Biomechanics 1 - TT

Question 1

casting for a TT socket

Answer 1

casting for negative mold

create positive mold

create socket

select components

assemble/static alignment of prosthesis

dynamic alignment prosthesis

Question 2

alignment

Answer 2

position of parts

one to another

Question 3

alignment –> parts

Answer 3

foot to knee

knee to socket

Question 4

how should we align the prosthesis

Answer 4

as close to normal alignment as possible

Question 5

optimal alignment has

Answer 5

pain free ambulation

protection of RL and intact joints

Question 6

optimal alignment increases/decreases

Answer 6

increases WBing and quality of gait

decrease energy cost

Question 7

overall goals of alignment

Answer 7

to align the prosthesis so that…

to reduce compensation that are the result of a prosthetic replacement

Question 8

to align the prosthesis so that… –> goals

Answer 8

there will be AP & ML stability at the knee and hip

there will be AP & ML stability of the RL in the socket

Question 9

to reduce compensation that are the result of a prosthetic replacement –> goals

Answer 9

keep as close to normal

Question 10

phases of alignment

Answer 10

static alignment

dynamic alignment

Question 11

static alignment is also called

Answer 11

bench

Question 12

bench alignment

Answer 12

alignment ‘gig’/LASAR

based on prosthetist judgement

Question 13

dynamic alignment

Answer 13

pt involved

gait analysis

Question 14

normal M/L alignment –> TT

Answer 14

normal base of support (BoS)

Question 15

normal BoS –> normal ML alignment

Answer 15

b/w the feet

measured heel center to heel center

Question 16

prosthetic goal –> ML alignment

Answer 16

to mimic normal BoS when possible

Question 17

transtibial BoS

Answer 17

prosthetic weight line

Question 18

prosthetic weight line –> TT BoS

Answer 18

patella tendon/midline socket

Question 19

patella tendon/midline socket –>prosthetic weight line

Answer 19

to the floor

Question 20

establishes –> TT BoS

Answer 20

midline for prosthetic alignment

measurement for BoS for prosthetic foot

Question 21

alignment terms –> M/L alignment

Answer 21

inset

outset

neutral

normal

Question 22

inset –> alignment terms

Answer 22

medial to weight line

Question 23

outset –> alignment terms

Answer 23

lateral to weight line

Question 24

neutral –> alignment terms

Answer 24

in line w/ weight line

Question 25

normal --> alignment terms

Answer 25

prosthetic foot set in inset alignment gives normal BoS

Question 26

what is there a tendency for the RL to do while walking --> RL socket pressures

Answer 26

RL to move w/in the socket

Question 27

what does the RL moving in the socket create --> RL socket pressures

Answer 27

pressure b/w these 2 surfaces

Question 28

goal --> RL socket pressures

Answer 28

minimize or compensate for those pressures

Question 29

socket pressures w/ an inset foot

Answer 29

in single stance -distal lateral -proximal medial

Question 30

why are pressures that are distal lateral more concerning?

Answer 30

foot is medial to the weight line and pushes the top of the socket out laterally

Question 31

PTB socket --> inset foot alignment

Answer 31

relief for the distal fibula

Question 32

TSB socket --> inset foot alignment

Answer 32

no reliefs urethane sleeve for pressures

Question 33

socket pressures w/ an outlet foot

Answer 33

lateral pressure shifts proximal medial pressure shifts distal

Question 34

pressures _____ not as problematic

Answer 34

proximal lateral

Question 35

PTB socket --> outlet foot

Answer 35

relief for head of fibula

Question 36

TSB socket --> outlet foot

Answer 36

urethane sleeve

Question 37

neutral foot alignment socket pressures

Answer 37

somewhere in the middle medial lateral

Question 38

ideal --> choosing inset v. outset

Answer 38

ideal is to aim for normal alignment w/ normal BOS or inset alignment

Question 39

when will normal alignment work --> choosing inset v. outset

Answer 39

normal length of RL good skin w/o skin dysfxn ideal RL

Question 40

alignment change/adjustment --> inset v. outset

Answer 40

when the pt feels pain move foot laterally

Question 41

possible reasons for pain/breakdown --> inset v. outset

Answer 41

short RL scar tissue sensitive skin prominent fibula

Question 42

how is decision confirmed --> inset v. outset

Answer 42

dynamic alignment pain gait deviation

Question 43

goal of A/P alignment

Answer 43

create stability

Question 44

create stability --> AP alignment

Answer 44

RL in socket in sagittal plane knee joint in sagittal plane

Question 45

what do we have to consider --> AP alignment

Answer 45

in relation to the stance phase of gait foot levers

Question 46

consider alignment in relation to stance phase of gait --> AP alignment

Answer 46

HS MS/HO PO

Question 47

normal ground rxn for at knee --> HS

Answer 47

posterior to knee knee flexion

Question 48

normal ground rxn for at knee --> MS/HO

Answer 48

anterior to knee knee extension

Question 49

normal ground rxn for at knee --> HO/TO

Answer 49

posterior to knee knee flexion

Question 50

normal AP alignment --> socket

Answer 50

center is set just anterior to anterior margin of the heel (breast of the heel)

Question 51

what does normal alignment mimic --> AP

Answer 51

normal GRF

Question 52

normal alignment has --> AP

Answer 52

normal gait levers

Question 53

socket position --> normal AP

Answer 53

socket set in in flexion (5 degrees) w/ respect to the foot

Question 54

where is the GRF --> HS

Answer 54

behind the knee

Question 55

GRF behind the knee --> HS

Answer 55

knee flexion body stable/socket move top of socket rotates anterior

Question 56

socket pressures --> HS

Answer 56

anterior - distal posterior - proximal

Question 57

what socket pressure is problematic --> HS

Answer 57

anterior distal

Question 58

@ HS --> pressure v. fit

Answer 58

anterior distal area for concern

Question 59

anterior distal --> HS

Answer 59

cut end of distal tib pressure sensitive

Question 60

PTB socket --> HS

Answer 60

relief at anterior distal socket

Question 61

TSB socket --> HS

Answer 61

no relief urethane sleeve to pad still a concern

Question 62

where does GRF move --> MS/HO

Answer 62

moves from neutral to anterior knee

Question 63

socket pressures --> MS/HO

Answer 63

anterior proximal posterior distal

Question 64

are there problematic pressures --> MS/HO

Answer 64

no

Question 65

what is a concern --> MS/HO

Answer 65

knee hyperextension

Question 66

socket pressures --> TO

Answer 66

anterior - distal posterior - proximal double support

Question 67

double support --> TO socket pressures

Answer 67

less force pressure less significant

Question 68

socket fit/design --> TO

Answer 68

same as HS

Question 69

what pts get normal alignment

Answer 69

w/o contractures adequate muscle strength adequate RL length good skin condition

Question 70

what pts may get alteration in alignment

Answer 70

w/ contracture mm weakness short RL scaring fragile skin

Question 71

what is TT bench assessed w/

Answer 71

w/ anticipated typical shoe

Question 72

ML alignment --> bench

Answer 72

foot medial to support line (inset) toe out approx 7 degrees

Question 73

AP alignment --> bench

Answer 73

socket flexed on shank 5 degrees AP socket center falls anterior to heel