Prosthetic Gait

Question 1

How does the COM move when a patient undergoes some type of LE amputation?

Answer 1

Moves higher going towards the contralateral side of the amputation. (Heavier part/more body mass of the body)

Works to counterbalance the missing LE.

(COM in photo goes towards Yellow Dot)

Question 2

How are the walls of a prosthetic device similar to that of muscles deviations? Low Walls

Answer 2

Similar to Weak Muscles.

Low Anterior Wall = Weak Quadriceps
Low Lateral Wall = Weak Abductors

(Event occurring during stance)

Question 3

How are the walls of a prosthetic device similar to that of muscles deviations? High Walls

Answer 3

Similar to Tight Muscles.

High Anterior Wall = Tight Hip Flexors, pulls the pelvis anteriorly, creating lumbar lordosis.

Question 4

How will having low walls affect trunk lean?

Answer 4

Low walls, trunk will lean towards the side with low walls. Acts as a magnet. (STANCE PHASE ONLY)

Question 5

Deviation of Lateral Lean is due to?

Answer 5

Low Lateral Wall or Short Prosthesis

“inadequate lateral wall”

Question 6

Excessive lumbar lordosis during gait?

Answer 6

“Anterior wall discomfort”

High Anterior Wall

Question 7

During early swing, what is the cause of a high heel raise for a patient with an above knee amputation (AKA)?

Answer 7

Slack Extension Aid (soft/inadequate extension)

High Heel Rise = Knee Flexion

Question 8

During late swing, what is the cause of a Terminal Impact for a patient with an AKA?

Answer 8

Taut extension aid (too much assisted extension)

• Knee whips into extension.

Question 9

During Heel off, what is the cause of a Heel Whip for a patient with an AKA? Cause of lateral and medial whip?

Answer 9

Knee bolt rotated

or

Prosthesis donned in malrotation.

Heel Whip: Motion going left and right during knee flexion.

LIME WHIP:
Lateral Whip
Internal Rotation
Medial Whip
External Rotation

Question 10

During heel contact what is the cause of foot rotation for a patient with an AKA?

Answer 10

Stiff heel cushion

Malrotated foot

Question 11

How is plantar flexion of the foot restricted? Cushions/Bumper

Answer 11

Restricted in DF by a stiff heel cushion or hard plantar flexion bumper

Question 12

What is a cause of too much plantar flexion of the foot? Cushions/Bumper

Answer 12

• Heel Cushion is too soft
• Soft Plantar Flexion Bumper

Plantar Flexion Bumper is allowing too much plantar flexion.

Question 13

How will a stiff heel cushion or hard plantar flexion bumper affect knee motion?

Answer 13

Cause excessive knee flexion, to allow the sole of the foot to reach the floor.

Too much DF = Knee Flexion

Question 14

How will a soft heel cushion or soft plantar-flexion bumper affect knee motion?

Answer 14

Cause hyperextension of the knee.

Too much PF = Knee Hyperextension

Question 15

What is the most common direction of contracture for an AKA?

Answer 15

Flexion and Abduction Contractures

Question 16

What are orthotic causes of Toe Drag?

Answer 16

• Inadequate Dorsiflexion Assist
• Inadequate Plantar Flexion Stop

Question 17

How does inadequate plantar flexion stop relate to their anatomical cause?

Answer 17

Inadequate plantar flexion stop similar to spastic muscles.

Question 18

How does inadequate dorsiflexion assist relate to their anatomical cause?

Answer 18

Inadequate dorsiflexion assist similar to weak muscles.

Question 19

After gait training is it to be expected to have redness over pressure tolerant areas? Pressure sensitive areas?

Answer 19

Yes it is to be expected! (Pressure tolerant)

No redness should be observed on pressure sensitive areas.

Question 20

What are Pressure Sensitive Areas of a Transtibial (BKA)?

Answer 20

Anterior Tibia
Anterior Tibial Crest
Fibular Head and Neck
Fibular Nerve

Question 21

What are the Pressure Tolerant Areas of a Transtibial (BKA)?

Answer 21

M-DPT
Medial Tibial Plateau & Flare
Distal End
Patellar Tendon
Tibial and Fibular Shafts

(Patellar Tendon Weight Bearing Socket)