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Prosthetics > Prosthetic Gait > Flashcards

Prosthetic Gait Flashcards

1
Q

K-levels are used to classify the patient’s ______ function

A

POTENTIAL

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2
Q

T or F: shoes matter with prosthetics

A

T

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3
Q

what 3 things does prothetic alignment aim to do

A

1 - increase residual limb WB capacity
2 - maintain ML stability in midstance
3 - encourage knee flexion in stance

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4
Q

too high of a heel leads to knee ______ and too low of a heel leads to knee ______-

A

flexion
extension

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5
Q

3 goals for socket shape

A

1 - distribute load over large area
2 - load pressure tolerant areas
3 - maintain ideal alignment for gait stability

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6
Q

pin and shuttle locks are for _____ while lanyard straps are for ________

A

TTA
TFA

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7
Q

4 critical parts of prosthetic alignment

A

1 - symmetrical leg length
2 - foot slightly inset
3 - flexed socked
4 - TKA line

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8
Q

knee stability is maintained by what 2 things

A

1 - voluntary muscle control
2 - TKA line

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9
Q

what is one thing not related to the amputation itself that you have to think about when deciding what suspension system is best for the patient

A

can they cognitively and physically put on and adjust the suspension system

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10
Q

when a pt sits, what should you look for in both TTA and TFA

A

can they sit comfortable with hips and knees at 90 and feet flat on the floor

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11
Q

With TTA, what 2 things should you check for while pt is sitting

A

1 - hamstring relief
2 - residual limb should not pull out of socket

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12
Q

what TFA, what are 3 things you should check for while pt is sitting

A

1 - can they sit forward
2 - are the knees level
3 - does knee flex

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13
Q

if the residual limb is short, they will need ______ trim lines

A

higher (allows for less range of motion)

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14
Q

what 4 things should you look for in static frontal plane analysis? (iliac crests, foot, socket, pylon)

A

1 - iliac crests are level - no trunk lean
2 - foot is inset
3 - socket adduction/abduction matches the sound limb
4 - pylon is vertical or foot is flat on the floor at midstance

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15
Q

what does an inset foot do?

A

loads the prox-medial and distal-lat aspects of the residual limb and encourages an energy efficient, narrow-based gait

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16
Q

are sockets usually adducted or abducted

A

adducted 2-5 degrees

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17
Q

what 3 things should you look for in static sagittal plane analysis

A

1 - no forced knee flex/ext when standing
2 - shoe has even contact with floor and is bearing weight evenly
3 - socket is in initial flexion

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18
Q

what does the initial flexion of the socket do (3)

A

1 - increases weight bearing capacity of load tolerant areas
2 - allows for smooth gait pattern by placing hamstrings on stretch
3 - lessens possibility of hyperextension of the knee

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19
Q

what 2 things should you look for in static transverse plane analysis

A

1 - degree of toe-out should be about equal to the sound limb
2 - degree of toe-out should not decrease stance phase stability

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20
Q

what part of the prosthetic prevents foot slap during gait

A

PF bumper

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21
Q

what should you look for in the trunk during gait (2)

A

lumbar lordosis
lateral trunk lean

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22
Q

what is a deviation you may see in the transverse plane at terminal stance

A

medial or lateral whip

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23
Q

T or F: both the sound lib and prosthetic can push off with the same level of force at pre-swing

A

F: the prosthetic will have less force during toe off

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24
Q

what are a few things that may cause atypical gait during prosthetic ambulation

A
  • loss of active torque generation
  • loss of somatosensory feedback and proprioception
  • additional degrees of freedom
  • decreased strength/ROM
  • pain
  • prosthetic fit
  • limitations of the device
  • functional impairments in contralateral limb
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25
Q

T or F: amputees have a higher energy expenditure

A

T

26
Q

what are 3 intrinsic factors that can impact energy expenditure

A

1 - age
2- disease
3 - gait deviations

27
Q

what are 4 extrinsic factors that can impact energy expenditure

A

1 - prosthetic mal-alignment
2 - leg length discrepancies
3 - limb socket interfaces
4 - knee type

28
Q

does a pt with bilateral TTA or unilateral TFA expend more energy

A

unilateral TFA
*the higher the amputation, the more energy you expend

29
Q

does foot type have a major effect on mechanics

A

no

30
Q

T or F: energy storing feet provide for a higher self-selected velocity

A

T

31
Q

do hydraulic/microprocessor knees or constant friction knees provide more symmetry and gait velocity

A

hydraulic/microprocessor

32
Q

for the geriatric and more sedentary amputee, a _____ knee may be more stable and efficient

A

locked

33
Q

metabolic costs are _______ with microprocessor knees

A

less

34
Q

T or F: in TTA gait, the stance limb is positioned in a manner nearly identical to that of uninjured led during initial contact

A

T

35
Q

TTA gait: what is happening at hip, knee and ankle during initial contact

A

1 - ankle is neutral
2 - knee extended
3 - hip flexed 25-35 degrees

36
Q

at IC, shock absorption and ankle motion is achieved by…

A

compression of the heel component

37
Q

during loading response at the ankle, there is an external ____ moment and internal ______ moment

A

PF
DF

38
Q

TTA spend more time on the ______ during loading response

A

heel

39
Q

T or F: in amputees the external PF/internal DF moment is increased in duration and magnitude during loading response

A

T

40
Q

during pre-swing, peak DF of the ankle is determined by… (3)

A

foot stiffness
alignment
ankle joint moment from loading the trailing limb

41
Q

patients can attain normal internal ______ torque during pre-swing with proper prosthetic management and use

A

plantar flexor

42
Q

T or F: mid-stance to pre-swing kinetics are generally similar to controls

A

T

43
Q

TTA amputees have _______ knee flexion from loading response to pre-swing compared to normal gait

A

decreased
*this may be an effective compensatory strategy

44
Q

TTA have ____ external knee flexion/internal knee extension moment during stance phase

A

reduced

45
Q

TTA may have _____ hip flexion at IC and toe off

A

increased

46
Q

what muscle often has increased activation during stance phase in TTA

A

hamstrings
*doesnt seem to effect the inematics/kinetics though

47
Q

you often see ______ frontal plane motion at the trunk and pelvis during gait in TTA

A

increased

48
Q

T or F: increased frontal plane motion at trunk and pelvis can be reduced with training and proper prosthetic management

A

T

49
Q

What is the most important part of swing phase

A

toe clearance

50
Q

what could cause decreased toe clearance in a TTA

A
  • loss of active control of ankle
  • distal migration of socket
    *may compensate proximally
51
Q

T or F: you see more gait deviations later in TTA

A

F:early

52
Q

gait deviations in TTA are influenced by what 2 things related to the prosthetic foot

A

1 - stiffness of the foot
2 - training to control loading of the foot

53
Q

T or F: TFA have near normal sagittal plane kinematics during stance at the ankle

A

T
*just like TTA

54
Q

in TFA, the external PF/internal DF moment is _______ during loading response

A

increased
*just like TTA

55
Q

T or F: TFA have more joint power compared to TTA

A

F: TTA has more

56
Q

TFA have _______ knee flexion throughout stance

A

reduced

57
Q

TFA have _______ external knee flexion/internal knee extension moment across stance

A

reduced

58
Q

in TFA: what happens at terminal stance at the knee

A

it moves from an extended position in mid-stance rapidly into knee flexion
*this could be a compensatory strategy

59
Q

In TFA, the hip is more _____ early in stance. this may increase demand on hip _______

A

flexed
extensors

60
Q

in TFA, there is ______ hip flexor torque

A

greater

61
Q

T or F: posterior pelvic tilt is common in terminal stance in TFA

A

F: anterior

Prosthetics (12 decks)

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