Gait Deviations

Question 1

What causes knee hyperextension IC to MS

Answer 1

heel too soft; posterior leaning pylon; socket not flexed enough or displaced posterior relative to foot; poor control

Question 2

What causes knee instability IC to MS

Answer 2

heel too stiff; DF foot, anteiror leaning pylon, anterior-distal pain or poor tolerance for loading in early stance phase

Question 3

What causes toe out IC to PS

Answer 3

too much ER of the prosthetic foot relative to the line of progression; the individuals hip is ER during ambulation

Question 4

What corrects toe out IC to PS

Answer 4

IR the prosthetic foot; retrain the individual

Question 5

What causes wide base gait/valgus MS

Answer 5

The socket is excessively abducted relative to the anatomical position of the individual’s residual limb; The prosthetic foot is aligned with excessive inversion

Question 6

What corrects wide based gait/valgus

Answer 6

Reduce the amount of abduction in the prosthetic socket; Reduce the amount of inversion at the ankle

Question 7

What causes narrow based bait/varus-lateral thrust of prosthesis MS

Answer 7

The socket is excessively abductive relative to the anatomical position of the individual’s residual limb, the prosthetic foot is aligned with excessive eversion

Question 8

What corrects narrow based gait/varus-lateral thrust of prothesis MS

Answer 8

reduce the amount of abduction in the prosthetic socket; reduce the amount of eversion at the ankle

Question 9

What causes knee hyperextension MS to PS

Answer 9

forefoot too stiff, aligned in PF, long toe level, inadequate training

Question 10

What causes knee instability MS to PS

Answer 10

forefoot too soft or aligned in excessive DF; insifficient foot length

Question 11

What causes lateral side bend IC to MS

Answer 11

prosthetic foot is outset greater than one inch; prosthesis too short; medial socket wall too high; insufficient socket adduction; amputee sensitivity; poor balance/insifficient residual limb for stability; weak abductors; painful residual limb

Question 12

What corrects lateral side bend IC to MS

Answer 12

inset the prosthetic foot; adjust prosthetic length issues; correct the adduction angle during static alignment or re-fabricate the socket

Question 13

What causes medial whip

Answer 13

knee axis of the prosthesis is in excessive ER; prosthesis is donned in ER; socket too tight or too loose

Question 14

what corrects medial whip

Answer 14

adjust the knee axis by IR until whip is resolved; re-don prosthesis without ER

Question 15

What causes lateral whip

Answer 15

knee axis of the prosthesis is in excessive IR; prosthesis donned in IR; socket too tight or loose

Question 16

What corrects lateral whip

Answer 16

adjust the knee axis by ER until whip resolved; re-donn with IR

Question 17

what causes excessive heel rise

Answer 17

prosthetic knee flexion resistance is inadequate for the patient

Question 18

what corrects excessive heel rise

Answer 18

increase the prosthetic knee flexion resistance according to the manufactuerer’s directions

Question 19

What causes circumduction

Answer 19

prosthetic knee flexion resistance is too great for patient; prosthetic knee flexion is limited for some reason; avoidance mech developed when the medial brim of the socket causes pain during swing phase; prosthesis is too long; Pt may lack confidence and not flex at the knee; stance control leg may not be stable

Question 20

what corrects circumduction

Answer 20

decrease knee flexion resistance; increase socket flexion if possible or refabricate the prosthesis; check brim of socket and remove inappropriate contours as necessary; make sure pelvis is level

Question 21

What causes vaulting

Answer 21

prosthesis too long or inadequate socket suspension; excessive knee unit resistance; inappropriate gait or inadequate training

Question 22

what corrects vaulting

Answer 22

check length of prosthesis/pelvis should be level; adjust knee unit resistance; instruct the individual about correct gait

Question 23

What causes Unequal step length; excessively short should side step length - often see uneven arm swing too

Answer 23

habitual gait pattern - poor or inadequate training and fear of putting weight on prosthesis; inadequate heel off; prosthetic socket has been modified with insufficient socket flexion

Question 24

What corrects Unequal step length; excessively short should side step length - often see uneven arm swing too

Answer 24

adjust the socket to include greater fleion; instruct the individual in proper gait patterns

Question 25

what causes pistoning

Answer 25

socket is too large for the individual; susoension is inadequate

Question 26

what corrects pistoning

Answer 26

modify the existing socket or suspension system; adjust the fit through prosthetic socks; refabricate the prosthetic socket

Question 27

what causes foot slap IC to LR

Answer 27

PF resistance too soft; foot too far anterior (short heel lever), poor control

Question 28

what causes foot ER at IC

Answer 28

foot too ER, socket fit

Question 29

What causes abducted gait during stance

Answer 29

prosthesis too long, high medial wall, abduction contracture, painful residual limb

Question 30

What happens in toe out

Answer 30

What Happens: The forefoot of the prosthesis is externally rotated relative to the line of progression, thereby shortening the toe lever of the prosthesis causing the individual to pass over the forefoot too quickly

Question 31

What is a consequence of wide based gait/valgus

Answer 31

Consequence: Excessive pressure at the proximal lateral brim

Question 32

What is a consequence of narrow based gait/varus-lateral thrust of prosthesis

Answer 32

Consequence: excessive pressure at the medial proximal and distal lateral brim