Prosthetic gait deviation Flashcards
excessive bending lateral from the midline (usually to prosthetic side)
Lateral bending of the trunk
Prosthetic causes for Lateral bending
- Prosthesis too short
- An improperly shaped lateral wall may fail to provide adequate support for the femur
- High medial wall may cause lean away to minimize discomfort
- A prosthesis aligned in abduction may cause a wide-based gait, resulting in lat lean
Amputee causes for Lateral bending
- inadequate balance
- abduction contracture
- residual limb over-sensitive & painful
- very short limb may fail to provide a sufficient lever arm for the pelvis
- habit pattern
very wide base w/ prosthesis held away from the midline at all times
Abducted gait
Prosthetic causes for Abducted gait
- prosthesis too long
- too much abduction built into prosthesis
- high medial wall–> pressure on ramus
- improperly shaped lateral wall doesn’t support the femur well
- pelvic band positioned too far away from pt body
Amputee causes for Abducted gait
- abduction contracture
- habit pattern
swing prosthesis laterally in a wide arch during swing phase
Circumducted gait
Prosthetic causes for circumducted gait
- too long prosthetic
- too much alignment stability/friction the knee–> difficult for knee flex
Amputee causes for circumdected gait
- abd contracture of residal limb
- lack confidence for fllexing the prosthetic knee bc of mm weakness/fear of stubbing toe
- habit pattern
rising on the toe of the normal foot permitting the amputee to swing the prosthesis through with little knee flexion
vaulting
Prosthetic causes for vaulting
- too long
- inadequate socket suspension
- limb discomfort
Amputee causes for vaulting
- habit pattern
- fear of stubbing toe
- limb discomfort
Prosthetic causes for Rotation of the prosthetic foot on heel strike
- too much resistance t lantar flexing by thePF bumper/ heel wedge
- too much toe-out built in
- loosely fitting socket
Amputee causes for Rotation of the prosthetic foot
- pt extend the residual limb too vigorously at heel strike
- poor mm control of residual heel
Prosthetic causes for Uneven arm swing on prosthetic side
-improperly fitting socket–> limb discomfort
Amputee causes for Uneven arm swing on prosthetic side
- bad balance
- fear/insecurity w/ uneven timing
- habit pattern
Prosthetic causes for Uneven timing of steps
- improperly fitting socket causing pain & desire to shorten stance phase on prosthetic side
- weak extension aid/insufficient friction in prosthetic knee causes excessive heel rise–> prolonged swing-through
- alignment stability
Amputee causes for Uneven arm swing on prosthetic side
- mm weakness
- bad balance
- fear/insecurity
Prosthetic causes for Uneven heel rise
- knee joint have insufficient friction
- inadequate extension aid
Amputee causes for Uneven heel rise
-amputee using more power than needed for knee flex
Rapid forward movement of that shank allowing the knee to reach maximum ext w/ too much force before heel strike
Terminal swing impact
Prosthetic causes for Terminal swing impact
- insufficient knee friction
- too strong knee extension
Amputee causes for Terminal swing impact
-Amputee makes sure of full knee extension by deliberalty and forcibly extending residual limb
Prosthetic causes for Instability of prosthetic knee
- knee jn too far ahead of the TKA line
- insufficient initial flex built into socket
- PF resistance too great–> knee buckling at heel strike
- failure to limit DF leads to incomplete knee control
Amputee causes for Terminal swing impact
- hip extensor weakness
- severe hip flex contracture
Prosthetic cause for Lateral whips
- excessive IR of prosthetic knee
- too tight socket fit
- excessive valgus in prosthetic knee
- badly aligned toe-break in a conventional foot–> twisting on toe-off
Prosthetic cause for Medial whips
- excessive ER of prosthetic knee
- too tight socket fit
- excessive valgus in prosthetic knee
- badly aligned toe-break in a conventional foot–> twisting on toe-off
Amputee causes for Medial/Lateral whips
-Faulty walking habits
Prosthetic causes for Foot Slap
-PF resistance is too soft
Amputee causes for Foot Slap
-amputee may be driving the prosthesis into the walking surface too forcibly to assure knee extension
Downward movement of the trunk as the body moves forward over the prosthesis
Drop off at the end of stance phase
Prosthetic cause of Drop off at the end of stance phase
- inadequate limitation of DF
- too short keel of SACH-type foot
- too far posterior toe break of a conventional foot
- too far anterior socket (when related to the foot)
Amputee cause of Drop off at the end of stance phase
-no specific medical causes
Prosthetic cause for Long prosthetic step
-insufficient initial flexion in the socket when an irreducible residual limb flexion contractor is present
Amputee cause for Long prosthetic step
-Flexion contracture un-accommodated prosthetically
Prosthetic causes for Excessive trunk extension
- improperly shaped posterior wall–> forward rot of pelvis to avoid full wt bearing on ischium
- insufficient initial flexion build into the socket
Amputee causes for Excessive trunk extension
- hip flexor tightness
- wk hip extensor–> lumbar substitution
- wk abdominal mm
- habit pattern
- shoulders moving backward for better balance
