Gait Deviations Flashcards
1
Q
Abducted Gait
A
- Width of the walking base is significantly greater than the normal range of 2-4 inches
- Exaggerated lateral displacement of the pelvis
- Lateral Bending
2
Q
When does abducted gait occur?
A
- Period of double limb support
3
Q
Where should you observe Abducted Gait?
A
- Behind the patient
4
Q
Causes of Abducted Gait
A
- Pain or discomfort in crotch area, possibly due to Skin infection, adductor roll, pressure from the brim of the medial socket wall
- Contracted abductors of the residual limb
- Prosthesis alignment
- Improper prosthesis alignment
- Amputee feels insecure and compensates by widening the walking base
5
Q
Lateral Bending of the Trunk
A
- Trunk bends towards the amputated side when the prosthesis is in stance phase
6
Q
When does Lateral bending of the trunk occur?
A
- Just after heel strike to mid-stance
7
Q
Where should you observe lateral bending from?
A
- Behind the patient
8
Q
Causes for Lateral bending of the trunk?
A
- Abducted Gait pattern
- Insufficient support by lateral socket wall
- Abducted socket
- Weak abductors
- Short Prosthesis
9
Q
Circumducted Gait
A
- The prosthesis follows a laterally curved line as it swings through
10
Q
When does circumducted gait occur?
A
- Thoughout swing phase
11
Q
Where should you observe circumducted gait from?
A
- Behind the patient
12
Q
Causes of circumducted gait pattern?
A
- Prosthesis is too long
- Amputee uses little or no knee flexion because of insecurity or fear
- Manual knee lock, excessive friction, or a tight extension aid may prevent the knee from bending
- Inadequate suspension alloing the prosthesis to slip off the residual limb (pistol action)
- Too small of a socket, The ischial tuberosity is above the ischial seat
- Foot set in plantar flexion
13
Q
Sing Phase Whips
A
- Medial whip: Toe off the heel moves medially
- Lateral Whip: Toe off the heel moves laterally
14
Q
When does Swing phase whips occur?
A
- during or just after toe-off
15
Q
Where should you observe Swing phase whips?
A
- From behind the patient
16
Q
Causes of Swing Phase Whips
A
- Residual limb with weak, loose musculature in which tissues rotate freely around femur
- Socket too tight or insufficiently contoured to accommodate muscles.
- Pressure from contracting muscle bellies causes the prosthesis to rotate around its long axis
- Toe break not set a right angle to the line of progression
- Improper alignment of knee bolt in the transverse plane
17
Q
Rotation of the foot on heel strike
A
- As the heel contacts the ground, the foot rotates laterally, sometimes with a vibratory motion
18
Q
When does rotation of the foot occur?
A
- Heel strike
19
Q
- Where should you observe rotation of the foot?
A
- From behind the patient
20
Q
Causes of Rotation of the foot on heel strike?
A
- Too hard of a plantar flexion bumper or heel cushion
- Correction after a lateral whip
- With a suction socket wearer, the foot rotation may be due to poor control of the socket by the residual limb
21
Q
Terminal Swing Impact
A
- The prosthetic shank comes to a sudden stop with forcible impact as the knee goes into extension
22
Q
When does Terminal Swing impact occur?
A
- At the end of Swing phase
23
Q
Where should you observe Terminal swing impact from?
A
- From the side of the Patient
24
Q
Causes of Terminal Swing impact
A
- Insufficient friction on the prosthetic knee
- Too much tension on the extension aid
- Amputee’s fear of the knee buckling
25
Foot Slap
- The foot plantarflexes too rapidly and strikes the floor with a slap
26
When does Foot slap occur?
- Just after heel strike
27
Where should you observe foot slap from?
- Side of patient, listen for slap
28
Causes of foot slap
- Plantar flexion bumper or heel cushio is too soft
29
Uneven Step Length
- The length of the step taken with the prosthesis differs from the length of the step taken with the sound foot
30
When does Uneven step length occur?
- Throughout the gait cycle
31
Where should you observe Uneven step length from?
- The side of the patient
32
Causes of Uneven Step Length
- Pain or fear, causes the amputee to shift weight off the prosthesis and onto the sound leg as quickly as possible
- Insufficient friction on the prosthetic knee
- Flexion contracture of the hip or insufficient flexion of the socket
33
Flexion contracture of the hip or insufficient flexion of the socket causes?
- Restricts hip extension range
- Decreased stance time on prosthetic limb
- Shorter step length on the sound side
34
Lordotic Gait
- Exaggerated Lordosis
35
- When does lordotic gait occur?
- Throughout stance phase
36
Where should you observe lordotic gait from?
- From the side of the patient
37
Causes of Lodotic Gait?
- Flexion contracture of the hip (produces anterior pelvic tilt, the amputee throws shoulders back to compensate)
- Insufficient initial flexion of socket
- Weak hip extensors ( Produces anterior pelvic tilt)
- Weak abdominal muscles (Abdominal mm's restrain the tendency of the pelvis to tilt forward)
- Painful ischial bearing (The amputee may roll the pelvis forward, attempting to relieve pressure on the ischium)
38
Vaulting
- The amputee bobs up and down excessively during gait due to excessive plantar flexion of the sound foot during stance
39
When does Vaulting occur?
- During swing phase of the prosthesis
40
Where should you observe Vaulting gait from?
- Behind the patient or from the side
41
Causes of Vaulting gait?
- Excessive length of the prosthesis
