Prosthetic Gait Deviations Flashcards Preview

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Flashcards in Prosthetic Gait Deviations Deck (50)
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1

List some possible gait deviations that can be observed in TTA?

  1. Excessive knee extension
  2. Knee Instability
  3. Hip drop
  4. Lateral thrust
  5. Wide based gait
  6. Drop-off/Knee Instability
  7. Vaulting
  8. Pistoning
  9. Uneven Step length
  10. Circumduction

 

2

List gait deviations that are observed in TTA during stance phase?

  1. Excessive knee extension
  2. Knee instability
  3. Hip drop
  4. Lateral thrust
  5. Wide based gait
  6. Drop off/knee instability

 

3

describe the gait deviation excessive knee extension (TTA)

knee joint is fully extended at IC, and stays that way through early stance phase

observed in the sagittal plane

4

what are some causes for the excessive knee extension gait deviation (TTA)

  1. Prosthetic causes
    • socket aligned too far posterior/foot aligned too far anterior
    • heel too soft
    • insufficient socket flexion
  2. Patient causes 
    • weak musculature around knee
    • locking knee to prevent fall

 

5

describe the gait deviation "knee instability" observed in TTA

knee joint appears unstable duringly early stance phase

view in sagittal plane

might notice shortened stance phase on prosthetic side during gait (don't confuse this with drop-off)

looks like pt is stepping into a hole

6

what are some causes of the gait deviation knee instability in TTA?

  1. Prosthetic causes:
    • socket aligned too far anterior/foot aligned too far posterior 
    • heel too firm
    • excessive foot DF
  2. Patient causes
    • weak quads
    • knee flexion contracture

 

7

describe the gait deviation hip drop observed in TTA

pelvic drop toward prosthetic side during MSt

view in frontal plane

might occur as a compensation to offload a painful area of the residual limb

8

what are some causes of the gait deviation, hip drop, observed in TTA?

  1. Prosthetic causes
    • prosthesis too short
  2. Patient causes
    • residual limb pain

 

9

describe the gait deviation Lateral Thrust, observed in TTA

narrow BOS with lateral thrust of the socket during MSt excessive varus thrust at knee

can be difficult to see - might look like compensated/uncompensated Trendelenburg

look at proximal pylon → will be lateral leaning

pt complains of proximal medial and distolateral skin breakdown/pain

10

what are some causes of the gait deviation Lateral Thrust observed in TTA?

  1. Prosthetic causes:
    • foot too far inset
    • laterally leaning pylon
  2. Patient causes:
    • glute med weakness
    • knee ligament insufficiency

 

11

what are some causes of the gait deviation Wide Based Gait observed in TTA?

  1. Prosthetic causes:
    • outset foot
    • medial leaning pylon
  2. Patient causes:
    • insufficient weight shift
    • hip abduction tightness
    • patient fear 

12

describe the gait deviation, drop-off/knee instability, observed in TTA

early and excessive knee flexion during TSt

pt appear to be falling off prosthetic at TSt and the knee looks like it buckles during the transition from TSt to ISw

non-prosthetic side might not achieve full IC/LR and instead have foot flat as they are "catching themselves"

13

what are some causes of the gait deviation, drop-off/knee instability, observed in TTA?

  1. Prosthetic causes:
    • socket aligned too far anterior/foot too far posterior 
    • inappropriate foot choice
  2. Patient causes:
    • knee flexion contracture

 

14

List gait deviations that are observable during swing phase in TTA

  1. Vaulting
  2. Pistoning
  3. Uneven step length
  4. Circumduction

 

15

describe the gait deviation, Vaulting, observed in TTA

excessive PF of sound limb during MSt to clear prosthetic foot

view in frontal plane

essentially doing a calf raise with every step

16

what are some causes of the gait deviation, Vaulting, observed in TTA?

  1. Prosthetic causes:
    • prosthesis too long
    • long toe lever arm
    • socket too far posterior 
  2. Patient causes:
    • holding knee in extension too long

 

17

what is pistoning?

loss of suspension

viewed in sagittal plane (or any plane)

18

what are some causes of pistoning?

  1. Prosthetic causes:
    • socket too large
    • not enough socks
  2. Patient causes:
    • volume changes (decrease in volume throughout the day)
    • not enough socks

 

19

what are some causes for uneven step length in TTA?

insufficient gait training

decreased patient confidence

 

20

describe the gait deviation, Circumduction, observed in TTA

pt swings leg around in abducted position to advance it forward

demonstrated more commonly in TFA

TTA tend to lock out knee making a functionally longer limb that is difficult to progress through gait

21

what are some causes for the gait deviation, Circumduction, observed in TTA?

  1. Prosthetic causes:
    • poor suspension
    • prosthesis too long 
  2. Patient causes:
    • feeling of instability
    • decreased knee flexion during swing

 

22

What are some main takaways from the TTA gait deviation lecture?

  1. any gait deviation is going to have an impact on gait efficiency and work
  2. analyze gait from multiple viewpoints to catch deviations
  3. patients may have a combo of deviations
  4. recognize when a deviation is out of your control and refer appropriately
  5. treat impairments when possible

 

23

List gait deviations observed in TFA

  1. Terminal Impact
  2. Foot slap
  3. Knee Instability
  4. Lateral Trunk Bend
  5. Abducted gait
  6. Excessive Trunk Extension
  7. Drop off
  8. Excessive heel rise
  9. Circumduction
  10. Vaulting
  11. Medial Whip
  12. Lateral Whip

 

24

describe the gait deviation, Terminal Impact, observed in TFA

forceful and excessive knee extension, usually audible

observed in sagittal plane

from IC/LR

25

what are some causes for the gait deviation Terminal Impact (TFA)?

  1. Prosthetic cause
    • inadequate knee friction
  2. Patient cause
    • fear of knee giving way
    • forceful hip flexion

 

26

describe the gait deviation, Foot Slap, observed in TFA

accelerated PF at heel strike resulting in the foot getting flat to the floor too soon 

IC/LR

observed in sagittal plane

27

what are some causes for the gait deviation Foot Slap (TFA)

  1. Prosthetic causes:
    • PF bumper too soft
  2. Patient causes 
    • increased hip extension force at IC

 

28

describe the gait deviation, knee instability, observed in TFA

knee giving way in early stance phase

observed in IC/LR in sagittal plane 

 

29

what are some potential causes of the gait devitation, Knee Instability observed in TFA

  1. Prosthetic causes
    • knee axis too far anterior
    • socket too far posterior
    • lack of socket flexion 
  2. Patient causes 
    • inadequate hip extension ROM
    • hip flexion contracture

 

30

what are some causes of the gait deviation lateral trunk bend observed in TFA?

  1. Prosthetic causes
    • socket too abducted
    • prosthesis too short
    • medial socket wall too high
  2. Patient causes
    • pain
    • glute med weakness
    • decreased balance
    • adductor roll