Gait-TF Flashcards by Alyssa Powell

What is Lateral Bending of the Trunk?

Excessive bending laterally from the midline, generally to the prosthetic side.

How well did you know this?

Not at all

Perfectly

What are the prosthetic causes of Lateral trunk bending?

Prosthesis too short or long
Improperly shaped Lateral wall
High Medial wall
Prosthesis aligned in abduction
Excessive foot outset
Pain at distal lateral femur

How well did you know this?

Not at all

Perfectly

Why does a improperly shaped lateral wall produce the lateral bend deviation?

Fails to support the femur

How well did you know this?

Not at all

Perfectly

Why does a high medial wall cause the lateral bend deviation?

May cause pain and the patient to lean away from the discomfort

How well did you know this?

Not at all

Perfectly

Why does an abducted socket produce lateral bend deviation?

Causes wide-based gait

How well did you know this?

Not at all

Perfectly

What are amputee causes of lateral trunk bend?

Inadequate balance
Abduction contracture
Over-sensitive residual limb to pain
Very Short limb-no lever arm
Habit

How well did you know this?

Not at all

Perfectly

What is abducted gait?

A very wide base with the prosthesis held away from the midline at all times

How well did you know this?

Not at all

Perfectly

what are prosthetic causes of abducted gait?

Prosthesis too long
Prosthesis to abducted
High medial wall
Improper lateral wall shape
Pelvic band positioned far away from the patient's body
Pain at distal lateral femur

How well did you know this?

Not at all

Perfectly

What are amputee causes of abducted gait?

Abduction contracture
Habit
Anterior pelvic tilt

How well did you know this?

Not at all

Perfectly

What is circumducted gait?

Swinging the prosthesis laterally in a wide arc during swing phase.

How well did you know this?

Not at all

Perfectly

What are the prosthetic causes of a circumducted gait?

Prosthesis too long
Knee too stable 
Excessive resistance to knee flexion
Extension bias too strong
Medial brim pressure
inadequate suspension

How well did you know this?

Not at all

Perfectly

What are amputee causes of circumducted gait?

Abducted contracture
Lacks confidence in leg
Habit

How well did you know this?

Not at all

Perfectly

What is Vaulting?

A rising on the toe of the normal foot permitting the amputee to swing the prosthesis through with little knee flexion

How well did you know this?

Not at all

Perfectly

What are the prosthetic causes of vaulting?

Prosthesis too long
Inadequate socket suspension
Limb discomfort
Excessive resistance to knee flexion
Too much stability
Extension bias too strong

How well did you know this?

Not at all

Perfectly

What is the amputee cause of vaulting?

Habit
Fear of stubbing toe
Limb discomfort

How well did you know this?

Not at all

Perfectly

What are the prosthetic causes of Rotation of the prosthetic foot on heel strike?

Too much resistance to plantarflexion by the bumper or heel wedge
Too much toe out
Socket too loose
Tight medial/posterior wall angle
Foot inset too far

How well did you know this?

Not at all

Perfectly

What are the amputee causes of rotation of the prosthetic foot on the heel strike?

Extends the residual limb to vigorously at heel strike

Poor muscle control

How well did you know this?

Not at all

Perfectly

What is uneven arm swing?

The arm on the prosthetic side held close to the body during locomotion

How well did you know this?

Not at all

Perfectly

What are the prosthetic causes of uneven arm swing?

Improperly fitting socket-can cause discomfort

How well did you know this?

Not at all

Perfectly

What are the amputee causes of uneven arm swing?

Bad balance
Fear and insecurity
Habit

How well did you know this?

Not at all

Perfectly

What is uneven timing?

Steps of unequal duration, usually a very short stance phase on prosthetic side.

How well did you know this?

Not at all

Perfectly

What are the prosthetic causes of uneven timing?

Improperly fitting socket
Weak extension aid or friction in knee
Alignment instability of knee
Insufficient initial socket flexion-for hip flexion contracture

How well did you know this?

Not at all

Perfectly

Why would a weak extension aid or friction in knee cause uneven timing?

Excessive heel rise resulting in a prolonged swing-through.

How well did you know this?

Not at all

Perfectly

What are the amputee causes of uneven timing?

Muscle weakness
Bad balance
Fear and insecurity

How well did you know this?

Not at all

Perfectly

What is uneven heel rise?

The prosthetic heel rising quite markedly and rapidly when the knee is flexed at beginning of swing phase.

What are the prosthetic causes of uneven heel rise?

Knee joint has insufficient friction | Inadequate extension aid

What are the amputee causes of uneven heel rise?

Using more power than neccessary to force the knee into flexion

What is terminal swing impact?

Rapid forward movement of the shank allowing the knee to reach maximum extension with too much force before heel strike

What are the prosthetic causes of terminal impact?

Insufficient knee friction Knee extension aid too strong Used or absent extension bumper

What are the amputee causes of terminal impact?

Amputee reassure himself that the knee is extended

What can instability of the prosthetic knee cause?

The amputee to fall

What are the prosthetic causes of knee instability?

``` Knee anterior to TKA line Insufficient initial flexion Plantarflexion resistance too strong Failure to limit dorsiflexion Increased Shoe heel height-causing anterior leaning pylon ```

What are the amputee causes of knee instability?

Weak hip extensors | severe hip flexion contracture

What is a medial whip?

When the heel travels medially on initial flexion at the beginning of swing phase

What is lateral whip?

The heel moves laterally

What are the prosthetic causes of whips?

``` Lateral- excessive internal rotation of knee or socket Rectus femoris channel too deep Medial-excessive external rotation of knee or socket Rectus femoris channel too shallow Socket too tight or poorly shaped Excessive valgus of knee Poor aligned toe-break-twisting toe-off Posterior/Medial wall too tight ```

What are the amputee causes of whips?

Habit | Weak Muscles

What is foot slap?

Too rapid descent of the anterior portion of the foot

What are the prosthetic causes of foot slap?

Plantarflexion resistance too soft

What are the amputee causes of foot slap?

Patient driving the foot into ground to ensure extesnion

What is drop-off?

A downward movement of the trunk as the body moves forward over the prosthesis

What are the prosthetic causes of drop-off?

``` Inadequate limitation of dorsiflexion Keel of SACH too short Toe break too far posterior Socket too anterior to foot Long stride on sound side ```

What is long prosthetic step?

The amputee takes a longer step with the prosthesis than the normal leg

What are the prosthetic causes of long prosthetic step?

Insufficient initial flexion in socket

What are the amputee causes of long prosthetic step?

Flexion contracture

What is excessive trunk extension?

The amputee creates an active lumbar lordosis

What are the prosthetic causes of excessive trunk extension?

Improperly shaped posterior wall | Insufficient initial flexion of socket

How can an improperly shaped posterior wall cause excessive trunk extension?

Causes forward rotation of the pelvis to avoid full weight-bearing on the ischium

What are the amputee causes of excessive trunk extension?

``` Flexor tightness Weak hip extensors Weak abdominal muscles Habit Bad balance Short residual limb ```

What are the prosthetic causes of pelvis rise?

Toe lever too long | Foot set in excessive plantarflexion

What are the prosthetic causes of pistoning?

Poor socket suspension

What are the prosthetic causes of inadequate or delayed heel rise?

Excessive mechanical resistance to knee flexion Prosthesis aligned with too much stability Limited pelvis rotation

What are the goals for initial contact?

Smooth controlled plantarflexion Knee extension smooth Equal step length

What are the goals for loading response?

Foot remains in the line of progression during plantarflexion

What are the goals for mid-stance?

Vertical pylon Narrow-based gait-2 to 4 in No excessive lateral trunk bend

What are the goals for terminal stance?

Center of gravity follows smooth arc without rise or fall of head Normal step length on sound side without lumbar lordosis

What are the goals for pre-swing?

Hip, knee, foot swing through on line of progression Smooth hip and knee flexion with quad-like control Hell rise equal Socket secure on limb

What are the goals for initial and mid-swing?

Center of gravity reaches the summit on its smooth arc, rhythmic path over foot

What are the goals for terminal swing?

Smooth and noiseless deceleration to full extension | Equal step length

Which gait deviations are seen during initial contact?

Knee instability Unequal step length Foot slap

What are the gait deviations seen during loading response?

Excessive foot rotation

What are the gait deviations seen during mid-stance?

Abducted gait Lateral Trunk bend Unequal toe rotation

What are the gait deviations seen during terminal stance?

Pelvis rise Drop-off Excessive lumbar lordosis

What are the deviations seen during pre-swing?

Medial/Lateral whip Pistoning Delayed heel rise Uneven heel rise

What are the gait deviations seen during initial and mid-swing?

Circumduction | Vaulting

What are the gait deviations seen during terminal swing?

Terminal impact | Unequal step length

What is the cause of the hip not over foot at foot flat?

Patient "leads" with prosthetic side with pelvic rotation

How can you correct the hip not over foot at foot flat?

Gait training

What causes narrow based gait?

Foot too inset

Inversion of the foot is caused by?

Too much socket abduction | Loose socket in M/L

What causes eversion of the foot?

Too much socket adduction | Loose socket M/L

What causes Goose Stepping?

Amputee waits for knee impact before putting foot on ground

What is goose stepping?

Heel does not contact floor

What causes knee hyperextension?

Knee unit extension stop excessive

What causes excessive knee flexion?

Swing extension resistance too low

Gait-TF Flashcards

(75 cards)