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PTRS 746 Exam 2 > Prosthetic Gait Deviations > Flashcards

Prosthetic Gait Deviations Flashcards

1
Q

Content: Terms to Describe Gait Deviation (6)

A
  1. Toe lever arm (shoe size)
  2. Heel lever arm
  3. Heel/Keel Stiffness
  4. Socket Flexion
  5. Socket Rotation
  6. External foot rotation
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2
Q

Q: How can too short of a toe lever effect gait?

A

Can cause fall off/fall forward over the toe

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3
Q

Q: How can a anteriorly shifted foot effect gait?

A

Makes it hard for the ankle to roll over the foot

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4
Q

Q: What gait deviation is socket flexion used to accomodate?

A

Contractures (hip and knee flexion)

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5
Q

T/F: Socket flexion can effect which areas are under pressure in the socket.

A

True

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6
Q

Q: What degree of foot ER is normal?

A

~5 degrees

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7
Q

Defn: Bench Alignment

A

Bench alignment is were the WB line is in relationship to the foot. Each prothesis has a preset (optimum) bench alignment with multiple components that can be altered by a prothetist

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8
Q

Content: Static Alignment (4)

A
  1. Before assessment it is important to be all the way down into the socket
  2. Height
  3. Foot Rotation
  4. Socket Position
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9
Q

Content: Assessing prosthetic height (3)

A
  1. “Do you feel level”
  2. Distance from tibial plateau to floor equal bilaterally
  3. ASIS symmetrical
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10
Q

Q: Why may a pt. feel unlevel when first trying a prosthesis? (2)

A
  1. Not used to WB
  2. Typically initially feel tall
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11
Q

Q: What question can be asked to assess socket position?

A

“Do you feel equal weight under your heel and the ball of your foot?”

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12
Q

Q: If the patient feels like they are on their toes, how can you adjust the socket position to achieve flat foot?

A

Flex the socket

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13
Q

Defn: Dynamic Alignment

A

The alignment of the prosthesis while the pt. is moving/ambulating

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14
Q

Q: What force do you want to see at the knee during mid stance?

A

Varus thrust

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15
Q

Q: How can too long of a toe lever affect gait?

A

Cause the knee to flex/buckle

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16
Q

Q: How would you alter socket flexion to a hip flexion contracture?

A

Increase socket flexion by 5 degrees

  • Allows for the knee to be in proper alignment
  • Allows pt. to swing forward
  • Increases step length by increases ability for hip to extend back
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17
Q

Q: What is the degree of ER at the foot and knee during stance?

A

5-7 degrees for both

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18
Q

Q: What is the Foot, Knee and Hip Joint/Pelvis alignment during swing?

A

Foot - perpendicular to line of progression

Knee - perpendicular to line of progression

Hip Joint/Pelvis - IR 5-7 degrees

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19
Q

Content: Trochanter/Knee/Ankle (TKA) (4)

A
  1. Stationary alignment line identifies the relative alignment between center of socket weight, rotation point of knee, rotation point of ankle
  2. WB line anterior to TKA = stable
  3. WB line posterior to TKA = buckle
  4. Socket angled, T moves posterior, knee can’t straighten (move knee posterior)
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20
Q

Content: AKA: Prosthetic Cause of Medial Whip (3)

A
  1. ER of the knee
  2. Tight socket
  3. Mis-aligned toe break
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21
Q

Content: AKA: Amputee Cause of Medial Whip (2)

A
  1. Gait habit
  2. Socket not put on properly
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22
Q

Content: AKA: Prosthetic Cause of Lateral Whip (3)

A
  1. IR of the knee
  2. Loose socket
  3. Mis-aligned toe break
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23
Q

Content: AKA: Amputee Cause of Lateral Whip (3)

A
  1. Gait habit
  2. Socket not put on properly
  3. IR of hip at toe off/hip flexion
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24
Q

Content: AKA: Prosthetic Cause of Abducted Gait (4)

A
  1. Prosthesis too long
  2. Medial wall to high
  3. Insufficient femoral stability
  4. Induces medial whip
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25
Q

Q: What question can you ask if you see whip?

A

“Do you feel like the socket is on right/feels good?”

26
Q

Content: AKA: Amputee Cause of Abducted Gait (3)

A
  1. Poor gait habit
  2. Abduction contracture
  3. Pt. insecure and desires wide base in belief it will increase stability
27
Q

Q: What positions should amputees never be left in?

A

With pillows under or between their legs (prevent flexion and abd contracture)

28
Q

Content: AKA: Prosthetic Cause of Circumducted Gait (2)

A
  1. Long prosthesis
  2. Excessive knee friction stability
29
Q

Content: AKA: Amputee Cause of Circumducted Gait (4)

A
  1. Lack of confidence in flexing knee
  2. Abd contracture
  3. Weak hip flexors
  4. Habit, using entire hip and pelvis to initiate gait
30
Q

Content: AKA: Prosthetic Cause of Vaulting (4)

A
  1. Long prosthesis
  2. Poor suspension
  3. Excessive PF
  4. Excessive knee resistance/stability
31
Q

Content: AKA: Amputee Cause of Vaulting (3)

A
  1. Gait habit - fear of catching toe
  2. Weak hip flexors on residual limb
  3. Improper initiation of hip flexors on residual limb
32
Q

T/F: Vaulting gait deviations are easy to fix.

A

False: Hard to get rid of

33
Q

Content: AKA: Prosthetic Cause of Heel Rise (3)

A
  1. Inadequate extension aid
  2. Insufficient knee friction
  3. Improper knee selection
34
Q

Content: AKA: Amputee Cause of Heel Rise

A

Excessive use of hip flexors to initiate swing phase, overpowering knee unit

35
Q

Content: AKA: Prosthetic Cause of Knee Instability (4)

A
  1. Excessive DF
  2. Knee aligned in unstable position
  3. Insufficient socket flexion
  4. Mal-alignment of foot
36
Q

Content: AKA: Amputee Cause of Knee Instability (2)

A
  1. Weak hip extensors
  2. Hip flexion contracture
37
Q

Q: What is one thing pts. can do that can effect their gait?

A

Change their shoes - altered heel height

38
Q

Q: Which leg should an amputee start their gait with?

A

Sound leg

The prosthesis is like a pendulum, its easier to start a pendulum from a pulled back position as opposed to the bottom of the swing

39
Q

Q: What are two types of uneven timing?

A
  1. Short Prosthetic Step
  2. Long Prosthetic Step
40
Q

Content: AKA: Prosthetic Cause of Short Prosthetic Step (5)

A
  1. Socket Pain
  2. Weak extension aid
  3. Unstable knee
  4. Excessive DF
  5. Poor suspension
41
Q

Content: AKA: Amputee Cause of Short Prosthetic Step (3)

A
  1. Patient Insecurity
  2. Weak hip muscles
  3. Poor balance
42
Q

Content: AKA: Prosthetic Cause of Long Prosthetic Step (3)

A
  1. Excessive PF
  2. Insufficient initial socket flexion
  3. Long toe lever arm
43
Q

Content: AKA: Amputee Cause of Long Prosthetic Step (3)

A
  1. Flexion contracture
  2. Patient insecurity
  3. Pain on sound side
44
Q

Content: AKA: Prosthetic Cause of Lateral Shift (2)

A
  1. Prosthetic foot too far inset
  2. Excessive socket adduction
45
Q

Content: AKA: Amputee Cause of Lateral Shift (2)

A
  1. Weak hip abductors
  2. Narrow gait base
46
Q

Content: AKA: Prosthetic Cause of Lateral Trunk Bend (4)

A
  1. Foot too far outset
  2. Ineffective lateral socket containment
  3. High medial wall
  4. Aligned in Abd
47
Q

Content: AKA: Amputree Cause of Lateral Trunk Bend (4)

A
  1. Habit
  2. Inadequate balance
  3. Abd contracture
  4. Short residual limb
48
Q

Content: AKA: Prosthetic Cause of Toe Drag (3)

A
  1. Long prosthesis
  2. Excessive PF
  3. Excessive knee friction
49
Q

Content: AKA: Amputree Cause of Toe Drag (4)

A
  1. Weak hip flexors
  2. Weak hip abd on sound side
  3. Poor posture
  4. Poor gait habits
50
Q

Q: What are the 4 factors of Gait?

A
  1. Patient
  2. Prosthetic alignment
  3. Socket fit
  4. Rehab teamwork
51
Q

Q: When are patients typically fit for prosthetics?

A

anywhere from 4 (early) to 8 wks, sometimes 12 wks

52
Q

Content: BKA: Prosthetic Causes of Drop Off (with excess knee flexion) (4)

A
  1. Short toe lever
  2. Excessive socket flexion - throws torso forward
  3. Excessive DF
  4. Incorrect foot type (ex. keel not firm enough)
53
Q

Content: BKA: Amputee Cause of Drop Off (with excess knee flexion) (3)

A
  1. Gait Habit
  2. Weak Quads
  3. Knee Flexion Contracture
54
Q

Content: BKA: Prosthetic Cause of Vaulting (4)

A
  1. Long prosthesis
  2. Poor suspension
  3. Excessive PF
  4. Excessive knee resistance/stability
55
Q

Content: BKA: Amputee Cause of Vaulting (3)

A
  1. Gait habit - fear of catching toe
  2. Weak hip flexors on residual limb
  3. Improper initiation of hip flexors on residual limb
56
Q

Content: BKA: Prosthetic Cause of Wide Gait (2)

A
  1. Prosthetic foot too far outset
  2. Excessive socket adduction
57
Q

Content: BKA: Amputee Cause of Wide Gait (3)

A
  1. Gait Habit
  2. Insecurity, wants to widen base in attempt to increase stability
  3. Weak ML knee control
58
Q

Content: BKA: Prosthetic Cause of Lateral Shift (3)

A
  1. Foot too far inset
  2. Insufficient socket adduction
  3. Short prosthesis
59
Q

Content: BKA: Amputee Cause of Lateral Shift (3)

A
  1. Inadequate balance
  2. Weak knee
  3. Narrow gait base
60
Q

Content: BKA: Long Prosthesis (5)

A
  1. LBP
  2. Feel like walking up a hill
  3. Noticeable rise and drop of shld on effected side
  4. Hesitation in gait timing from prosthetic mid-stance to sound side heel strike
  5. Pain in hip on amputated side - taking more pressure
61
Q

Content: BKA: Short Prosthesis (6)

A
  1. LBP
  2. Feel like stepping in a hole
  3. Noticeable rise and drop of shld on the sound side
  4. Uneven arm motion to accommodate uneven stride length
  5. Appears like patient may be vaulting
  6. Hip pain on sound side
62
Q

Content: BKA: External Foot Rotation (7)

A
  1. Pt. wants foot to match sound side
  2. IR of knee at toe off
  3. Induces “medial whip”
  4. Drop off at end of stance phase
  5. LBP
  6. Skin irritation due to rotational stress in socket
  7. Mid stance falling over foot (valgus thrust)

PTRS 746 Exam 2 (9 decks)

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