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Amputation and Prosthetics > Prosthetic Gait Deviations > Flashcards

Prosthetic Gait Deviations Flashcards

1
Q

List some possible gait deviations that can be observed in TTA?

A
  1. Excessive knee extension
  2. Knee Instability
  3. Hip drop
  4. Lateral thrust
  5. Wide based gait
  6. Drop-off/Knee Instability
  7. Vaulting
  8. Pistoning
  9. Uneven Step length
  10. Circumduction
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2
Q

List gait deviations that are observed in TTA during stance phase?

A
  1. Excessive knee extension
  2. Knee instability
  3. Hip drop
  4. Lateral thrust
  5. Wide based gait
  6. Drop off/knee instability
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3
Q

describe the gait deviation excessive knee extension (TTA)

A

knee joint is fully extended at IC, and stays that way through early stance phase

observed in the sagittal plane

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4
Q

what are some causes for the excessive knee extension gait deviation (TTA)

A
  1. Prosthetic causes
    • socket aligned too far posterior/foot aligned too far anterior
    • heel too soft
    • insufficient socket flexion
  2. Patient causes
    • weak musculature around knee
    • locking knee to prevent fall
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5
Q

describe the gait deviation “knee instability” observed in TTA

A

knee joint appears unstable duringly early stance phase

view in sagittal plane

might notice shortened stance phase on prosthetic side during gait (don’t confuse this with drop-off)

looks like pt is stepping into a hole

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6
Q

what are some causes of the gait deviation knee instability in TTA?

A
  1. Prosthetic causes:
    • socket aligned too far anterior/foot aligned too far posterior
    • heel too firm
    • excessive foot DF
  2. Patient causes
    • weak quads
    • knee flexion contracture
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7
Q

describe the gait deviation hip drop observed in TTA

A

pelvic drop toward prosthetic side during MSt

view in frontal plane

might occur as a compensation to offload a painful area of the residual limb

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8
Q

what are some causes of the gait deviation, hip drop, observed in TTA?

A
  1. Prosthetic causes
    • prosthesis too short
  2. Patient causes
    • residual limb pain
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9
Q

describe the gait deviation Lateral Thrust, observed in TTA

A

narrow BOS with lateral thrust of the socket during MSt excessive varus thrust at knee

can be difficult to see - might look like compensated/uncompensated Trendelenburg

look at proximal pylon → will be lateral leaning

pt complains of proximal medial and distolateral skin breakdown/pain

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10
Q

what are some causes of the gait deviation Lateral Thrust observed in TTA?

A
  1. Prosthetic causes:
    • foot too far inset
    • laterally leaning pylon
  2. Patient causes:
    • glute med weakness
    • knee ligament insufficiency
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11
Q

what are some causes of the gait deviation Wide Based Gait observed in TTA?

A
  1. Prosthetic causes:
    • outset foot
    • medial leaning pylon
  2. Patient causes:
    • insufficient weight shift
    • hip abduction tightness
    • patient fear
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12
Q

describe the gait deviation, drop-off/knee instability, observed in TTA

A

early and excessive knee flexion during TSt

pt appear to be falling off prosthetic at TSt and the knee looks like it buckles during the transition from TSt to ISw

non-prosthetic side might not achieve full IC/LR and instead have foot flat as they are “catching themselves”

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13
Q

what are some causes of the gait deviation, drop-off/knee instability, observed in TTA?

A
  1. Prosthetic causes:
    • socket aligned too far anterior/foot too far posterior
    • inappropriate foot choice
  2. Patient causes:
    • knee flexion contracture
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14
Q

List gait deviations that are observable during swing phase in TTA

A
  1. Vaulting
  2. Pistoning
  3. Uneven step length
  4. Circumduction
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15
Q

describe the gait deviation, Vaulting, observed in TTA

A

excessive PF of sound limb during MSt to clear prosthetic foot

view in frontal plane

essentially doing a calf raise with every step

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16
Q

what are some causes of the gait deviation, Vaulting, observed in TTA?

A
  1. Prosthetic causes:
    • prosthesis too long
    • long toe lever arm
    • socket too far posterior
  2. Patient causes:
    • holding knee in extension too long
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17
Q

what is pistoning?

A

loss of suspension

viewed in sagittal plane (or any plane)

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18
Q

what are some causes of pistoning?

A
  1. Prosthetic causes:
    • socket too large
    • not enough socks
  2. Patient causes:
    • volume changes (decrease in volume throughout the day)
    • not enough socks
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19
Q

what are some causes for uneven step length in TTA?

A

insufficient gait training

decreased patient confidence

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20
Q

describe the gait deviation, Circumduction, observed in TTA

A

pt swings leg around in abducted position to advance it forward

demonstrated more commonly in TFA

TTA tend to lock out knee making a functionally longer limb that is difficult to progress through gait

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21
Q

what are some causes for the gait deviation, Circumduction, observed in TTA?

A
  1. Prosthetic causes:
    • poor suspension
    • prosthesis too long
  2. Patient causes:
    • feeling of instability
    • decreased knee flexion during swing
22
Q

What are some main takaways from the TTA gait deviation lecture?

A
  1. any gait deviation is going to have an impact on gait efficiency and work
  2. analyze gait from multiple viewpoints to catch deviations
  3. patients may have a combo of deviations
  4. recognize when a deviation is out of your control and refer appropriately
  5. treat impairments when possible
23
Q

List gait deviations observed in TFA

A
  1. Terminal Impact
  2. Foot slap
  3. Knee Instability
  4. Lateral Trunk Bend
  5. Abducted gait
  6. Excessive Trunk Extension
  7. Drop off
  8. Excessive heel rise
  9. Circumduction
  10. Vaulting
  11. Medial Whip
  12. Lateral Whip
24
Q

describe the gait deviation, Terminal Impact, observed in TFA

A

forceful and excessive knee extension, usually audible

observed in sagittal plane

from IC/LR

25
Q

what are some causes for the gait deviation Terminal Impact (TFA)?

A
  1. Prosthetic cause
    • inadequate knee friction
  2. Patient cause
    • fear of knee giving way
    • forceful hip flexion
26
Q

describe the gait deviation, Foot Slap, observed in TFA

A

accelerated PF at heel strike resulting in the foot getting flat to the floor too soon

IC/LR

observed in sagittal plane

27
Q

what are some causes for the gait deviation Foot Slap (TFA)

A
  1. Prosthetic causes:
    • PF bumper too soft
  2. Patient causes
    • increased hip extension force at IC
28
Q

describe the gait deviation, knee instability, observed in TFA

A

knee giving way in early stance phase

observed in IC/LR in sagittal plane

29
Q

what are some potential causes of the gait devitation, Knee Instability observed in TFA

A
  1. Prosthetic causes
    • knee axis too far anterior
    • socket too far posterior
    • lack of socket flexion
  2. Patient causes
    • inadequate hip extension ROM
    • hip flexion contracture
30
Q

what are some causes of the gait deviation lateral trunk bend observed in TFA?

A
  1. Prosthetic causes
    • socket too abducted
    • prosthesis too short
    • medial socket wall too high
  2. Patient causes
    • pain
    • glute med weakness
    • decreased balance
    • adductor roll
31
Q

describe the gait deviation, Lateral Trunk Bend, observed in TFA

A

excessive lateral lean during stance phase

might have a decrease in contact with lateral wall of the socket which will decrease the ability of the glute to stabilize the pelvis

observed in MSt, in frontal plane

32
Q

describe the gait deviation, abducted gait, observed in TFA

A

excessive hip abduction during stance leading to a wide based gait pattern

observed in MSt in the frontal plane

33
Q

what are some causes of abducted gait?

A
  1. Prosthetic causes
    • foot/leg too far outset
    • prosthesis too long
    • medial socket wall too high
    • lateral wall not adducted enough
  2. Patient causes
    • abduction contracture
    • lateral-distal RL pain
    • decreased balance/trying to incr BOS
    • adductor roll
34
Q

describe the gait deviation, Excessive Trunk Extension, observed in TFA

A

excessive lumbar lordosis during stance or a posterior trunk lean

observed in MSt in sagittal plane

35
Q

what are some causes of excessive trunk extension?

A
  1. Prosthetic causes
    • increased socket extension
    • not enough flexion build into socket
  2. Patient causes
    • weak hip extensors
    • weak abdominals
    • hip flexion contracture
36
Q

describe the gait deviation drop off (TFA)

A

sudden and excessive knee flexion during late stance phase

observed in TSt in sagittal plane

37
Q

what are some causes of the gait deviation drop off?

A
  1. Prosthetic causes
    • short toe lever
    • socket set too posterior to knee axis
  2. Patient causes
    • N/A
38
Q

describe the gait deviation excessive heel raise (TFA)

A

prosthetic heel rises excessively (both in distance and velocity)

observed in PSw → Sw in sagittal plane

39
Q

what are some causes for the gait deviation excessive heel raise?

A
  1. Prosthetic causes:
    • insufficient knee friction
  2. Patient causes:
    • early forceful hip flexion
40
Q

describe the gait deviation Circumduction (TFA)

A

user swings leg in a circular motion laterally to advance it during swing

observed in Sw in frontal plane

41
Q

what are some potential causes of the gait deviation circumduction (TFA)?

A
  1. Prosthetic cause
    • prosthesis too long
    • inadequate suspension
    • excessive knee friction
  2. Patient cause
    • hip flexor weakness
    • hip abduction contracture
    • fear
42
Q

describe the gait deviation Vaulting observed in TFA

A

excessive PF of the sound limb to clear the prosthetic limb

observed in Sw in frontal plane

looks like they are doing a calf raise with every step

43
Q

what are some potential causes of the gait deviation: Vaulting

A
  1. Prosthetic cause
    • Prosthesis too long
    • inadequate suspension
    • excessive knee friction
  2. Patient cause
    • hip flexor weakness
    • hip abduction contracture
    • fear
44
Q

describe the gait deviation Medial Whip (TFA)

A

medially directed whipping motion of the prosthesis

observed in Sw in frontal/transverse plane

45
Q

what are some potential causes of the gait deviation Medial Whipping?

A
  1. Prosthetic causes
    • ER of knee compartment
    • improper alignment of knee bit
  2. Patient causes
    • improper donning
46
Q

describe the gait deviation, Lateral Whip (TFA)

A

laterally directed whipping motion of the prosthesis

observed in Sw in frontal/transverse plane

47
Q

what are some potential causes of the gait deviation Lateral Whip?

A
  1. Prosthetic cause
    • IR of knee component
    • improper alignment of knee bit
  2. Patient cause
    • improper donning
48
Q

What TFA gait deviations are observed in stance phase?

A
  1. Terminal Impact
  2. foot slap
  3. knee instability
  4. lateral trunk bend
  5. abducted gait
  6. excessive trunk extension
  7. drop off
  8. excessive heel raise
49
Q

what TFA gait deviations are observed in swing phase?

A
  1. circumduction
  2. vaulting
  3. medial whip
  4. lateral whip
50
Q

what is the relationship between # of prosthetic components and deviations?

A

more components = increased likelihood of deviations

Amputation and Prosthetics (8 decks)

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