Prosthetic Gait Deviations

Question 1

Transfemoral amputation: circumduction possible causes

Answer 1

• long prosthesis
• locked knee
• small/loose socket
• inadequate suspension
• foot plantar flexed
• abduction contracture
• poor knee control

Question 2

Transfemoral amputation: abducted gait possible causes

Answer 2

• medial wall discomfort
• long prosthesis
• low lateral wall/malalignment
• tight hip abductors

Question 3

Transfemoral amputation: vaulting possible causes

Answer 3

• prosthesis too long
• inadequate suspension
• socket too small
• prosthetic foot set in to much PF
• too little knee flexion

Question 4

Transfemoral amputation: lateral trunk bending during stance possible causes

Answer 4

Trunk bends forward to prosthetic side
- low lateral wall
- short prosthesis
- high medial wall
- weak abductors
- abductor contracture
- hip pain
- short amputation limb

Question 5

Transfemoral amputation: forward flexion during stance possible causes

Answer 5

• unstable knee unit
• short ambulatory aids
• hip flexion contracture

Question 6

Transfemoral amputation: lumbar lordosis during stance possible causes

Answer 6

exaggeration of the lumbar curve
- insufficient support from A-P walls
- painful ischial weight-bearing
- hip flexion contracture
- weak hip extensors or abdominals

Question 7

Transfemoral amputation: high heel rise possible causes

Answer 7

during early swing, heel rises excessively
- inadequate knee friction
- too little tension in extension aide

Question 8

Transfemoral amputation: terminal swing impact possible causes

Answer 8

prosthesis comes to a sudden stop as the knee extends during late swing
- insufficient knee friction or
- too much tension in extension aid (pt fears knee will buckle)
- forceful hip flexion

Question 9

Transfemoral amputation: swing phase whips possible causes

Answer 9

at toe-off, the heel moves either medially or laterally
- socket is rotated
- knee bolt is rotated
- foot is malaligned

Question 10

Transfemoral amputation: foot rotation at heel strike possible causes

Answer 10

as the heel contacts the ground, the foot rotates laterally, sometimes w/ vibratory motion
- foot is malalgned
- stiff heel cushion
- PF bumber

Question 11

Transfemoral amputation: foot slap possible causes

Answer 11

excessive PF at heel strike
- heel cushion or PF bumper is too soft

Question 12

Transfemoral amputation: uneven step length possible causes

Answer 12

pt favors sound limb and limits weight-bearing time on prosthetic limb
- socket discomfort or poor alignment
- hip flexion contracture or hip instability
- pt habit and need for focused gait training

Question 13

Transtibial amputation: excessive knee flexion during stance possible causes

Answer 13

• socket may be aligned too far forward or tilted anteriorly
• PF bumper is too hard and limits PF
• high heel shoes
• knee flexion contracture or weak quads

Question 14

Transtibial amputation: inadequate knee flexion during stance possible causes

Answer 14

• socket may be aligned to far back or tilted posteriorly
• PF bumper or heel cushion too soft
• low heel shoes
• anterodistal discomfort
• weak quads

Question 15

Transtibial amputation: lateral thrust at midstance possible causes

Answer 15

foot inset is too much

Question 16

Transtibial amputation: medial thrust at midstance possible causes

Answer 16

foot is outset too much

Question 17

Transtibial amputation: drop off or premature knee flexion in late stance possible causes

Answer 17

• socket is too far forward or excessively flexed
• DF bumper is too soft
• resulting in excess DF
• prosthetic foot keel too short
• knee flexion contracture

Question 18

Transtibial amputation: delayed knee flexion during late stance

Answer 18

pt feels as though walking “uphill”
- socket is set too far back or lacks sufficient flexion
- DF bumper is too stiff causing excess PF
- prosthetic foot keel too long