TF Gait Deviations Flashcards
Describe terminal impact during IC->LR of TF gait:
forceful and excessive knee extension, usually audible
What prosthetic causes of terminal impact during IC->LR of TF gait?
Inadequate knee friction (won’t slow leg down)
What user causes of terminal impact during IC->LR of TF gait?
- Fear of knee giving way
2. Forceful hip flexion
Describe foot slap during IC->LR of TF gait:
Accelerated PF at heel strike resulting in the foot getting flat to the floor too soon
What prosthetic causes of foot slap during IC->LR of TF gait?
PF bumper too soft
What user causes of foot slap during IC->LR of TF gait?
Increased hip extension force at IC
Describe knee instability during IC->LR of TF gait:
Knee giving way in early stance phase
What prosthetic causes of knee instability during IC->LR of TF gait?
- Knee axis too far anterior
- Socket too far posterior
- > Gravity line falls posterior to knee causing flexor moment - Lack of socket flexion
What user causes of knee instability during IC->LR of TF gait?
- Inadequate hip extension ROM
2. Hip flexion contracture
T/F Knee instability during IC->LR of TF gait is major cause of concern in the transfemoral amputee as it can lead to falls
True
Describe lateral trunk bend during MSt of TF gait:
- Excessive lateral lean during stance phase
- this deviation is seen when there is inadequate contact between the residuum and the lateral wall of the socket, thus limiting the action of gluteus medius
What prosthetic causes of lateral trunk bend during MSt of TF gait?
- Socket too abducted (shift body over it)
- Prosthesis too short
- Medial socket wall too high (dig into groin -> lean away from medial wall)
What user causes of lateral trunk bend during MSt of TF gait?
- Pain
- Glute med weakness
- Decreased balance
- Adductor roll
lateral trunk bend during MSt of TF gait causes pain where?
Distal lateral
What two deviations can you find during lateral trunk bend during MSt of TF gait?
- Bell clapping laterally into lateral wall of socket
2. compensated Trendelenburg
Describe abducted gait during MSt of TF gait:
Excessive hip abduction during stance leading to a wide based gait pattern
What prosthetic causes of abducted gait during MSt of TF gait?
- Foot/leg too far outset
- Prosthesis too long (user will bring the leg out in an attempt to level the pelvis)
- Medial socket wall too high
- Lateral wall not adducted enough (too big/sloppy – actively abduct femur into socket to get contact with wall)
What user causes of abducted gait during MSt of TF gait?
- Abduction contracture
- Lateral-distal RL pain
- Decreased balance/trying to incr BOS
- Adductor roll
Describe excessive trunk extension during MSt of TF gait:
Excessive lumbar lordosis during stance or a posterior trunk lean
What prosthetic causes of trunk extension during MSt of TF gait?
- Increased socket extension
2. Not enough flexion built into socket
What user causes of trunk extension during MSt of TF gait?
- Weak hip extensors
- Weak abdominals
- Hip flexion contracture
- Very short RL – decreased ability to stabilize, lean back and rock forward to generate momentum
Often see decreased strength in what back muscles in patients with excessive trunk extension during MSt?
Weak multifidus
Describe drop/knee instability during Tst of TF gait:
Sudden and excessive knee flexion during late stance phase
What prosthetic causes of drop/knee instability during Tst of TF gait?
- Short toe lever (loss of anterior support caused by a short keel)
- Socket set too posterior to knee axis
Describe excessive heel raise during PSw->Sw of TF gait:
Prosthetic heel rises excessively (both in distance and velocity)
What prosthetic causes of excessive heel raise during PSw->Sw of TF gait?
Insufficient knee friction – flex too soon so lift heel off ground excessively
What user causes of excessive heel raise during PSw->Sw of TF gait?
Forceful hip flexion to ensure a heel rise and the knee progressing through swing to extension
Describe circumduction during Sw of TF gait:
User swings leg in a circular motion laterally to advance it during swing
What prosthetic causes of circumduction during Sw of TF gait?
- Prosthesis too long
- Inadequate suspension
- Medial wall too high – circumduction to take pressure off
- Excessive knee friction – functionally long prosthesis
What user causes of circumduction during Sw of TF gait?
- Hip flexor weakness
- Hip abduction contracture
- Fear
What prosthetic causes of vaulting during sw of TF gait?
Prosthesis too long
Inadequate suspension
Excessive knee friction
What user causes of vaulting during sw of TF gait?
Hip flexor weakness
Hip abduction contracture
Fear
T/F vaulting during sw of TF gait has an abnormal prosthetic path leading to fall risk
False, almost normal prosthetic path leading to fall risk
T/F Pistoning is often seen with vaulting.
True
Describe medial whip during Sw of TF gait:
Medially directed whipping motion of the prosthesis (named according to the direction in which the prosthetic heel moves at heel off)
What prosthetic causes of medial whip during Sw of TF gait?
- External rotation of knee component
2. Improper alignment of knee bolt
What user causes of medial whip and lateral whip during Sw of TF gait?
Improper donning
Describe lateral whip during Sw of TF gait:
Laterally directed whipping motion of the prosthesis (named according to the direction in which the prosthetic heel moves at heel off)
What prosthetic causes of lateral whip during Sw of TF gait?
- Internal rotation of knee component
2. Improper alignment of knee bolt
TT or TF amputation more efficient in regard to metabolic cost of ambulation?
TT
Traumatic etiology or vascular amputation more efficient in regard to metabolic cost of ambulation?
Traumatic
TTA trauma O2 consumption and gait velocity changes:
15%+
-10%
TTA vascular O2 consumption and gait velocity changes:
30%+
-30%
TFA trauma O2 consumption and gait velocity changes:
40%+
-20%
TFA vascular O2 consumption and gait velocity changes:
65%+
-40%
What factors tend to influence the metabolic cost of ambulation?
length of the residual limb
the cause of amputation
