Midterm/Practical Flashcards
Prosthetic Causes of Medial Whip
ER rotation of knee
tight socket
mis-aligned toe break
Amputee causes of medial whip
gait habit
socket not put on properly
ER rotation of hip at toe off/hip flexion
Treatment for medial whip:
Stretch ER (FAIDER, IT band) Gait training to re-educate foot/ knee and placement during swing
Prosthetic causes of lateral whip
IR rotation of knee
loose socket
mis-aligned toe break
Amputee causes of lateral whip
gait habit
socket not put on properly
IR of hip at toe off/flexion
Treatment for lateral whip
stretch internal rotators: piriformis stretch
gait retaining
Prosthetic causes of abducted gait
prosthesis too long
medial wall too high
insufficient femoral stability
induces medial whip
Amputee causes of abducted gait
abduction contracture
poor gait habit, patient insecure and desires wide base in belief it will increase stability
pelvic instability
Treatment of abducted gait
seated/standing abductor stretch
gait re-training focusing on BOS in p-bars for patient stability
strengthening of abductors (clams, donkey kicks, fire hydrants)
Prosthetic causes of circumducted gait
long prosthesis
excessive knee friction
excessive knee stability
Amputee causes of circumducted gait
lack of cofidence in flexing knee
abduction contracture
weak hip flexors
habit
Treatment of circumducted gait
stretch abductors
strengthen hip flexors (SLR, standing knee flexion and holding)
practice knee flexion in P-bars/gait re-training
Prosthetic causes of vaulting
long prosthetic
poor suspension
excessive plantarflexion of foot
excessive knee resistance or stability
Amputee cause of vaulting
gait habit, fear of catching toe
weak hip flexors on residual limb
improper initiation of hip flexors on residual limb
Treatment of vaulting
strengthen hip flexors of residual limb (SLR, standing knee flexion and hold)
foot ROM: stretch plantarflexors and strengthen dorsiflexors: resisted ROM
Prosthetic causes of heel rise
inadequate extension aid
insufficient knee friction
improper knee selection
Amputee cause of heel rise
excessive use of hip flexors to initiate swing phase, overpowering knee unit
Treatment of heel rise
stretch hip flexors (thomas stretch, standing quad stretch)
strengthen hip extensors (leg 3 way)
Prosthetic cause of knee instability
excessive dorsiflexion
knee aligned in unstable position
insufficient socket flexion
mal-alignment of foot
Amputee causes of knee instability
weak hip extensors
hip flexion contracture
Treatment of knee instability
strengthen hip extensors (leg 3 way, clams)
stretch hip flexors (thomas stretch, standing quad stretch)
Prosthetic causes of unequal step length
less time of prosthesis
Amputee causes of unequal step length
excessive lumbar lordosis
Treatment of unequal step length
pelvic tilt
gait training
strengthen hip extensors/abs
Prosthetic causes of foot slap
soft plantarflexion bumper
insufficient plantarflexion resistance in prosthetic foot
Prosthetic causes of hyperextension of knee
Heel cushion too soft; keel or toe lever arm that is too long or too firm
Amputee causes of foot slap
fear of instability in early stance and wearer forcefully drives heels into ground to ensure knee extension
Treatment for foot slap
gait retaining to trust prosthetic in P bars
Amputee causes of hyperextension of knee
laxity of posterior capsule of knee or hamstring tendon
Treatment of hyperextension of knee
strengthening of posterior capsule/hamstring
hamstring curls
russian hamstring curls
Prosthetic causes of excessive external rotation of foot
keel is too hard/firm
shoe too tight for prosthetic foot
Amputee causes of excessive external rotation of foot
weakness of hip muscles
fear of knee instability
Treatment of excessive external rotation of foot
strength hip muscles: clams, leg 3-way
gait training for knee instability
Prosthetic causes of excessive varus
Too much inset of prosthetic foot relative to socket
M-L dimension is excessive
Toe out
Amputee causes of excessive varus
hypermobile lateral/collateral ligaments
Treatment for excessive varus
quad set
short arc quads
SLR
Prosthetic causes of excessive valgus
Insufficient lateral displacement of foot (laterally) relative to socket
inversion of foot
Amputee causes of excessive valgus
hypermobile lateral/collateral ligaments
Treatment of excessive valgus
quad set
short arc quads
SLR
Prosthetic causes of drop off
Keel or toe lever is too soft or too short
Shoe heel height too high
Prosthetic causes of excessive abduction/adduction
Walking on lateral side of foot; socket in excessive abduction relative to limb
Walking on medial side of foot, socket maybe in excessive adduction
Prosthetic causes of heel compression
heel too soft
Prosthetic causes of hip hiking/pelvic elevation
prosthetic too long
knee with insufficient friction
Amputee causes of hip hiking
weak glute medius
Treatment for hip hiking
stengthen glut med: hip 3 way
step ups on weak side
Prosthetic causes of lateral trunk bending
insufficient length of prosthesis
medial wall excessively high
Amputee causes of lateral trunk bending
weak hip abductors
Treatment of lateral trunk bending
strengthen hip abductors
clams, monster walking
