Improving Transfemoral Amputee Gait

Question 1

Four Factors of Gait

Answer 1

Patient
Socket Fit
Prosthetic alignment
Physical Therapy

Question 2

The six determinants or variables that affect energy expenditure of gait:

Answer 2

pelvic rotation

pelvic tilt

knee flexion at mid-stance

foot and ankle motion

knee motion

lateral pelvic displacement

Question 3

🔧 Prosthetic Alignment Types

Answer 3

bench
static
dynamic

Question 4

Bench Alignment –

Answer 4

done off-patient

Sagittal: 5–10° socket flexion (+ contracture if present)

Coronal: 5–7° adduction, foot centered under ischial tuberosity

Transverse: knee/foot 5–7° externally rotated

Question 5

Static Alignment –

Answer 5

Performed with the patient standing

Question 6

Dynamic Alignment -

Answer 6

during gait

Question 7

medial whip

Answer 7

prosthetic cause: ER of knee, tight socket, foot rotated

amputee cause: Poor donning, ER of hip at toe-off

PT focus: Hip rotator strength, donning techniques

Question 8

lateral whip

Answer 8

prosthetic cause: IR of knee, loose socket

amputee cause: IR at toe-off, tight adductors

PT focus: Strengthen ERs, stretch flexors/adductors

Question 9

abducted gait

Answer 9

prosthetic cause: Long prosthesis, high medial wall

amputee cause: Insecurity, abduction contracture

PT focus: Stretch abductors, balance training

Question 10

circumduction gait

Answer 10

prosthetic cause: Long prosthesis, stiff knee

amputee cause: Weak hip flexors, bad habits

PT focus: Strengthen hip flexors, gait retraining

Question 11

vaulting

Answer 11

prosthetic cause: Long prosthesis, poor suspension

amputee cause: Habit, weak hip flexors

PT focus: Strength, coordination, retrain timing

Question 12

heel rise

Answer 12

prosthetic cause: Weak extension aid, low knee friction

amputee cause: Overuse of hip flexors

PT focus: Coordination of hip/knee motion

Question 13

knee instability

Answer 13

prosthetic cause: Poor TKA alignment, excessive DF

amputee cause: Weak hip extensors, flexion contracture

PT focus: Strengthen extensors, stretch flexors

Question 14

uneven timing

Answer 14

prosthetic cause: Socket pain, weak extension aid

amputee cause: Weak hip muscles, insecurity

PT focus: Strengthen, balance, confidence-building

Question 15

lateral trunk bend

Answer 15

prosthetic cause: Foot too lateral, abduction in socket

amputee cause: Habit, short residual limb

PT focus: Core strength, balance

Question 16

toe drag

Answer 16

prosthetic cause: Long prosthesis, excessive PF

amputee cause: Weak extensors/abductors, posture

PT focus: Strength and swing phase training

Question 17

wide gait

Answer 17

prosthetic cause: Long prosthesis, high medial wall

amputee cause: Abduction contracture, security-seeking habit

PT focus: Core/residual limb strength, stretch abductors

Question 18

foot rotation (IE/ER)

Answer 18

prosthetic cause: Rotated socket/knee/foot

amputee cause: Improper donning, compensation strategies

PT focus: Educate donning, posture control

Question 19

uneven pelvic rotation

Answer 19

prosthetic cause: Poor suspension, trim line issues

amputee cause: Weak abductors, excessive adductors

PT focus: Strength, stretch, gait training

Question 20

Strengthening

Answer 20

Core, hip abductors/extensors/flexors

Question 21

ADL Analysis:

Answer 21

Modify poor habits

Question 22

Balance & Proprioception:

Answer 22

Increase sensory input and confidence

Question 23

Donning/Doffing Skills:

Answer 23

For consistent fit and alignment

Question 24

Repetition & Retraining:

Answer 24

Correct gait mechanics and reduce fear