TF 3

Question 1

What does an abduction gait result from?

Answer 1

• weak hip extensors
• prosthesis too long
• pain

Question 2

How would an abduction gait result from weak hip extensors?

Answer 2

• amputee worries about the knee going into flexion
• might not get straight again and the amputee doesn’t have the extension strength to make it straight
• COMPENSATE by keeping it straight throughout the entire gait cycle

Question 3

abduction gait: pain

Answer 3

pressure on the pubic ramus (crotch)

Question 4

An abduction gait makes this activity difficult

Answer 4

ascending/descending stairs

Question 5

How is a circumduction gait different from an abduction gait?

Answer 5

foot returns to normal position on supporting surface in stance

Question 6

circumduction gait: How might the prosthesis cause this?

Answer 6

• overly stable knee

- prosthesis too long

Question 7

circumduction gait: How might friction affect this?

Answer 7

increased resistance makes it hard to bend the knee for swing

Question 8

Function of resistance in the prosthetic knee

Answer 8

helps slow the knee down from extending too quickly

Question 9

What types of pts often exhibit vaulting?

Answer 9

those with poor trunk control

Question 10

Vaulting: How might the prosthesis cause this?

Answer 10

• functionally longer leg during swing (due to pistoning)
• excessive friction resists knee flexion
• extension aid that’s too strong

Question 11

What are the gait deviations we talked about?

Answer 11

• abduction gait
• circumduction gait
• vaulting
• rotation of prosthetic foot
• terminal extension
• knee instability
• whips
• foot slap
• long prosthetic step
• pimp walk
• unequal step length

Question 12

What anatomical problem causes rotation of the prosthetic foot?

Answer 12

lack of control of the RL

Question 13

What prosthetic problem causes rotation of the prosthetic foot?

Answer 13

• vigorous extension

- loose socket

Question 14

rotation of prosthetic foot: How could this be caused by vigorous extension

Answer 14

• pt scared they can’t extend the leg
• overcontract glute max
• forces prosthesis into ER

Question 15

What are we concerned about (in the socket) with rotation?

Answer 15

skin breakdown from rotational forces

Question 16

What causes the terminal extension gait deviation?

Answer 16

• extension aid too strong
• not enough friction
• audible cues

(not mutually exclusive)

Question 17

Why would the pt want terminal extension?

Answer 17

• audible cue tells them the knee is extended
• might have weak glutes or unsure of their stability
• throw knee to extension

*want to discourage from doing this

Question 18

What anatomical issue will cause instability of the prosthetic knee?

Answer 18

hip flexion contracture/deformity

Question 19

What happens if the pt has a hip flexion contracture?

Answer 19

• socket pulled forward
• creates flexion moment at knee
• knee collapses if pt doesn’t use extensors

Question 20

If the pt has a contracture when they see the prosthetist, what will be done?

Answer 20

• adjustment of alignment to accommodate for the deformity
• pylon moved posterior to allow knee extension with contracture
• makes gait more safe

Question 21

Accommodation will be done with this amount of contracture

Answer 21

good for small contractures (5-10˚)

Question 22

What can cause instability of the prosthetic knee related to the prosthesis?

Answer 22

limited “DF”

Question 23

What causes limited DF?

Answer 23

• anterior bumper is too hard

- causes knee to buckle to move from mid-terminal stance