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Lower Extremity III > Gait-TF > Flashcards

Gait-TF Flashcards

1
Q

What is Lateral Bending of the Trunk?

A

Excessive bending laterally from the midline, generally to the prosthetic side.

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2
Q

What are the prosthetic causes of Lateral trunk bending?

A 
Prosthesis too short or long
Improperly shaped Lateral wall
High Medial wall
Prosthesis aligned in abduction
Excessive foot outset
Pain at distal lateral femur
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3
Q

Why does a improperly shaped lateral wall produce the lateral bend deviation?

A

Fails to support the femur

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4
Q

Why does a high medial wall cause the lateral bend deviation?

A

May cause pain and the patient to lean away from the discomfort

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5
Q

Why does an abducted socket produce lateral bend deviation?

A

Causes wide-based gait

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6
Q

What are amputee causes of lateral trunk bend?

A 
Inadequate balance
Abduction contracture
Over-sensitive residual limb to pain
Very Short limb-no lever arm
Habit
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7
Q

What is abducted gait?

A

A very wide base with the prosthesis held away from the midline at all times

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8
Q

what are prosthetic causes of abducted gait?

A 
Prosthesis too long
Prosthesis to abducted
High medial wall
Improper lateral wall shape
Pelvic band positioned far away from the patient's body
Pain at distal lateral femur
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9
Q

What are amputee causes of abducted gait?

A

Abduction contracture
Habit
Anterior pelvic tilt

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10
Q

What is circumducted gait?

A

Swinging the prosthesis laterally in a wide arc during swing phase.

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11
Q

What are the prosthetic causes of a circumducted gait?

A 
Prosthesis too long
Knee too stable 
Excessive resistance to knee flexion
Extension bias too strong
Medial brim pressure
inadequate suspension
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12
Q

What are amputee causes of circumducted gait?

A

Abducted contracture
Lacks confidence in leg
Habit

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13
Q

What is Vaulting?

A

A rising on the toe of the normal foot permitting the amputee to swing the prosthesis through with little knee flexion

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14
Q

What are the prosthetic causes of vaulting?

A 
Prosthesis too long
Inadequate socket suspension
Limb discomfort
Excessive resistance to knee flexion
Too much stability
Extension bias too strong
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15
Q

What is the amputee cause of vaulting?

A

Habit
Fear of stubbing toe
Limb discomfort

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16
Q

What are the prosthetic causes of Rotation of the prosthetic foot on heel strike?

A 
Too much resistance to plantarflexion by the bumper or heel wedge
Too much toe out
Socket too loose
Tight medial/posterior wall angle
Foot inset too far
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17
Q

What are the amputee causes of rotation of the prosthetic foot on the heel strike?

A

Extends the residual limb to vigorously at heel strike

Poor muscle control

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18
Q

What is uneven arm swing?

A

The arm on the prosthetic side held close to the body during locomotion

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19
Q

What are the prosthetic causes of uneven arm swing?

A

Improperly fitting socket-can cause discomfort

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20
Q

What are the amputee causes of uneven arm swing?

A

Bad balance
Fear and insecurity
Habit

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21
Q

What is uneven timing?

A

Steps of unequal duration, usually a very short stance phase on prosthetic side.

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22
Q

What are the prosthetic causes of uneven timing?

A

Improperly fitting socket
Weak extension aid or friction in knee
Alignment instability of knee
Insufficient initial socket flexion-for hip flexion contracture

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23
Q

Why would a weak extension aid or friction in knee cause uneven timing?

A

Excessive heel rise resulting in a prolonged swing-through.

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24
Q

What are the amputee causes of uneven timing?

A

Muscle weakness
Bad balance
Fear and insecurity

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25
Q

What is uneven heel rise?

A

The prosthetic heel rising quite markedly and rapidly when the knee is flexed at beginning of swing phase.

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26
Q

What are the prosthetic causes of uneven heel rise?

A

Knee joint has insufficient friction

Inadequate extension aid

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27
Q

What are the amputee causes of uneven heel rise?

A

Using more power than neccessary to force the knee into flexion

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28
Q

What is terminal swing impact?

A

Rapid forward movement of the shank allowing the knee to reach maximum extension with too much force before heel strike

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29
Q

What are the prosthetic causes of terminal impact?

A

Insufficient knee friction
Knee extension aid too strong
Used or absent extension bumper

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30
Q

What are the amputee causes of terminal impact?

A

Amputee reassure himself that the knee is extended

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31
Q

What can instability of the prosthetic knee cause?

A

The amputee to fall

32
Q

What are the prosthetic causes of knee instability?

A 
Knee anterior to TKA line
Insufficient initial flexion
Plantarflexion resistance too strong
Failure to limit dorsiflexion
Increased Shoe heel height-causing anterior leaning pylon
33
Q

What are the amputee causes of knee instability?

A

Weak hip extensors

severe hip flexion contracture

34
Q

What is a medial whip?

A

When the heel travels medially on initial flexion at the beginning of swing phase

35
Q

What is lateral whip?

A

The heel moves laterally

36
Q

What are the prosthetic causes of whips?

A 
Lateral- excessive internal rotation of knee or socket
Rectus femoris channel too deep
Medial-excessive external rotation of knee or socket
Rectus femoris channel too shallow
Socket too tight or poorly shaped
Excessive valgus of knee
Poor aligned toe-break-twisting toe-off
Posterior/Medial wall too tight
37
Q

What are the amputee causes of whips?

A

Habit

Weak Muscles

38
Q

What is foot slap?

A

Too rapid descent of the anterior portion of the foot

39
Q

What are the prosthetic causes of foot slap?

A

Plantarflexion resistance too soft

40
Q

What are the amputee causes of foot slap?

A

Patient driving the foot into ground to ensure extesnion

41
Q

What is drop-off?

A

A downward movement of the trunk as the body moves forward over the prosthesis

42
Q

What are the prosthetic causes of drop-off?

A 
Inadequate limitation of dorsiflexion 
Keel of SACH too short 
Toe break too far posterior
Socket too anterior to foot
Long stride on sound side
43
Q

What is long prosthetic step?

A

The amputee takes a longer step with the prosthesis than the normal leg

44
Q

What are the prosthetic causes of long prosthetic step?

A

Insufficient initial flexion in socket

45
Q

What are the amputee causes of long prosthetic step?

A

Flexion contracture

46
Q

What is excessive trunk extension?

A

The amputee creates an active lumbar lordosis

47
Q

What are the prosthetic causes of excessive trunk extension?

A

Improperly shaped posterior wall

Insufficient initial flexion of socket

48
Q

How can an improperly shaped posterior wall cause excessive trunk extension?

A

Causes forward rotation of the pelvis to avoid full weight-bearing on the ischium

49
Q

What are the amputee causes of excessive trunk extension?

A 
Flexor tightness
Weak hip extensors
Weak abdominal muscles
Habit
Bad balance
Short residual limb
50
Q

What are the prosthetic causes of pelvis rise?

A

Toe lever too long

Foot set in excessive plantarflexion

51
Q

What are the prosthetic causes of pistoning?

A

Poor socket suspension

52
Q

What are the prosthetic causes of inadequate or delayed heel rise?

A

Excessive mechanical resistance to knee flexion
Prosthesis aligned with too much stability
Limited pelvis rotation

53
Q

What are the goals for initial contact?

A

Smooth controlled plantarflexion
Knee extension smooth
Equal step length

54
Q

What are the goals for loading response?

A

Foot remains in the line of progression during plantarflexion

55
Q

What are the goals for mid-stance?

A

Vertical pylon
Narrow-based gait-2 to 4 in
No excessive lateral trunk bend

56
Q

What are the goals for terminal stance?

A

Center of gravity follows smooth arc without rise or fall of head
Normal step length on sound side without lumbar lordosis

57
Q

What are the goals for pre-swing?

A

Hip, knee, foot swing through on line of progression
Smooth hip and knee flexion with quad-like control
Hell rise equal
Socket secure on limb

58
Q

What are the goals for initial and mid-swing?

A

Center of gravity reaches the summit on its smooth arc, rhythmic path over foot

59
Q

What are the goals for terminal swing?

A

Smooth and noiseless deceleration to full extension

Equal step length

60
Q

Which gait deviations are seen during initial contact?

A

Knee instability
Unequal step length
Foot slap

61
Q

What are the gait deviations seen during loading response?

A

Excessive foot rotation

62
Q

What are the gait deviations seen during mid-stance?

A

Abducted gait
Lateral Trunk bend
Unequal toe rotation

63
Q

What are the gait deviations seen during terminal stance?

A

Pelvis rise
Drop-off
Excessive lumbar lordosis

64
Q

What are the deviations seen during pre-swing?

A

Medial/Lateral whip
Pistoning
Delayed heel rise
Uneven heel rise

65
Q

What are the gait deviations seen during initial and mid-swing?

A

Circumduction

Vaulting

66
Q

What are the gait deviations seen during terminal swing?

A

Terminal impact

Unequal step length

67
Q

What is the cause of the hip not over foot at foot flat?

A

Patient “leads” with prosthetic side with pelvic rotation

68
Q

How can you correct the hip not over foot at foot flat?

A

Gait training

69
Q

What causes narrow based gait?

A

Foot too inset

70
Q

Inversion of the foot is caused by?

A

Too much socket abduction

Loose socket in M/L

71
Q

What causes eversion of the foot?

A

Too much socket adduction

Loose socket M/L

72
Q

What causes Goose Stepping?

A

Amputee waits for knee impact before putting foot on ground

73
Q

What is goose stepping?

A

Heel does not contact floor

74
Q

What causes knee hyperextension?

A

Knee unit extension stop excessive

75
Q

What causes excessive knee flexion?

A

Swing extension resistance too low

Lower Extremity III (9 decks)

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