MT: TF Prosthetic Gait Deviation Flashcards
Why is uneven arm swing a problem?
- Goal of arm swing: minimize energy expenditure while maximizing stability and mobility
- what does arm swing do: reduces angular momentum of the body, improve stbaility and energy efficiency
Uneven arm swing prosthetic causes
- poor socket fit
- lack of suspension (fear)
Uneven arm swing patient causes
- fear
- poor balance
- habit
- lack of proper training
Initial Contact Gait Deviation
- knee instability (sagittal)
- step length asymmetry
- foot slap
Knee instability prosthetic causes
- knee to anterior
- insufficient socket flextion (for hip ext strength)
- too firm/high heel/shoe
Knee instability patient causes
- weak hip extensors
- short residual limb
Step length asymmetry prosthetic causes
shortened prosthetic step
- painful socket
- too short toe lever on the foot
Step length asymmetry patient causes
shortened prosthetic step
- lack of confidence in prosthesis
- gait habit
Foot slap prosthetic causes
- too soft a heel cushion or plantarflexion bumper of foot
Foot slap patient causes
- forced heel compression to ensure knee stability
- habit
Loading Response Gait Deviation
- external rotation of foot
External Rotation of Foot Prosthetic Causes
- heel too firm
- excessive toe out
- poorly fitting socket
External Roation of foot Patient Causes
- too tight shoe
- too hard heel of shoe
- incorrectly donned prosthesis
- poor muscle control
Midstance Gait Deviations
- Abducted Gait
- lateral trunk bend
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Abducted Gait Prosthetic Causes
- medial proximal socket pressure
- lateral distal femur pressure
- poorly contoured lateral wall
- insufficient socket adduction during bench alignment
Abducted Gait Patient Causes
- weak or contracted abductors
- poor balance
- gait habit
Lateral Trunk Bend Prosthetic Causes
Compensated Trendelenburg
- prosthesis too shrot
- foot too far outset
- insufficient socket adduction
- medial brim pain
- too large ML
- poorl designed lateral wall of socket
Lateral Trunk Bend Patient Causes
Compensated Trendelenburg
- weak abductors
- abductor contracture
- short residuum
Terminal Stance Gait Deviations
- excessive lumbar lordosis
Excessive Lumbar Lordosis
new to TF
- insufficient socket flexion
- hip flexion contracture
- weak hip or ab muscles
- short residual limb
PreSwing Gait Deviations
- Lateral Whip
- excessive heel rise
Lateral Whip prosthetic causes
- knee axis too internally rotated
- ill fitting socket
Lateral Whip patient causes
- incorrectly donned prosthesis
- weak musculature
Excessive Heel rise prosthetic causes
- insufficient knee friction or resistance
Excessive heel rise patient causes
excessive hip flexion force
Midswing gait deviations
- circumduction
- vaulting
Circumduction prosthetic causes
- too long prosthesis
- pistoning
- plantarflexed foot
- insufficient knee flexion
Circumduction patient causes
- lack of confidence in knee stability
- lack of hip flexion
Vaulting prosthetic causes
- too long
- insufficient suspension
- too much knee flexion resistance
Vaulting patient causes
habit
Terminal Swing Gait Deviations
- Terminal impact
- Step length asymmetry (long)
Terminal Impact Prosthetic Causes
- insufficient friction/resistance
- too strong extension assist
- worn extension stop
Terminal Impact Patient cause
- gabit to assure knee extension
- preference
Step length asymmetry prosthetic causes
long prosthetic step
insufficient socket flexion
