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S3- Amputation And Prosthetics > Gait Review and Normal Amputee Gait > Flashcards

Gait Review and Normal Amputee Gait Flashcards

1
Q

Forces applied by prosthetic and orthotic devices are ________ forces.

A

external

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2
Q

The gait cycle is from initial contact of one foot to initial contact of the ________ foot.

A

same

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3
Q
  • _______ is synonymous with a gait cycle.

- ______ is sequence of events that occur within heel contacts of opposite feet.

A
  • Stride

- Step (2 in 1 gait cycle)

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4
Q
  • Gait cycle is __% stance phase, and __% swing phase.

- Gait cycle is __% single-limb support and __% double-limb support.

A
  • 60% stance, 40% swing

- 80% single, 20% double

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5
Q

Describe:

  • Stride length
  • Step length
  • Degree of toe-out
  • Step width
A

Stride Length
-distance between 2 successive heel contacts of same foot
Step Length
-dstance between successive heel contacts of different feet
Degree of Toe-Out (5-7° normal)
-Angle between line of progression of the body and a line intersecting the center of the heel and second toe
Step width (8-10cm)
-lateral distance between heel centers of 2 consecutive foot contacts

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6
Q

An asymmetric ____ length is often observed in prosthetic users. Why?

A
  • Step
  • Potentially due to spending less time in stance phase of involved side. Results in shortening swing time and step length on noninvolved side.
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7
Q

A prosthetic on the L side results in a decreased __________ on the L side and a decreased ________ on the R side.

A
  • stance phase

- step length

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8
Q

What are the temporal descriptors of gait?

A
  • Stride time- time for a full gait cycle
  • Step time- time for completion of a R or L step
  • Cadence (step rate)- number of steps/min
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9
Q

What is the spatial-temporal descriptor?

A

Gait speed- distance covered in a specific amount of time

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10
Q

What is a normal walking speed?

A

1.37m/sec (3mph)

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11
Q

Gait speed decreases when either ________ or ______ is reduced.

A

step length or cadence

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12
Q

What are some common reasons for decreased gait speed in this population?

A
  • decreased confidence
  • poor gait training
  • may not have had normal gait speed before
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13
Q

What are the 4 phases of stance phase?

A
  • Loading Response (IC/LR)
  • Midstance (MSt)
  • Terminal Stance (TSt)
  • Preswing (PSw)
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14
Q

What are the 3 phases of swing phase?

A
  • Initial Swing (ISw)
  • Midswing (MSw)
  • Terminal Swing (TSw)
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15
Q

What are the key features of IC/LR?

A
  1. ) Shock absorption through
    - Plantarflexion
    - Knee flexion
    - Pronation
    - Hip Adduction
  2. ) Forward propulsion through hip extension
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16
Q

What are the key features of MSt?

A
  1. ) Shock absorption
  2. ) Stabilize in single limb support
  3. ) Forward progression of tibia
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17
Q

What are the key features of TSt?

A
  1. ) Continued stabilization in single limb support
  2. ) Forward propulsion through plantarflexion
  3. ) Forward progression
18
Q

What are the key features of PSw?

A
  1. ) Continued forward propulsion through plantarflexion

2. ) Continued forward progression

19
Q

What are the key features of ISw?

A
  1. ) Forward propulsion of swing leg through hip flexion
  2. ) Foot clearance through
    - dorsiflexion
    - knee flexion
20
Q

What are the key features of MSw?

A

1.) Forward propulsion of swng leg through hip flexion

21
Q

What are the key features of TSw?

A
  1. ) Prepare for initial contact through
    - controlled knee extension
    - ankle positioned into less supination
22
Q

Key Muscle Activity - Hip:
Hip Extensors
-Activated in ___________ prior to initial contact to initiate hip extension and prepare the LE for weight acceptance at the beginning of stance.
Hip Flexors
-Advance lower extremity forward during ________ and lift lower extremity to allow for toe clearance during swing.
Hip Abductors
-Control the slight lowering of the ________ pelvis on the side of the swing limb.
Hip Adductors
-Assist with initiation of hip flexion after _______.

A
  • terminal swing (TSw)
  • initial swing (ISw)
  • contralateral
  • toe-off
23
Q

How do transfemoral ambulators initiate knee extension?

A

hip extension

24
Q

Key Muscle Activity - Knee:
Knee Extensors
-___________ control knee flexion in LR then act __________ to extend the knee and support body in midstance.
Knee Flexors
-Deccelerate knee _________ in preperation for placement of the foot on the ground.

A
  • Eccentrically, concentrically

- extension

25
Q

Key Muscle Activity - Ankle
Ankle Dorsiflexors
-Eccentric activation to control ___________ of the ankle at initial contact until foot comes in contact with the ground
Ankle Plantarflexors
-Eccentric contraction moving into midstance to control ______ advancement and concentric contraction at _________ and ______ to propel forward (“push-off”)
Ankle invertors
-Eccentrically contracts to control ________ until midstance then concentrically contracts to ________ the foot for push-off in terminal stance/preswing
Ankle evertors
-Also active as co-contraction to counter strong ________ occurring during loading response to midstance

A
  • plantarflexion
  • tibial, terminal stance (TSt) and preswing (PSw)
  • pronation, supination
  • inversion
26
Q

GRFV

  • If torque needed is in direction of movement: __________ contraction
  • If torque needed is opposite to direction of movement: ________ contraction
A
  • concentric

- eccentric

27
Q
  • The loss of plantarflexors in amputees results in what?

- What phase(s) of gait will this be most noticeable?

A
  • shorter contralateral step length
  • reduced gait speed
  • impaired balance

-Most noticeable in MSt, this is when the gastroc is the most active

28
Q

Activity at the ____ and _____ produces majority of force for knee flexion during swing phase. This is the principle utilized in prosthetic design for individuals with transfemoral amputation.

A

hip and ankle

29
Q

No prosthetic mechanism is needed to produce knee flexion given the individual can do what?

A
  • flex the hip

- ambulate fast enough to produce momentum

30
Q

PROSTHETIC GAIT

A

PROSTHETIC GAIT

31
Q

Do trauma patients or dysvascular patients tend to walk faster?

A

Trauma

32
Q

________ and __________ efficiency both decrease as the level of the amputation moves more proximal.

A

energy and biomechanical

33
Q

What is the key alignment issue in transtibial prosthetic gait?

A

socket-foot relationship (too far anterior/posterior)

34
Q

Transtibial Prosthetic Gait:

IC/LR

  • _____ stride length
  • _______ knee flexion

MSt

  • _____ position (close to _______ during MSt)
  • _____ step width

TSt

  • smooth progression over the _____
  • smooth _______ of the limb

PSw
-______,_____, and _____ position to maintain stability

Swing Phase
-Prosthetic _____

A
  • equal
  • controlled
  • pylon (vertical)
  • normal (2-4in)
  • foot
  • flexion (equal to intact)
  • pelvic, trunk, and head
  • path
35
Q

_______ and __________ is a common cause for many TTA deviations and is caused by poor __________.

A
  • pistoning and bellclapping

- suspension

36
Q

What does pistoning and bellclapping result in?

A
  • decreased stability
  • decreased confidence
  • excessive pressure/shearing forces
37
Q

Transfemoral patients have an overall decrease in gait speed of around ___%.

A

40%

38
Q

What is the key alignment issue in transfemoral prosthetic gait?

A
  • socket-knee

- knee-foot

39
Q

Transfemoral Prosthetic Gait:

IC/LR

  • _______ stride length
  • ______ gait cycle
  • knee joint _______

MSt

  • weight shift over _______
  • _______ to propulsion
  • ______ position

TSt

  • SLS time _______
  • _______ progression of COM over foot
  • _______ lumbar lordosis

PSw

  • ______ heel rise
  • adequate _______

Swing phase
-______

A
  • decreased
  • shorter
  • stability
  • prosthetic
  • braking
  • pylon
  • decreased
  • normal
  • normal
  • normal
  • suspension

-velocity

40
Q

Energy Expenditure:

  • For normal individuals, the energy cost of walking and gait speed are ______.
  • For transtibial amputees, they have a __-__% increase in O2 consumption.
  • For transfemoral amputees, they have a ___-___% increase in O2 consumption.
A
  • linear
  • 16-28%
  • 60-110%
41
Q

Prosthetic Gait: Main Takeaways

  • A solid foundation in normal gait lends itself well to prosthetic gait analysis
  • Development of gait __________ and __________, as well as increased metabolic cost, is unavoidable
  • “Normal” prosthetic gait is a function of ______ fit, __________ alignment, components, and ____ ability
  • No matter the cause or level, amputees have increased ________ costs for ambulation
A
  • abnormalities and compensations
  • socket fit, prosthetic alignment, components, and user ability
  • metabolic

S3- Amputation And Prosthetics (10 decks)

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