Prosthetic Gait Training Flashcards
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
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
At IC, the prosthetic side should not be (abducted/adducted)
abducted
At IC, the sound side should not be too (abducted/adducted)
adducted
TF amputees will have the ability to flex their knee at loading response (true/false)
false
Rotational components may be added to the prosthetic to absorb impact at what phase is this addressing
loading response
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
Patients with an inability to maintain body weight over prosthesis during _ will result in _
midstance
lateral lean of the trunk
At what phase is there decreased prosthetic stance time?
a. IC
b. LR
c. MStance
d. TStance
Mstance
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
At Terminal stance hip _ activity is increased
extensor
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
During pre-swing, amputees frequently _ the prosthetic limb in preparation for swing
kick
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
During initial swing, most patients have limited _
forward pelvic rotation
decreased forward _ _ leads to decreased knee _ which results in poor _ _
pelvic progression
flexion
ground clearanace
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
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
Does the prosthetic or sound side limb usually have a longer step length?
prosthetic
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
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
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
TT Amputee cause for early phase decreased knee flexion
weak quads
anterior distal discomfort
increased quads muscle tone
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
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
ER
lateral whip causes excessive (ER/IR) of knee axis
IR
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
