Set 4 AKA Gait

Question 2

Lateral bending

Answer 2

is excess bending laterally from the mid-line, generally to the prosthetic side. Prothesis CausesToo Short, Lateral wall improper shape results decre. femur support; Medial Wall Discomfort results in amputee leans away to minimize discomfort; ABD alignment cause wide-based gait Amputee Causes:short limb results in decre. lever arm for pevlis, poor balance, limb-oversensitive and painful, ABD contracture

Question 3

Abducted Gait

Answer 3

very wide base with prosthesis held away from midline at all timesProsthesis Causes: too long, too much built in ABD, lateral wall improper shaped results in decr. femur suppose; medial wall disocmfort results hold prosthesis away to avoid ramus pressure; pelvic band position too far from pt bodyAmputee:lazy gait; abd contracture; habit pattern

Question 4

Circumducted Gait

Answer 4

swinging of prosthesis laterally in a wide arc during swing phaseProsthesis Causes:too long; too much alignment stability or knee friction which can cause difficult to bend knee in swingAmputee Causes:pt lacks confidence to flex knee, leads to muscle weakness or fear of stubbing toe; habit pattern

Question 5

Vaulting

Answer 5

rising on the toe of the normal food during swing phase on prosthetic sideProsthesis Causes:Too long; inadequate socket suspension; excess alignment stability or knee flexion limitationAmputee Causes:fear of stubbing toe, habit pattern, discomfort; used as timing mechanism

Question 6

rotation of prosthetic foot on heel strike

Answer 6

Prosthesis Cause:too much resistance to PF by PF bumper or heel wedge; excess toe out built in; loosely fit socket; glut. max too tight in socketAmputee Cause:pt may extend stump too vigorously at heel strike, poor muscle control of residual limb

Question 7

uneven arm swing

Answer 7

arm on the prosthetic side held close to the body during locomotionNO prosthesis cause; duh!!Amputee Causes: poor balance; fear/insecurity accommodated by uneven timing; habit pattern

Question 8

uneven timing

Answer 8

steps of unqeual duration, usually by very short stance phase on prosthetic sideProsthesis Causes: improper socket can cause pain and desire to shorten stance on prost. side; weak ext.aid/insufficient friction in pros. knee can result in excess heel rise can result in uneven timing due to extended swing thru; alignment stability if knee bucklesAmputee Causes:Weak limb, poor balance; fear/insecurity

Question 9

uneven heel rise

Answer 9

prosthetic heel rising quite markedly and rapidly when knee is flxed at beginning of stance phase.Prosthesis Cause: insufficient knee joint friction; inadquate ext.aidAmputee Cause: may use more power than needed to force knee into flexion

Question 10

terminal swing impact

Answer 10

rapid forward movement of teh shin allowing the knee to reach max. extension with too much force before heel strikeProsthetic Cause: insufficient knee friction, knee ext. aid may be too strongAmputee Cause: amputee may try to assure himself that the knee is in full ext. by deliberately and forcibly extending the limb

Question 11

instability of the prosthetic knee

Answer 11

Prosthetic Cause:knee joint may be too far ahead of the TKA; insufficient initial flexion may have been built into the socket ; PF resistance may be too great causing the knee to buckle at heel strike; failure to limit DF can lead to incomplete knee controlAmputee Cause: pt may have hip extensor weakness; severe hip flexion contracture may cause instability

Question 12

medial / lateral wip

Answer 12

during flex at beginning of swing phase, the heel travels either medial / lateralProsthestic Cause: lat whip may result from the excessive IR of the prosthetic knee ; medial whip from excessive ER of the knee ; socket may fit too tightly thus reflecting stump rotation ; excessive valgus ; badly aligned toe break in foot may cause twisting on toe-offAmputee Cause: faulty walking habits may result in whips

Question 13

drop off at the end of stance phase

Answer 13

a downward movement of the trunk as the body moves forward over the prosthesisProsthetic Causes: inadequate limitation of DF of the prosthetic foot; the socket may have been placed too far anterior in relation to the footAmputee Cause: none

Question 14

long prosthetic step over normal leg

Answer 14

Prosthetic Cause: insufficient initial flexion in the socket can cause this defect, when an irreducible hip flexion contracture is presentAmputee Causes: flexion contracture which cannot be accommodated prosthetically

Question 15

excessive trunk extension during stance phase occurs when the amputee creates an active lumbar lordosis

Answer 15

Prosthetic Cause: improperly shaped posterior wall may cause forward rotation of the pelvis to avoid full weight bearing on the ischium; insufficient initial flexion may have been built into the socketAmputee Cause:hip flexor tightness, weak hip extensors/subsitiuting lumbar erector spinae ; weak abdominal muscles; deviation due to habit pattern; pt may be moving shoulders backwards in an effort to obtain better balance