TT Gait Deviations

Question 1

What are prosthetic causes of excessive knee extension during IC->Mst?

Answer 1

1. Socket aligned to far posterior or foot too far anterior
2. Heel too soft
3. Insufficient socket flexion

Question 2

What are user causes of excessive knee extension during IC->Mst?

Answer 2

1. Weak musculature around the knee

2. Locking knee in extension for stability because of fear

Question 3

Excessive knee extension causes what type of moment at the knee?

Answer 3

Knee extensor moment

Question 4

Where would you see skin break down with excessive knee extension?

Answer 4

Skin break down on anterior distal tibia from extending excessively in socket (bell clapping)

Question 5

What are prosthetic causes of knee instability during IC->LR?

Answer 5

1. Socket aligned too far anterior/foot aligned too far posterior
2. Heel too firm
3. Excessive foot DF

Question 6

What are user causes of excessive knee extension during IC->LR?

Answer 6

1. Weak quads

2. Knee flexion contracture

Question 7

Where would you see skin break down/pressure with knee instability?

Answer 7

Unstable/pressure at posterior distal residual limb

Question 8

Knee instability of TT gait will effect stance phase on prosthetic in what way?

Answer 8

Shortened during stance

Question 9

Describe hip drop during Mst on prosthetic:

Answer 9

pelvic drop toward prosthetic side during Mst (best seen in frontal plane)

Question 10

What are prosthetic causes of hip drop during Mst on prosthetic?

Answer 10

Prosthesis too short

Question 11

What are user causes of hip drop during Mst on prosthetic?

Answer 11

Residual limb pain

Question 12

What occurs with a narrow-based gait (lateral thrust)?

Answer 12

narrow BOS with lateral thrust of socket during Mst, excessive varus thrust at knee (frontal plane)

Question 13

What are prosthetic causes of lateral thrust during Mst?

Answer 13

Foot too far inset

Laterally leaning pylon

Question 14

What are user causes of lateral thrust during Mst?

Answer 14

Glute med weakness

Knee Ligament insufficiency

Question 15

During lateral thrust during Mst where will you see increased pressure?

Answer 15

Proximal medial and distal lateral

Question 16

What type of gait pattern might you see if there is lateral thrust during Mst?

Answer 16

uncompensated trendelenburg gait pattern.

Question 17

What are prosthetic causes of wide based gait during Mst?

Answer 17

Outset foot

Medial leaning pylon

Question 18

What are user causes of wide based gait during Mst?

Answer 18

Insufficient weight shift (swaying of trunk to ipsilateral side during stance phase bilaterally)
Hip abduction tightness
Patient fear

Question 19

During wide based gait during Mst where will you see increased pressure?

Answer 19

increased pressures proximolaterally at the limb/socket interface

Question 20

Describe drop-off/knee instability during TSt?

Answer 20

early and excessive knee flexion during TSt

Question 21

What are prosthetic causes of drop-off/knee instability during TSt?

Answer 21

1. Socket aligned too far anterior/foot too far posterior

2. Inappropriate foot choice

Question 22

What are user causes of drop-off/knee instability during TSt?

Answer 22

Knee Flexion contracture (results in early and excessive knee flexion)

Question 23

How will drop-off/knee instability during TSt effect step length of intact limb?

Answer 23

Shortened step length with intact limb (skip IC and get foot flat contact)

Question 24

What is vaulting?

Answer 24

excessive PF of sound limb during MSt to clear prosthetic foot
(leads to fatigue in sound limb in calf)

Question 25

What are prosthetic causes of vaulting during Sw of prosthetic?

Answer 25

1. Prosthesis too long
2. Long toe lever arm
3. Socket too far posterior

Question 26

What are user causes of vaulting during Sw of prosthetic?

Answer 26

Holding Knee in extension for too long

Question 27

What is pistoning?

Answer 27

loss of suspension
prosthesis begins to slip off the residuum during swing
(can be because limb size decreases in size as day goes on)

Question 28

What are prosthetic causes of pistoning during Swing phase, IC ->Mst?

Answer 28

Socket too large

Not enough socks

Question 29

What are user causes of pistoning during Swing phase, IC ->Mst?

Answer 29

Volume changes

Not enough socks

Question 30

Describe the change in step length with prosthesis with pistoning:

Answer 30

short step with prosthesis because they feel like limb will fall off

Question 31

T/F Prosthesis experiencing pisotning is a fall risk.

Answer 31

True

Question 32

Describe the uneven step length experienced during swing phase of TT prothesis:

Answer 32

taking a long step with the prosthetic limb, step-to pattern with sound limb
(shorter stance phase on prosthetic side)

Question 33

What are user causes of uneven step length?

Answer 33

Insufficient gait training

Decreased patient confidence

Question 34

Describe what circumduction of the prosthetic during swing phase?

Answer 34

patient swings leg around in an abducted position to advance it forward

Question 35

What are prosthetic causes of circumduction of prosthesis during swing phase?

Answer 35

1. Poor suspension

2. Prosthesis too long

Question 36

What are user causes of circumduction of prosthesis during swing phase?

Answer 36

1. Feeling of instability

2. Decreased knee flexion during swing