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Orthodics > Gait Deviations > Flashcards

Gait Deviations Flashcards

1
Q

How wide is BOS?

A

2 to 4 inches

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2
Q

What is standard bench alignment in the socket?

A

5 degrees of flexion and 5 degrees of adduction

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3
Q

Reason for bench alignment:

A

elongate quads muscles so they are better prepared to accept full weight of the body

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4
Q

Reason for bench alignment in adduction:

A

ensures that the foot is sufficiently inset to create the appropriate varus moment during stance; this properly loads the proximomedial and distolateral aspects

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5
Q

Four goals in prosthetic alignment:

A
  1. Facilitating heel strike at initial contact
  2. Providing adequate single limb stability during stance phase
  3. Creating smooth forward progression during the transition from early to late stance phase
  4. Insuring adequate swing phase toe clearance
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6
Q

Causes of hyperextension:

A

Heel cushion that is too soft
Keel or toe level arm that is too long or too firm
Laxity of posterior capsule or hamstring tendon

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7
Q

When is pistoning seen?

A

Socket it too large or inadequate suspension

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8
Q

Where is pistoning best observed?

A

bottom of shin

near knee cap

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9
Q

What can cause excessive varus?

A

Too much inset of prosthetic foot

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10
Q

What causes drop off?

A

Keel or toe level is too soft or too short

Shoe heel height too high

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11
Q

What is foot slap?

A

rapid PF after heel contact

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12
Q

Causes of foot slap:

A

Soft plantarflexion bumper

Insufficient plantarflexion resistance in prosthetic foot

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13
Q

Causes of hyperextension of knee:

A

Heel cushion too soft; keel or toe lever arm that is too long or too firm

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14
Q

Antomical cause of hyperextension of the knee:

A

laxity of posterior capsule of knee or hamstring tendon

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15
Q

Where is pistoning seen?

A

bottom of shin

near knee cap: shape between limb and socket wall

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16
Q

Causes of pistoning:

A

Socket it too large or inadequate suspension

Heel cushion too soft

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17
Q

What is excessive external rotation?

A

Lateral movement of forefoot at beginning stance

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18
Q

Causes of excessive external rotation:

A

keel is too hard/firm

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19
Q

Causes of excessive varus:

A

Too much inset of prosthetic foot
M-L dimension is excessive
Toe out

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20
Q

Causes of vaulting:

A

Too long prosthesis/suspension
Lack of toe clearance
Knee too stiff

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21
Q

Causes of asymmetrical shoulder movement:

A

Leg length discrepancies

22
Q

Causes of drop off:

A

Keel or toe lever is too soft or too short

Shoe heel height too high

23
Q

Causes of excessive abduction:

A

Walking on lateral side of foot; socket in excessive abduction relative to limb

24
Q

Causes of excessive adduction:

A

Walking on medial side of foot, socket maybe in excessive adduction

25
Q

Causes of excessive heel compression:

A

heel to soft

26
Q

Causes of excessive valgus:

A

Insufficient medial displacement of foot

27
Q

Causes of hip hiking:

A

Prosthetic too long

Knee with insufficient friction

28
Q

Causes of medial whip:

A

excessive ER of knee

29
Q

Causes of lateral whip:

A

excessive IR of hip

30
Q

Causes of lateral trunk bending:

A

Insufficient length of prosthesis

Weak hip abductors

31
Q

Causes of excessive heel rise:

A

Inadequate resistance to knee flexion

32
Q

Causes of ER of foot:

A

Too firm heel durometer;
insufficient space in socket to accommodate for muscle contraction
Socket too tight

33
Q

Causes of abducted gait:

A

Excessive pressure on ramus

Medial brim is too high

34
Q

Causes of circumduction of leg:

A

Knee flexion resistance to provide forefoot clearance
Antalgic gait mechanism when medial brim impinges tissue
Excessive rim/lengthen

35
Q

Causes of terminal impact:

A

Too little control of flexion=excessive and forceful knee extension
Not sufficient resistance to extension

36
Q

Causes of unequal step length:

A

Excessive lumbar lordosis

Less time on prosthesis

37
Q

Potential causes of knee extended:

A
  1. Too long of a toe lever
  2. Socket to far posterior to foot
  3. Insufficient knee flexion (socket or patient)
  4. Soft heel
  5. Inadequate training
  6. Weak quads
38
Q

Causes of knee instability; shorten stance phase on prosthetic side:

A
  1. Socket to far forward over foot
  2. Heel is too hard
  3. Too much knee flexion (socket or patient)
  4. Higher heeled shoes
  5. Too short of toe lever
39
Q

Knee Instability: Initial Contact to Midstance

A
  1. The knee axis may be aligned too far anterior to the TKA line, promoting a flexion moment.
  2. The socket may not have been set in the optimal preflexed position, which places the hip extensor muscles at a biomechanical advantage for stabilizing the knee.
  3. The prosthetic foot may have been aligned in excessive dorsiflexion.
  4. The plantar flexion bumper or SACH heel may be too stiff.
40
Q

Excessive knee flexion/knee instability

A

Excessive transtibial socket flexion (anterior tilt)
Transtibial socket positioned anterior to prosthetic foot
Excessive heel cushion stiffness (SACH foot)
Prosthesis too long

41
Q

What do shoes with lower heels create?

A

an extension moment at the knee

42
Q

What do shoes with higher heels create?

A

flexion moment at the knee

43
Q

Transradial sockets:

A

standard socket covers 2/3 forearm
standard socket may be shortened to allow for increased pronation/supination
supracondylar sockets are self-suspending and require no additional harness apparatus

44
Q

Transhumeral socket:

A

standard socket extends to acromion level
modified design allows for more stability with rotational movements
lightweight friction units may be used with passive prosthetic arm

45
Q

Suspension for transradial

A

triceps cuff
harness
cable system

46
Q

Suspension for transhumeral

A

harness
cable system
suction

47
Q

Elbow unit for transradial

A

attaches to either triceps cuff or upper arm pad

flexible or rigid hinge connects socket proximal component

48
Q

Elbow unit for transhumeral

A

internal or external locking elbow unit

49
Q

Transradial / transhumeral wrist unit:

A

quick change unit
wrist flexion unit
ball and socket
constant friction

50
Q

Transradial/ transhumeral terminal device

A

voluntary opening or closing
body-powered, externally powered, myoelectric or hybrid
hook, mechanical hand, cosmetic glove

Orthodics (16 decks)

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