Week 10 gait

Question 1

Foot Slap : Stance phase

Answer 1

Prosthetic Causes
1. Too soft heel cushion
2. Too soft plantar flexion resistance
3. Too short heel levers
4. Sagittal view
Patient Causes
1. Too forceful heel strike for proprioceptive feedback
2. Patient driving prosthesis into walking surface too forcefully
3. Not common

Question 2

Rotation At the Foot IR/ER : Stance Phase

Answer 2

Prosthetic causes
1. Stiff heel cushion
2. stiff plantar flex bumper
3. socket loose rotating during swing
4. too much are little toe in and outs
5. Occurs at heel strike, lasts until mid stance
Patient Causes
1. to hard heel strike
2. Poor eccentric control of limb at terminal swing
3. Poor pelvic control
4. Improper donning
5. excessive soft tissue in residual limb with intimate fit socket

Question 3

Excessive Knee Flexion: Stance phase

Answer 3

Prosthetic Causes
1. Too hard heel cushion
2. Socket too anterior to foot which increases flex moment
3. socket set in too much flexion
4. Prosthesis too long
5. Suspension too loose
6. Foot dorsiflexed
Patient Causes
1. Knee flexion contracture
2. Weak quads or gluts
3. Pain
4. Improper donning sock management too many or too little

Question 4

Early Knee Flexion/Drop off: Stance Phase

Answer 4

Prosthetic Causes
1. MS-Ts
2. High shoe heel
3. DF stop too soft
4. Excessive df of foot
5. Too much socket flexion
6. Foot places too far posterior to socket or socket anterior to foot
Patient Causes
1. Knee flexion contracture
2. Weak Quads

Question 5

Excessive Knee Extension : stance phase

Answer 5

Prosthetic Causes:
1. Insufficient socket flexion
2. Long toe lever arm causes knee to remain in extension
3. Too soft heel support
4. Socket too far posterior on the foot
5. IC to foot flat
Patient Causes
1. Inadequate gait training; weakness in the quads
2. Feels like walking uphill
3. May complain of anterior distal pain/skin abrasion if maintaining knee extension

Question 6

Narrow Based Gait: Stance Phase

Answer 6

Prosthetic Causes
1. Lateral leaning Pylon
2. Foot inset
3. Like a weak gluteus Medius gait with excessive trunk lean
Patient Causes:
1. Pain
2. Pressure
3. medial proximal and lateral distal end of socket causing excessive lateral lean

Question 7

Lateral Bending of the Trunk Toward the Prosthetic Side : Stance phase

Answer 7

Prosthetic Causes
1. Prosthetic too short
2. Increased foot outset leading to abduction alignment
Patient Causes
1. Weak abductors on prosthetic side
2. Weak core
3. Inability to fully weight bear
4. Poor balance in SLS
5. Fear or habit

Question 8

Varus/Valgus Moment: Stance Phase

Answer 8

Prosthetic Causes
1. Mid stance- Terminal Stance
2. varus= inset foot, lateral leaning components
3. Valgus = outset foot, medial leaning components
4. Poorly fitting socket
Patient Causes
1. Short residual limb
2. Ligament laxity
3. Weak hip abductors
4. Hip tightness
5. Q angle

Question 9

Wide Based Gait/ Abducted : Stance Phase

Answer 9

Prosthetic Causes
1. Poor pressure distribution
2. Medial Leaning pylon
3. Outset foot
4. Prosthesis too long
Patient Causes
1. Pain with weight bearing
2. Increased pressure proximal lateral brim
3. Increased pressure distal end of residual limb
4. Patient has poor balance
5. Habit
6. Abducted intact limb

Question 10

Uneven Step Length: Stance Phase

Answer 10

Prosthetic Causes
1. Length Issues Possible
2. Patient with prosthetic side and short step with uninvolved side
Patient Causes
1. Inadequate training
2. Lack of trust with weight shift and SLS required

Question 11

Decreased Stance Phase on Prosthetic Side: Stance phase

Answer 11

Prosthetic Causes
1. Mostly patient causes; poorly fitting prosthesis may be causing the pain
Patient Causes
1. Pain
2. Poor balance or fear
3. Weak hip abductors and extensors
4. Poor weight shift onto prosthesis
5. Hip flexion contracture

Question 12

Lumbar Lordosis: Stance phase

Answer 12

Prosthetic Causes
1. NA
Patient causes
1. Tight hip flexors or contracture on prosthetic side
2. Weak hip extensors
3. Weak Abdominals
4. Anterior Pelvic tilt

Question 13

Reduced Arm Swing and Trunk Rotation : Stance Phase

Answer 13

Prosthetic Causes
1. Mostly patient causes; poorly fitting prosthesis may cause pain
Patient Causes
1. Gait speed too low
2. Tight hip rotators
3. poor weight shift
4. Poor forward translation onto prosthesis
5. Pain or fear

Question 14

Circumduction: Swing Phase

Answer 14

Prosthetic Causes
1. More common in transfemoral
2. Too long
3. Poor suspension
4. Incorrect socket fit
5. Excess plantar flexion at foot
Patient causes
1. Abductor contracture
2. Weak/poo hip flexion
3. Fear
4. pain
5. Bad habit

Question 15

Foot Drag: Swing Phase

Answer 15

Prosthetic Causes
1. Foot drag- one of the most common problems of swing phase
2. Inadequate suspension
3. A prosthesis that is too long
Patient Causes
1. Weakness in hip abductors
2. Inadequate gait training

Question 16

Lateral Bending Away from Prosthesis: Swing Phase

Answer 16

Prosthetic Causes
1. Prosthetic is too long
2. Poor fitting prosthesis
3. Pistoning
Patient Causes
1. Weak hip flexor and or hamstring muscles on prosthetic side
2. Weak hip abductors on the uninvolved limb
3. poor balance in single leg stance

Question 17

Medial/Lateral Whip: Swing Phase

Answer 17

Prosthetics Causes
1. Inadequate suspension
2. Medial Whip; ER socket
3. lateral Whip: IR Socket
Patient Causes
1. Patient did not align the socket correctly during donning process

Question 18

Pistoning: Swing Phase

Answer 18

Prosthetic Causes
1. Too loose fitting socket
Patient Causes
1. Patient does not apply enough socks
2. Significant Loss of Volume

Question 19

Decreased Step Length Prosthetic Side : Swing Phase

Answer 19

Prosthetic Causes
1. prosthesis too short
2. Anterior leaning pylon
3. Inadequate suspension
Patient Causes
1. Pain in intact limb
2. Hip flexion contracture or tightness on intact limb
3. Knee flexion contracture on the prosthetic side