Prosthetic Gait Analysis

Question 1

Most Typical Amputee Causes of gait deviations

Answer 1

• Volumetric fluctuations
• weakness
• painful residual limb
• ligamentous instability
• fear
• habit
• weight gain/loss

Question 2

Most Typical Prosthetic Causes of gait deviations

Answer 2

• improperly fitting socket
• poorly aligned prosthesis
• wrong or misaligned components
• socket produces painful residual limb

Question 3

Prosthetic Gait Assessment

Foot slap

Answer 3

• Heel cushion is too soft
• PF bumper is too soft
• Fear: come down hard on heel

Question 4

Knee instability (or knee-buckling) during weight acceptance

Answer 4

• Weak hip extensors
• GRF is too far posterior
• Foot is set in too much DF
• Heel cushion too firm
• PF bumper is too firm
• keel too short

Question 5

abducted gait deviation (wide BOS)

Answer 5

• Leg stays wide throughout the cycle
• Medial pain, abd contracture, swelling, habit, fear
• Prosthesis too long, poor fit

Question 6

Lateral trunk deviation during stance

Answer 6

• Trendelemburg gait
• Weak hip abd, abd contracture, balance, habit
• Prosthesis is too short, poor fit

Question 7

Uneven heel rise during swing:

Answer 7

• Can be Excessive heel rise:
  
  • Strong hip flexion movt
  • Insufficient knee friction
• Or can be Insufficient heel rise:
  
  • Weak hip flexors, fear
  • Excessive knee friction

Question 8

Lateral whip immediately following toe-off

Answer 8

• heel moves laterally 1st part of swing
• Socket is too loose
• knee axis misaligned

Question 9

Medial whip immediately following toe-off (when swing starts)

Answer 9

• heel moves medially 1st part of swing
• Socket is too loose
• knee axis misaligned

Question 10

vaulting gait deviation (swing)

Answer 10

• Pronounced PF
• too long prosthesis
• can become a habit

Question 11

Circumduction

Answer 11

• Too much knee flexion resistance
• Too longer prothesis
• Medial impingement

Question 12

Hip hiking (or pelvic elevation)

Answer 12

• Between initial swing and midswing
• Too long prosthesis
• Energy consuming
• Insufficient friction at the knee
• Excessive knee extension assist

Question 13

Terminal swing impact

(an audible “clunck” at end of terminal swing phase)

Answer 13

• Abrupt hip extension is produced to ensure the knee reaches full extension (fear)
• Insufficient knee friction, extension stop worn, too strong of an extension aid

Question 14

Transtibial gait deviation during weight acceptance

Answer 14

• Knee buckling:
  
  • Weak quads, knee flexion contracture
  • Foot is set in too much DF
  • Heel cushion or PF bumper is too firm
• Excessive knee extension
  
  • Weak quads, habit
  • Foot is set in too much PF
  • Heel cushion or PF bumper is too soft

Question 15

Transtibial gait deviation during stance: prosthetic thrust

Answer 15

• Frontal plane movement of the prosthesis on the RL
• lt is normal to see a slight lat thrust (varus moment-superior border of prosthesis moves lateral) which produces a gapping at lat/sup border
• lf excessive varus:
  
  • LcL laxity
  • Socket is too loose
  • Foot too far medially

Question 16

Transtibial gait deviation during late stance: drop off (early knee flexion)

Answer 16

• Pain
• Keel is too short
• DF bumper is too soft
• shoe heel height is too high

Question 17

Transtibial gait deviation during late stance: increased knee extension (Delayed knee flexion)

Answer 17

• Pt c/o feeling like always “walking uphill”
• Pain, habit, fear
• Keel is too long
• DF bumper is too firm