MT: TF Prosthetic Gait Deviation

Question 1

Why is uneven arm swing a problem?

Answer 1

• Goal of arm swing: minimize energy expenditure while maximizing stability and mobility
• what does arm swing do: reduces angular momentum of the body, improve stbaility and energy efficiency

Question 2

Uneven arm swing prosthetic causes

Answer 2

• poor socket fit
• lack of suspension (fear)

Question 3

Uneven arm swing patient causes

Answer 3

• fear
• poor balance
• habit
• lack of proper training

Question 4

Initial Contact Gait Deviation

Answer 4

• knee instability (sagittal)
• step length asymmetry
• foot slap

Question 5

Knee instability prosthetic causes

Answer 5

• knee to anterior
• insufficient socket flextion (for hip ext strength)
• too firm/high heel/shoe

Question 6

Knee instability patient causes

Answer 6

• weak hip extensors
• short residual limb

Question 7

Step length asymmetry prosthetic causes

shortened prosthetic step

Answer 7

• painful socket
• too short toe lever on the foot

Question 8

Step length asymmetry patient causes

shortened prosthetic step

Answer 8

• lack of confidence in prosthesis
• gait habit

Question 9

Foot slap prosthetic causes

Answer 9

• too soft a heel cushion or plantarflexion bumper of foot

Question 10

Foot slap patient causes

Answer 10

• forced heel compression to ensure knee stability
• habit

Question 11

Loading Response Gait Deviation

Answer 11

• external rotation of foot

Question 12

External Rotation of Foot Prosthetic Causes

Answer 12

• heel too firm
• excessive toe out
• poorly fitting socket

Question 13

External Roation of foot Patient Causes

Answer 13

• too tight shoe
• too hard heel of shoe
• incorrectly donned prosthesis
• poor muscle control

Question 14

Midstance Gait Deviations

Answer 14

• Abducted Gait
• lateral trunk bend
  *

Question 15

Abducted Gait Prosthetic Causes

Answer 15

• medial proximal socket pressure
• lateral distal femur pressure
• poorly contoured lateral wall
• insufficient socket adduction during bench alignment

Question 16

Abducted Gait Patient Causes

Answer 16

• weak or contracted abductors
• poor balance
• gait habit

Question 17

Lateral Trunk Bend Prosthetic Causes

Compensated Trendelenburg

Answer 17

• prosthesis too shrot
• foot too far outset
• insufficient socket adduction
• medial brim pain
• too large ML
• poorl designed lateral wall of socket

Question 18

Lateral Trunk Bend Patient Causes

Compensated Trendelenburg

Answer 18

• weak abductors
• abductor contracture
• short residuum

Question 19

Terminal Stance Gait Deviations

Answer 19

• excessive lumbar lordosis

Question 20

Excessive Lumbar Lordosis

new to TF

Answer 20

• insufficient socket flexion
• hip flexion contracture
• weak hip or ab muscles
• short residual limb

Question 21

PreSwing Gait Deviations

Answer 21

• Lateral Whip
• excessive heel rise

Question 22

Lateral Whip prosthetic causes

Answer 22

• knee axis too internally rotated
• ill fitting socket

Question 23

Lateral Whip patient causes

Answer 23

• incorrectly donned prosthesis
• weak musculature

Question 24

Excessive Heel rise prosthetic causes

Answer 24

• insufficient knee friction or resistance

Question 25

Excessive heel rise patient causes

Answer 25

excessive hip flexion force

Question 26

Midswing gait deviations

Answer 26

* circumduction * vaulting

Question 27

Circumduction prosthetic causes

Answer 27

* too long prosthesis * pistoning * plantarflexed foot * insufficient knee flexion

Question 28

Circumduction patient causes

Answer 28

* lack of confidence in knee stability * lack of hip flexion

Question 29

Vaulting prosthetic causes

Answer 29

* too long * insufficient suspension * too much knee flexion resistance

Question 30

Vaulting patient causes

Answer 30

habit

Question 31

Terminal Swing Gait Deviations

Answer 31

* Terminal impact * Step length asymmetry (long)

Question 32

Terminal Impact Prosthetic Causes

Answer 32

* insufficient friction/resistance * too strong extension assist * worn extension stop

Question 33

Terminal Impact Patient cause

Answer 33

* gabit to assure knee extension * preference

Question 34

Step length asymmetry prosthetic causes | long prosthetic step

Answer 34

insufficient socket flexion