Prosthetic Gait Training Flashcards by Madelynn Kahl

Normal Prosthetic gait is determined by 
_ of amputation
technical capabilities of _ components
_ of muscles of involved LE
_ of hip and knee on involved side

level of amputation
technical capabilities of prosthetic components
strength of muscles of involved LE
ROM of hip and knee on involved side

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At IC, knee extension should be _ degrees TT; _ degrees TF

a. 0-5; 0
b. 5-10; 5
c. 15; 0
d. 10-15; 0-5

0-5;0

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At IC, the prosthetic side should not be (abducted/adducted)

abducted

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At IC, the sound side should not be too (abducted/adducted)

adducted

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TF amputees will have the ability to flex their knee at loading response (true/false)

false

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Rotational components may be added to the prosthetic to absorb impact at what phase is this addressing

loading response

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Events including: controlled tibial advancement, maintain lateral hip stability, maintain erect trunk should be achieved at what phase of gait?

a. IC
b. LR
c. MStance
d. TStance

Midstance

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Patients with an inability to maintain body weight over prosthesis during _ will result in _

midstance

lateral lean of the trunk

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At what phase is there decreased prosthetic stance time?

a. IC
b. LR
c. MStance
d. TStance

Mstance

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Events of this phase of gait include: weight shift over met heads, neutral ankle, heel off, maintain lateral hip stability, body falling to contralateral limb

a. IC
b. LR
c. MStance
d. TStance

Terminal stance

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At Terminal stance hip _ activity is increased

extensor

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Events of this phase: knee flexion to 40 degrees, all motions are passive, transitional period of double-limb support during which time the limb is rapidly unloaded and prepared for swing

a. Initial swing
b. Mstance
c. Tstance
d. Preswing

pre swing

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During pre-swing, amputees frequently _ the prosthetic limb in preparation for swing

kick

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Events during this phase: knee flexion to 60 degrees, hip flexion to 15 degrees, lift the limb from the floor

a. Initial swing
b. Mstance
c. Tstance
d. Preswing

initial swing

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During initial swing, most patients have limited _

forward pelvic rotation

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decreased forward _ _ leads to decreased knee _ which results in poor _ _

pelvic progression
flexion
ground clearanace

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During this phase: ankle DF to neutral, hip flexion to 25 degrees, knee extends to 25 degrees of knee flexion

a. Initial swing
b. Mswing
c. Tswing
d. Preswing

mid swing

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During this phase: full knee extension to create step length, deceleration of thigh for heel contact

a. Initial swing
b. Mswing
c. Tswing
d. Preswing

terminal swing

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Does the prosthetic or sound side limb usually have a longer step length?

prosthetic

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Transtibial gait deviation: Amputee cause for Excessive knee flexion

a. weak hip flexors or knee flexion contracture
b. weak hip abductors or hip flexion contracture
c. poor muscle control or weak quads
d. weak quads or knee flexion contracture

weak quads

knee flexion contracture

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TT Excessive knee flexion due to the prosthetic can be caused by all of the following EXCEPT

a. heel cushion or bumper too stiff
b. foot too far posterior
c. plantarflexed foot
d. patient wears higher heeled shoes

plantarflexed foot

caused by dorsiflexed foot

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TT Decreased knee flexion caused by the prosthesis includes all of the following EXCEPT

a. heel cushion or bumper too soft
b. excessive PF of foot
c. foot too far posterior
d. patient wears lower heel shoes

foot too far posterior

foot will be too far anterior

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TT Amputee cause for early phase decreased knee flexion

weak quads
anterior distal discomfort
increased quads muscle tone

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TT Amputee cause for late phase stance decreased knee flexion
increased _ tone 
knee joint _
poor pelvic _ 
_ proprioception/sensation

increased quad tone
knee joint pain
poor pelvic control
decreased proprioception/sensation

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TT Prosthetic causes for increased lateral knee thrust - increased foot _ - increased (abducted/adducted) socket - wide _ socket dimension

inset abducted M/L

TT Amputee cause for increased lateral knee thrust

ligamentous laxity

TT Prosthetic causes for increased medial knee thrust increased foot _ increased (abducted/adducted) gait

outset | abducted

TT Amputee causes for increased medial knee thrust ligamentous _ weak hip _

laxity | abductors

Increased lateral trunk lean seen in a TT amputee can be caused by the prosthesis being too long (true/false)

FALSE | too short

TT increased lateral trunk lean amputee causes include all of the following EXCEPT a. weak hip abductors b. balance deficits c. ipsilateral hip pain d. weak quads

weak quads

TT Prosthetic cause for abducted gait the prosthesis is too (short/long) excessive foot _

long | outset

TT abucted gait amputee causes include all of the following EXCEPT a. weak hip abductors b. feeling of insecurity c. balance disturbance d. habit

weak hip abductors

TT Excessive knee flexion drop off prosthesis causes include all of the following EXCEPT a. DF of the foot b. bumper too stiff c. foot too far posterior d. toe lever too short

bumper too stiff | bumper would be too soft potentially

TT excessive knee flexion amputee cause: a. hip flexion contracture b. knee flexion contracture c. plantarflexion contracture d. a and b

hip or knee flexion contracture

TT if the patient is vaulting the prosthesis cause could be - prosthesis too (long/short) - _ suspension

long | inadequate suspension

TT vaulting amputee cause could be due to

habit poor pelvic/hip control and weakness inadequate knee flexion

TT Vaulting occurs on the (prosthesis/sound) limb

swing side of prosthesis

TT rotation of prosthesis caused by the heel response is too _

hard

TT rotation of prosthesis amputee causes weak _ poor _ decreased _

weak hip rotators poor pelvic control decreased weight bearing

If a TT amputee is showing toe drag, the prosthesis cause could be too (short/long) inadequate _

prosthesis too long | inadequate suspension

TT amputee cause for toe drag

inadequate hip/pelvic control due to weakness | incorrect sock ply

TT decreased step length of contralateral limb prosthetic causes improperly _ with discomfort

fitting socket

TT amputee causes of decreased step length on the contralateral limb include all of the following EXCEPT a. habit b. weak hip abductors c. hip or knee flexion contracture d. restrictive AD

weak hip abductors

TF increased lateral trunk bending prosthetic causes include all of the following EXCEPT a. prosthesis too long b. too little lateral wall adduction c. medial wall too high d. excessive outset foot

prosthesis too long | it would be too short

TF increased lateral trunk bending amputee cause by all of the following EXCEPT a. weak hip abductors b. short residual limb c. adductor roll d. fear or habit

fear or habit

TF abducted gait prosthetic causes including all of the following EXCEPT a. prosthesis too long b. lateral wall too high c. too little lateral wall adduction d. foot outset too much

lateral wall too high | medial wall would be high

Abducted gait can be caused by the prosthesis being too (short/long)

long

TF abducted gait amputee causes include all of the following EXCEPT a. adductor roll b. fear or habit c. socket too tight d. hip abduction contracture

socket too tight | socket would be too loose with instability

TF circumducted gait prosthesis causes include all of the following EXCEPT a. too much DF of foot b. inadequate suspension c. insufficient knee flexion d. prosthesis too long

too much DF of foot | PF would cause

TF circumducted gait amputee causes include all of the following EXCEPT a. hip abductor contracture b. too loose of a socket c. improper sock ply d. weak hip flexors

too loose of a socket

TF medial or lateral whips prosthesis caused by

malrotation of knee unit | improperly fitting socket

medial whip causes excessive (ER/IR) of knee axis

lateral whip causes excessive (ER/IR) of knee axis

TF Rotation of foot and heel strike prosthetic causes (soft/stiff) heel cushion alignment in excessive toe (in/out) too (tight/loose) socket fit

stiff out loose

TF Rotation of foot and heel strike amputee causes - too vigorous (flex/ext) of residual limb - poor residual limb _ - insufficient _ through prosthesis

extension muscle control weight bearing

Excessive heel rise prosthetic cause could be due to

insufficient resistance to knee flexion | inadequate extension aid

Amputee cause for excessive heel rise

too forceful hip flexion

Terminal impact prosthetic cause due to insufficient knee _ extension bumper in knee joint _ or _

friction | absent or worn

Terminal impact amputee causes

forceful hip flexion followed by forceful hip extension | may be trying to feel for when the heel goes down

Foot slap prosthetic cause can be due to a. too much DF b. PF bumper too soft c. PF bumper too stiff d. too much PF

PF bumper too soft

Improperly fitted socket causing pain can create what type of deviation a. foot slap b. abducted gait c. uneven step length d. lateral trunk lean

uneven step length

An improperly shaped socket can cause what type of gait deviation a. vaulting b. lateral hip thrust c. uneven step length d. increased lumbar lordosis

increased lumbar lordosis

``` Increased lumbar lordosis amputee causes include hip _ contracture weak hip _ weak _ _ ```

flexor extensors abdominals habit

What is the most common reason for increased lumbar lordosis? a. weak hip extensors b. hip flexor contracture c. weak abdominals d. improperly shaped socket

hip flexor contracture

TF vaulting prosthetic causes include all of the following EXCEPT a. inadequate suspension b. excessive friction in knee c. too much PF d. short prosthesis

short prosthesis | long prosthesis would create vaulting

Amputees can create a vaulting gait pattern to _ momentum using _ with excessive _

increase sound side plantarflexion

Vaulting can be due to amputee a. weak hip abductors b. weak hip extensors c. weak hip flexors d. weak glutes

weak hip flexors

Vaulting can be due to amputee fear of

stubbing prosthetic toe

Delayed pelvic rotation is due to amputee having poor

poor muscle coordination

Fixing _ will fix other gait deviations

delayed pelvic rotation

the prosthesis is too (short/long) if there is a lateral hip thrust

short

Amputee causing lateral hip thrust include all of the following EXCEPT a. weak hip abductors b. poor muscle control c. weak hip flexors d. short residual limb

weak hip flexors

Alignment of the prosthesis is too far (anterior/posterior) if there is limited knee flexion

posterior

Limited knee flexion in a TF amputee is caused by weak _ _ (short/long) residual limb inadequate timing of _

weak hip flexors short residual limb inadequate timing of the pelvis

``` Knee instability prosthetic causes - heel response too (soft/stiff) into PF - excessive (PF/DF) of foot _ contracture knee joint too far (anterior/posterior) to TKA line ```

too stiff excessive DF hip flexion contracture anterior to TKA line

Knee instability amputee causes include all of the following except a. fear b. poor muscle control c. hip flexion contracture d. delayed/decreased weight bearing

fear

If there is foot drag the prosthesis is too (short/long)

long

Foot drag caused by the amputee can be because of

poor coordination weak hip or knee flexors improperly donning

an amputee can have an uneven arm swing if their prosthesis

poorly fits causing pain

Uneven arm swing can be caused by

poor balance/proprioceptive changes fear and insecurity poor training/habit

Excessive pistoning can be caused by

not seated in socket inadequate suspension inadequate sock ply large flabby residual limb

Pelvic rise/hip hike can be caused by the prosthesis - foot alignment in excessive (PF/DF) - knee too far (posterior/anterior) to TKA line - prosthesis too (short/long) - _ knee

PF posterior long manual locking

Pelvic rise/hip hike can be combined with _ gait devation

circumduction

The patient is forcefully flexing the hip then forcefully extending the hip this gait deviation is

terminal impact

an increased lumbar lordotic curve can be due to not enough socket (flexion/extension)

flexion

delayed pelvic rotation is due to

poor muscle coordination

poor balance/proprioceptive changes can cause this type of gait

uneven arm swing

if the patients is walking with an abducted gait the socket could be too (tight/loose)

loose