med weakness
3. Decreased balance
4. Adductor roll

Question 14

lateral trunk bend during MSt of TF gait causes pain where?

Answer 14

Distal lateral

Question 15

What two deviations can you find during lateral trunk bend during MSt of TF gait?

Answer 15

1. Bell clapping laterally into lateral wall of socket

2. compensated Trendelenburg

Question 16

Describe abducted gait during MSt of TF gait:

Answer 16

Excessive hip abduction during stance leading to a wide based gait pattern

Question 17

What prosthetic causes of abducted gait during MSt of TF gait?

Answer 17

1. Foot/leg too far outset
2. Prosthesis too long (user will bring the leg out in an attempt to level the pelvis)
3. Medial socket wall too high
4. Lateral wall not adducted enough (too big/sloppy – actively abduct femur into socket to get contact with wall)

Question 18

What user causes of abducted gait during MSt of TF gait?

Answer 18

1. Abduction contracture
2. Lateral-distal RL pain
3. Decreased balance/trying to incr BOS
4. Adductor roll

Question 19

Describe excessive trunk extension during MSt of TF gait:

Answer 19

Excessive lumbar lordosis during stance or a posterior trunk lean

Question 20

What prosthetic causes of trunk extension during MSt of TF gait?

Answer 20

1. Increased socket extension

2. Not enough flexion built into socket

Question 21

What user causes of trunk extension during MSt of TF gait?

Answer 21

1. Weak hip extensors
2. Weak abdominals
3. Hip flexion contracture
4. Very short RL – decreased ability to stabilize, lean back and rock forward to generate momentum

Question 22

Often see decreased strength in what back muscles in patients with excessive trunk extension during MSt?

Answer 22

Weak multifidus

Question 23

Describe drop/knee instability during Tst of TF gait:

Answer 23

Sudden and excessive knee flexion during late stance phase

Question 24

What prosthetic causes of drop/knee instability during Tst of TF gait?

Answer 24

1. Short toe lever (loss of anterior support caused by a short keel)
2. Socket set too posterior to knee axis

Question 25

Describe excessive heel raise during PSw->Sw of TF gait:

Answer 25

Prosthetic heel rises excessively (both in distance and velocity)

Question 26

What prosthetic causes of excessive heel raise during PSw->Sw of TF gait?

Answer 26

Insufficient knee friction – flex too soon so lift heel off ground excessively

Question 27

What user causes of excessive heel raise during PSw->Sw of TF gait?

Answer 27

Forceful hip flexion to ensure a heel rise and the knee progressing through swing to extension

Question 28

Describe circumduction during Sw of TF gait:

Answer 28

User swings leg in a circular motion laterally to advance it during swing

Question 29

What prosthetic causes of circumduction during Sw of TF gait?

Answer 29

1. Prosthesis too long 2. Inadequate suspension 3. Medial wall too high – circumduction to take pressure off 4. Excessive knee friction – functionally long prosthesis

Question 30

What user causes of circumduction during Sw of TF gait?

Answer 30

1. Hip flexor weakness 2. Hip abduction contracture 3. Fear

Question 31

What prosthetic causes of vaulting during sw of TF gait?

Answer 31

Prosthesis too long Inadequate suspension Excessive knee friction

Question 32

What user causes of vaulting during sw of TF gait?

Answer 32

Hip flexor weakness Hip abduction contracture Fear

Question 33

T/F vaulting during sw of TF gait has an abnormal prosthetic path leading to fall risk

Answer 33

False, almost normal prosthetic path leading to fall risk

Question 34

T/F Pistoning is often seen with vaulting.

Answer 34

True

Question 35

Describe medial whip during Sw of TF gait:

Answer 35

Medially directed whipping motion of the prosthesis (named according to the direction in which the prosthetic heel moves at heel off)

Question 36

What prosthetic causes of medial whip during Sw of TF gait?

Answer 36

1. External rotation of knee component | 2. Improper alignment of knee bolt

Question 37

What user causes of medial whip and lateral whip during Sw of TF gait?

Answer 37

Improper donning

Question 38

Describe lateral whip during Sw of TF gait:

Answer 38

Laterally directed whipping motion of the prosthesis (named according to the direction in which the prosthetic heel moves at heel off)

Question 39

What prosthetic causes of lateral whip during Sw of TF gait?

Answer 39

1. Internal rotation of knee component | 2. Improper alignment of knee bolt

Question 40

TT or TF amputation more efficient in regard to metabolic cost of ambulation?

Answer 40

TT

Question 41

Traumatic etiology or vascular amputation more efficient in regard to metabolic cost of ambulation?

Answer 41

Traumatic

Question 42

TTA trauma O2 consumption and gait velocity changes:

Answer 42

15%+ | -10%

Question 43

TTA vascular O2 consumption and gait velocity changes:

Answer 43

30%+ | -30%

Question 44

TFA trauma O2 consumption and gait velocity changes:

Answer 44

40%+ | -20%

Question 45

TFA vascular O2 consumption and gait velocity changes:

Answer 45

65%+ | -40%

Question 46

What factors tend to influence the metabolic cost of ambulation?

Answer 46

length of the residual limb | the cause of amputation