biomech of pro gait Flashcards
what is the weight acceptance part of gait
initial contact
loading
what is the stance/single limb support part of gait
mid swing
terminal swing
what is the swing/limb advancement part of gait
pre swing
initial swing
mid swing
terminal swing
what kind of moment is it at initial contact
knee ext moment
varus moment
IC - ground reaction force
in front of hip - pulling into flexion
behind knee - pulling into ext
behind foot - pulling into PF
the body is trying to resists these moement created by the ground reaction force
Varus moment - ground reaction force
- Medial knee – varus moment
- Medial hip – abductor, fall away from the line
Transtibial IC
the PF torque is transitioned up the whole chain
The prothesis will pull the leg forward and push them into knee flexion
Transfemoral IC
cannot use quad to compensate for torque moment
- Use glutes, hamstrings pull the femur into extension
- Fire the glute and push back against the socket
loading response GRF
knee flexion moment
ankle - PF
knee - flex
hip - ext
Varus response remains
mid stance moments
knee flex and ext moments
terminal stance moments
initial heel rise and knee ext moment
decreased varus moment
pre swing moments
heel rise/toe off and knee flex moment
what are factor that infulence gait
eitology: dysvascualr or trauma
location: tib or femur
what was the greatest O2 consumption
transfemoral and dysvascular
what is normal O2 consumption
.15%
what is the goal in amb with pro
stabilize the knee without limiting mobility
alignment term - bench
the initial alignment produced before pt fitting
alignment term - static
with pro on pt some WB before walking
alignment term - dynamic
have the pt walk with pro
different gait characteristic will indicate areas of misalignment
where does the kinematic chain close
the wall of the pro socket
important for socket pressure and skin integrity
what are some factors that will influence transtibial gait - A-P stability
knee ext
hip ext
limb length
ROM
activity level
what are some factors that will influence transtibial gait - M-L stability
co-contraction of quads and hamstring from IC > mid stance
timing of hip abd
ligamentous stability of the knee
what is socket flexion
bench
the proximal end of the socket is ant tilted on the pylon in regards to the foot flat on the floor
what is the goals of socket flexion and lateral tilt of the socket
max WB of the residual limb
what is the lateral tilt of the socket for
to max contact with the residual limb for max weight bearing
what does too much transtib socket flexion do
excessive knee flexion moment
require excessive knee ext (quads) strength - this increases pressure of the ant distal and post proximal parts of the residual limb
the occurs when the chain in closed
what does malalignment of the lateral tilt or the foot position on the socket do
creates an excessive varus of valgus moment at the knee
how do we inspect for a M-L misalignment transtib
foot flat in midstance
what are some factors that will influence transfemoral gait - A-P stability
hip extensors/core
pelvic anterior translations in midstance
limb length
ROM
activity level
ability to chnage cadence
what are some factors that will influence transtibial gait - M-L stability
limb length
trong isp abd
strong core
activity level
what alignment for transfemoral do we use to max A-P stability
initial socket flexion
what does initial socket flexion facilitate
use of glute max
max strength at mid range
places the knee center post to the hip and ankle in stance
what aligment does a hip flexion contracture cause
the distal femur to sit anterior to the hip and the foot
mid stance with a hip flexion contracture
knee flex moment?
what is the initial bench aligment of the tranfemoral in the M-L view
hip abd
what does a hip abd alignment allow for
takes advantage of hip abd and max contact with the shaft of the femur
right glute weakness what are we going to see
pelvic drop - right
lateral trunk lean - right
right glute weakness what are we going to see - compensated
pelvic drop right
lateral trunk lean - left
what is the AMP good at predicting
K levels
not conculsive on fall risks
