Gait Deviations

Question 1

Changes in Limb Edema/ Volume

Answer 1

 Compliance in using compression
 Change in limb volume throughout the day
 Can change quickly (15-30 minutes) if not wearing
sleeve/shrinker
 Will rapidly lose limb volume in first 6-12 months
 15-20 ply of socks maximum – more compromises fit

Question 2

Inadequate Number of Sock Ply - Too Many

Answer 2

• loss of total contact at distal end of
• Patient may feel like prothetic is too long (difficulty with toe clearance)

Question 3

Inadequate Number of Sock Ply - Too Few

Answer 3

• increased pressure on distal end (bottom out) and on pressure intolerant areas
• loss of prosthetic control - increased pistoning/rotation
• TF: increased pressure in groin area

Question 4

Change of Footwear

Answer 4

• prothetic feet designed to work with a static heel

Question 5

lower heel height

Answer 5

less knee stability in stance - more demand on muscular control

Question 6

higher heel height

Answer 6

excessive knee stability in stance - possible hyperextension

Question 7

overuse of prosthesis

Answer 7

• first time prothetic users or new prothesis
• gradual break in period for tissues to accommodate to forces
• results in pain, muscle soreness, skin break down
• may result in period of not being able to use prothesis

Question 8

improper donning of prosthesis

Answer 8

• includes all components
• changes orientation on residual limb
• decrease efficiency
• changes pressure distribution

Question 9

worn or loosened components

Answer 9

• changes/problems with prosthetic parts can change alignment or fit
• sleeves that are worn (holes or tears)
• may result in inadequate suspension

Question 10

patient innovation

Answer 10

• pt may try to make prothetic adjustments without consulting the prosthetist or PT
• padding added or removed in socket
• change in foot wear
• adjustment of knee mechanics
• wearing bandages or extra padding on residual limb
• wearing socks under the sleeve