Transtibial Gait Deviations

Question 1

Foot too inset:
Forces being applied:
1.
2.
Moment at knee:
1.

Answer 1

Forces being applied:
1. Medial proximal
2. Lateral distal
Moment at knee:
1. Varus

Question 2

Foot too outset:
Forces being applied:
1.
2.
Moment at knee:
1.

Answer 2

Forces being applied:
1. Lateral proximal
2. Medial distal
Moment at knee:
1. Valgus

Question 3

Foot too posterior:
Forces being applied:
1.
2.
Moment at knee:
1.

Answer 3

Forces being applied:
1. Anterior distal
2. Posterior proximal
Moment at knee:
1. Flexion

Question 4

Foot too anterior:
Forces being applied:
1.
2.
Moment at knee:
1.

Answer 4

Forces being applied:
1. Anterior proximal
2. Posterior distal
Moment at knee:
1. Extension

Question 5

Standard bench alignment:
1.
2.
3.
4.

Answer 5

1. 5-7 degrees flexion
2. 5 degrees adduction
3. Foot inset 1/2”
4. Foot posterior 1-1 1/2” (inset foot to create varus moment at knee. Pre-flex socket to avoid knee hyperextension and create smooth rollover)

Question 6

Why is varus moment desirable?
1.
2.
3.

Answer 6

1. Energy efficient gait
2. Minimize center of gravity
3. Have a narrow base of support

Question 7

Why is the socket pre-flexed?
1.
2.
3.
4.

Answer 7

1. Prevent knee hyperextension
2. Load anterior panel
3. Match natural gait knee flexion during loading response
4. Creates smooth rollover

Question 8

Anterior distal pain:
1.
2.
3.
4.

Answer 8

1. Foot too posterior
2. Foot too dorsi-flexed (socket too flexed)
3. Heel too firm
4. Socket relief inadequate

Question 9

Knee extension through midstance:
1.
2.
3.
4.

Answer 9

1. Foot too anterior
2. Foot too plantarflexed
3. Heel too soft
4. Insufficient socket flexion

Question 10

Lateral trunk bending:
1.
2.
3.
4.

Answer 10

1. Foot too outset
2. Prosthesis too short or too long
3. Pain in residual
4. Habit

Question 11

Heel whip:
1.
2.

Answer 11

1. Hamstring relief inadequate
2. Suspension issue

Question 12

Lateral thrust, lateral gap:
1.
2.

Answer 12

1. Foot too inset
2. Socket M/L too big

Question 13

Medial leaning pylon:
1.
2.

How do you adjust it to get to normal alignment?

Where are the pressures being applied in the socket?

Answer 13

1. Foot too outset
2. Socket adducted

You adjust the screws by loosening the lateral and tightening the medial.

Pressure areas are: proximal lateral and distal medial

Question 14

Lateral leaning pylon:
1.
2.

How do you adjust it to get to normal alignment?

Where are the pressures being applied in the socket?

Answer 14

1. Foot too inset
2. Socket abducted

You adjust the screws by loosening the medial and tightening the lateral.

Pressure areas are: proximal medial and distal lateral

Question 15

Drop off (stepping in a hole):
1.
2.
3.

Answer 15

1. Foot too posterior
2. Foot too dorsiflexed (excess socket flexion)
3. Keel too short

Question 16

Rapid knee flexion:
1.
2.
3.
4.

Answer 16

1. Foot too posterior
2. Foot too dorsiflexed (excess socket flexion)
3. Heel too firm
4. Weak quadriceps

Question 17

Heel off too early:
1.
2.
3.
4.

Answer 17

1. Foot too anterior
2. Insufficient socket flexion
3. Heel too soft
4. Foot too plantarflexed