Prosthetic Gait Flashcards
Where does COM move after amputation?
-Towards heavier part of body.
-Away from amputated limb.
-LE amputation = also shifts upward/superior.
-UE amputation = shifts lower.
How does the socket wall mimic muscle-related deviations?
-Socket wall becomes the “new muscle” (anterior wall = functions like quads).
-Low socket wall = weak muscles.
-High socket wall = tight muscles.
Example: lateral trunk lean d/t weak hip ABD or d/t low lateral wall.
What may cause foot rotation during IC?
-Stiff heel cushion.
-Incorrectly rotated foot.
What may cause lateral trunk lean during stance?
-Short prosthesis.
-Low lateral wall.
What may cause excessive abduction during stance?
-Long prosthesis.
-Abducted hip joint.
What may cause lordosis during stance?
Anterior wall discomfort
What may cause forward flexion during stance?
-Unstable knee joint.
-Short walker.
What may cause heel whip during heel-off?
-Knee bolt rotated.
-Prosthesis donned in poor rotation.
Medial heel whip indicates the knee bolt is…
ER
Lateral heel whip indicates the knee bolt is…
IR
What may cause high heel rise during early swing?
-Inadequate friction
-Slack extension aid (knee flexes too much)
What may cause terminal impact during late swing?
-Inadequate friction
-Taut extension aid (uncontrolled whip into max extension)
If Heel/PF Bumper is too stiff/hard…
-PF is restricted, less absorption of heel strike.
Compensations:
-Abrupt or excessive knee flex.
-Excessive DF.
If Heel/PF Bumper is too soft…
-GRF moves too far anteriorly from IC to mid-stance.
Compensations:
-Knee hyperext.
-Excessive PF.
Orthotics: inadequate DF assist mimics…
Weak DF
Orthotics: inadequate PF stop mimics…
PF spasticity
Orthotics: common deviations d/t inadequate DF assist or inadequate PF stop
-Toe drag
-Circumduction
-Hip hiking
-Vaulting
Orthotics: common deviations d/t inadequate knee lock
Excessive knee flex
Orthotics: common deviations d/t excessive knee lock
Too much knee ext, so to clear foot off ground:
-Toe drag
-Circumduction
-Hip hiking
-Vaulting
Most common contractures after amputation
Hip flex
Hip ABD
How does a neuroma happen? Common sxs?
-Nerves that were separated during amputation try to reconnect, but end up becoming a disorganized lump of N cells.
-Sharp, shooting, burning pain.
-Tender to pressure.
Pressure Tolerant vs. Pressure Sensitive definitions
Tolerant: some redness is expected after prosthetic use (red = OK).
Sensitive: no redness should be observed (red = BAD).
Pressure Tolerant Areas
-Patellar Tendon
-Medial tibial plateau
-Tib/fib shafts
-Distal end
Pressure Sensitive Areas
-Anterior tib
-Anterior tibial crest
-Fib head
-Fibular N
What is Pistoning & when does it occur?
-Residual limb pistons up/down.
-Socket too large.
What is Drop-Off & when does it occur?
-Early knee flex.
-Keel too short (insufficient PF).
K Level 0
Non-ambulatory, bedbound.
Not a candidate for prosthetic.
K Level 1
Limited household ambulation.
Candidate for manual lock or stance control knee & SACH or single-axis foot.
K Level 2
Unlimited household ambulation.
Limited community ambulation.
Candidate for pneumatic knee & multi-axis foot.
K Level 3
Unlimited community ambulation.
Candidate for hydraulic knee & energy storing foot.
K Level 4
Able to participate in sport or high-level activities.
Candidate for hydraulic or microprocessor knee & energy storing foot.
