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Integ > Prosthetic gait deviations > Flashcards

Prosthetic gait deviations Flashcards

1
Q

Eric Lieux:
TF IC to Midstance
Deviation: knee instability (flexion)

A

Causes:

  1. Knee Center Too far Anterior
  2. Excessive Resistance to Planter Flexion
  3. Weak Hip Extensors

Correction:
Strengthen hip extensors

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2
Q

Eric Lieux:
TF IC to Midstance
Deviation: Unequal stride

A

Cause:
Bad Gait Habit
NO TRUST

Correction:
- Work on equal stride length; put down tape to make them even

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3
Q

Eric Lieux:
TF IC to Midstance
Deviation: ER of the foot

A

Causes:

  1. Anterior Medial Brim
  2. Planter Flexion too Stiff
  3. R.O. M. Limited

Correction
Increase ROM
- want foot to hit ground, go to 5th met head, jump to first met he’d and out to big toe; need that transfer for normal gait!

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4
Q

Eric Lieux:
TF IC to Midstance
Deviation: Lateral trunk bending exceeds 1-2” at the head

A

Causes:

  1. Insufficient Adduction
  2. Foot out set too Far
  3. Prosthesis too Short
  4. Femur too Short
  5. Hip Pathology
  6. Weak Hip Abductors
  7. Painful Lateral Distal Femur Pressure

Correction:
Core strengthening with knee pain; for lateral distal femur pressure pain, scar tissue is a huge problem

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5
Q

Eric Lieux:
TF Midstance
Deviation: abducted gait

A

Causes:

  1. Medial Wall Problems
  2. Prosthesis too Long
  3. Poor Gait Habit
  4. Lateral Distal Femur Pressure
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6
Q

Eric Lieux:
TF Midstance
Deviation: Inversion or eversion of the foot

A

Causes:

  1. Improper Adduction or Abduction of Prosthetic Socket
  2. Loose Socket ML

Correction:
1st step if a prosthesis hurts, add a sock

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7
Q

Eric Lieux:
TF terminal stance
Deviation: Pelvic rise (vaulting)

A

Causes:

  1. Toe Lever too Long
  2. Shoe changed by amputee to lower heel

Correction:
Instruct amputee in regards to correct heel height

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8
Q

Eric Lieux:
TF terminal stance
Deviation: Drop off, torso lowers excessively

A

Cause:
1. Toe Lever arm Inadequate

Correction:
Gait training to achieve equal time on each leg and equal length of stride

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9
Q

Eric Lieux:
TF terminal stance
Deviation: Excessive lumbar lordosis

A

Cause of deviation:

  1. Insufficient socket Flexion
  2. Developing Hip Flexion contracture

Correction:
Stretch out contracture

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10
Q

Eric Lieux:
TF Pre-swing through initial swing
Deviation: Circumduction of the prosthesis

A

Causes:

  1. Medial Brim Problem
  2. Prosthesis too Long
  3. Inadequate Knee Flexion

Correction:
this is a habit, hard to break

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11
Q

Eric Lieux:
TF Pre-swing through initial swing
Deviation: Piston action

A

Cause:
inadequate fit and/or suspension
- should slip less than ¼ inch

Correction:
Check suspension

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12
Q

Eric Lieux:
TF Pre-swing through initial swing
Deviation: Medial whip; an abrupt medial moment of the heel as it raises from the floor, accompanied by a lateral movement of the knee and shank

A

Cause:

  1. Knee axis in excessive External Rotation
  2. Socket unstable on stump
  3. Muscular skeletal Pathology
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13
Q

Eric Lieux:
TF Pre-swing through initial swing
Deviation: Lateral whip; an abrupt lateral moment of the heel as it raises from the floor, accompanied by a medial movement of the knee and shank

A

Causes:

  1. Knee axis in excessive Internal Rotation
  2. Socket unstable on stump
  3. Muscular skeletal Pathology
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14
Q

Eric Lieux:
TF Mid-swing
Deviation: Vaulting on sound side

A

Causes:

  1. Prosthesis too long
  2. Prosthetic Knee too stiff
  3. Bad gait Habit
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15
Q

Eric Lieux:
TT IC
Deviation: Ball of the foot dorsiflexed more than 1.5”

A

Causes:

  1. Stride length too long
  2. Excessive socket flexion

Correction:
Train patient to maintain equal stride length

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16
Q

Eric Lieux:
TT IC
Deviation: Knee fully extended

A

Causes:

  1. Heel lever arm too short
  2. Heel Resistance too soft
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17
Q

Eric Lieux:
TT IC
Deviation: Excessive or insufficient compression

A

Cause:

heel resistance too soft or too firm

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18
Q

Eric Lieux:
TT
Deviation: continual anterior distal tibia pressure

A

Cause:
Excessive use of knee extensors

Correction:
Teach amputee hamstring gait

19
Q

Eric Lieux:
TT Mid-stance
Deviation: Lateral trunk bending exceeds 1” at the head

A

Causes:

  1. Hip pathology - IT band
  2. Foot outset too far
  3. Prosthesis too short
20
Q

Eric Lieux:
TT Mid-stance
Deviation: Gait base exceeds 2” - “wide base gait”

A

Causes:

  1. Foot outset too far
  2. Prosthesis too long
  3. Hip pathology
21
Q

Eric Lieux:
TT Mid-stance
Deviation: Inversion or eversion of the foot; walking on lateral or medial edged

A

Causes:

  1. Improper adduction or abduction
  2. Loose Socket M. L.
22
Q

Eric Lieux:
TT Mid-stance
Deviation: Lateral displacement exceeds ½”

A

Causes:

  1. Foot outset too far
  2. Loose socket M. L.
23
Q

Eric Lieux:
TT Mid-stance
Deviation: No lateral displacement or any displacement medially

A

Causes:

  1. Foot outset too far
  2. Pain in peroneal area
  3. Short stump
  4. Knee pathology
24
Q

Eric Lieux:
TT Terminal stance
Deviation: Knee goes into extension; pressure on anterior knee

A

Causes:

  1. Toe lever arm too long
  2. Amputee changed shoe to lower heel
  3. Insufficient socket flexion
25
Q

Eric Lieux:
TT Weight transfer to pre-swing
Deviation: Drop off; WB period shortened and knee flex accentuated

A

Cause:

Toe lever arm too short

26
Q

Eric Lieux:
TT swing phase
Deviation: Whip; An abrupt lateral or medial movement of the heel as it raises from the floor, accompanied by a medial movement of the knee and shank

A

Causes:

  1. Suspension incorrect
  2. Hip and or knee pathology
27
Q

Book
TF
Deviation: Lateral displacement, abduction in stance

A

Prosthetic causes:

  1. Long prosthesis
  2. Abducted hip joint
  3. Inadequate lateral wall adduction
  4. Sharp or high medial wall

Anatomical causes:

  1. Abduction contracture
  2. weak abductors
  3. lateral/distal pain
  4. adductor redundancy instability
28
Q

Book
TF
Deviation: Lateral displacement, Circumduction in swing

A

Prosthetic causes:

  1. Long prosthesis
  2. locked knee unit
  3. loose friction
  4. inadequate suspension
  5. small socket
  6. loose socket
  7. foot PF’d

Anatomical causes:

  1. Abduction contracture
  2. poor knee control
29
Q

Book
TF
Deviation: Trunk shifts, lateral bend in stance

A

Prosthetic causes

  1. short prosthesis
  2. inadequate lateral wall adduction
  3. sharp or high medial wall

Anatomical causes:

  1. Abduction contracture
  2. Weak abductors
  3. hip pain
  4. instability
  5. show amputation limb
30
Q

Book
TF
Deviation: Trunk shifts, forward flexion in stance

A

Prosthetic causes:

  1. unstable knee unit
  2. Short walker or crutches

Anatomical causes:
1. instability

31
Q

Book
TF
Deviation: Trunk shifts, Lordosis in stance

A

Prosthetic causes:
1. inadequate socket flexion

Anatomical causes:

  1. hip flexion contracture
  2. weak extensors
32
Q

Book
TF
Deviation: Rotations, medial (or lateral ) whip at heel off

A

Prosthetic causes:

  1. faulty socket contour
  2. knee bolt externally (or internally) rotated
  3. Foot malrotated
  4. prosthesis donned in malrotation

Anatomical causes:
1. with sliding friction unit, fast pace

33
Q

Book
TF
Deviation: Rotations, Foot rotation at heel contact

A

Prosthetic causes:

  1. Stiff heel cushion
  2. malrotated foot

no anatomical causes

34
Q

Book
TF
Deviation: Excessive knee motion, heel high rise in early swing

A

Prosthetic causes:

  1. Inadequate friction
  2. Slack extension aid

no anatomical causes

35
Q

Book
TF
Deviation: Excessive knee motion, terminal impact at late swing

A

Prosthetic causes:

  1. Inadequate friction
  2. Taut extension aid

Anatomical cause:
1. forceful hip flexion

36
Q

Book
TF
Deviation: Reduced knee motion, vault during swing

A

Prosthetic causes:

  1. Long prosthesis
  2. locked knee unit
  3. loose friction
  4. inadequate suspension
  5. small socket
  6. loose socket
  7. foot PF’d

Anatomical cause:
1. with sliding friction unit, fast pace

37
Q

Book
TF
Deviation: Reduced knee motion, hip hike in swing

A

Prosthetic causes:

  1. Long prosthesis
  2. locked knee unit
  3. loose friction
  4. inadequate suspension
  5. small socket
  6. loose socket
  7. foot PF’d

Anatomical causes:

  1. Weak DFs
  2. PF spasticity
  3. pes equinus
  4. weak hip flexors
38
Q

Book
TF
Deviation: uneven step length

A

Prosthetic causes:

  1. uncomfortable socket
  2. insufficient socket flexion

Anatomical causes:

  1. hip flexion contracture
  2. instability
39
Q

Book
TT
Deviation: Early stance, excessive knee flexion

A

Prosthetic causes:

  1. High shoe heel
  2. insufficient PF
  3. Stiff heel cushion
  4. socket too far anterior
  5. Socket excessively flexed
  6. Cuff tabs too posterior

Anatomical causes:

  1. Flexion contracture
  2. Weak quadriceps
40
Q

Book
TT
Deviation: Early stance, insufficient knee flexion

A

Prosthetic causes:

  1. Low shoe heel
  2. Excessive PF
  3. Soft heel cushion
  4. Socket too far posterior
  5. Socket insufficiently flexed

Anatomical causes:

  1. Extensor spasticity
  2. Weak quadriceps
  3. Anterior-distal pain
  4. Arthritis
41
Q

Book
TT
Deviation: Midstance, lateral thrust

A

Prosthetic cause:
1. excessive foot inset

no anatomical causes

42
Q

Book
TT
Deviation: Midstance, medial thrust

A

Prosthetic cause:
1. excessive foot outset

no anatomical causes

43
Q

Book
TT
Deviation: Late stance, early knee flexion (also referred to as “drop off”)

A

Prosthetic cause:

  1. High shoe heel
  2. insufficient PF
  3. Keel too short
  4. DF stop too soft
  5. Socket too far anterior
  6. Socket excessively flexed
  7. Cuff tabs too posterior

Anatomical cause:
1. flexion contracture

44
Q

Book
TT
Deviation: Late stance, delayed knee flexion (perception of walking uphill)

A

Prosthetic cause:

  1. Low shoe heel
  2. excessiv PF
  3. Keel too long
  4. DF stop too stiff
  5. Socket too far posterior
  6. Socket insufficiently flexed

Anatomical cause:
1. extensor spasticity

Integ (11 decks)

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