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38 Cards in this Set
- Front
- Back
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what could cause excessive knee flexion from heel contact to midstance
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- knee/hip flexion contracture
- decreased quad strength - weak hip extensors - anterior-distal stump pain |
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what would be the prosthetic considerations for excessive knee flexion from heel contact to midstance
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- foot set in DF
- socked aligned in too much flex/too far forward in relation to foot - stiff heel (SACH)/stiff pflex bumper - prosthesis too long |
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what could casue decreased knee flexion from heel contact to midstance
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- decreased quad strength
- posterior-distal stump pain - excessive soft tissue in popliteal area |
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what would be the prosthetic considerations for decreased knee flexion from heel contact to midstance
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- foot in too much PF
- heel/PF bumper too soft - posterior socket alignment in relation to the foot - prosthesis too short |
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what could cause sudden early knee flexion at the end of midstance
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- flexion contracture
- knee instability - weak hip extensor muscles - anterior-distal stump pain - decreased proprioception |
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what are the prosthetic considerations for decreased knee flexion from heel contact to midstance
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- foot set in excessive DF
- keel of SACH too short - socket anterior to foot - socket too loose |
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what could cause delayed knee flexion at the end of stance phase
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- weak hip flexors
- posterior-distal stump pain |
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what are the prosthetic considerations for delayed knee flexion at the end of stance phase
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- socket too posterior in relation to the foot
- foot too large (keel not set up properly) - excessive foot PF - prosthetic foot too hard (SACH) |
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what could cause excessive lateral thrust in midstance
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- weak hip ABD
- medial collateral ligament weakness - distal-medial stump pain |
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what are the prosthetic considerations for excessive lateral thrust in midstance
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- foot set too medial
- socket too far lateral in relation to foot - socket too large |
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what could cause heel whips
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- weak hip rotators
- knee instability |
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what is a heel whip
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foot rotates laterally or medially
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what are the prosthetic considerations for heel whips
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- suspension too loose
- toe break/keel improperly aligned - stiff foot (SACH) - malalignment of hinges |
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what could cause decreased weight bearing in midstance
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- decreased quad strength
- knee instability - stump hypersensitivity |
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what are the prosthetic considerations for decreased weight-bearing in midstance
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- socket too large/too small
- distal socket contact missing |
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what is the most common gait pattern seen with AKA
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abducted gait
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what could cause abducted gait
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- adductor roll
- abd/flex contracture - weak ADD/ext/ABD of opposite hip - pain on distal lateral stump - general stump sensitivity - incomplete insertion of stump into socket |
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what are the prosthetic considerations for abducted gait
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- prosthesis too long
- excessive knee friction - inadequate suspension - medial socket wall too high |
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what could cause circumducted gait
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- short stump causing inadequate lever control
- pistoning due to flabby tissue - weak hip flex/ABD on opposite side - ABD contracture - pain at anterior-distal stump |
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what are the prosthetic considerations for a circumducted gait
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- prosthesis too long
- too much knee friction/excessive ext assist - too much PF - pistoning due to socket too large - socket too small - loose suspension |
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what could cause lateral trunk bending in stance
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- short stump causing inadequate lever control
- pistoning due to flabby tissue - weak hip abd on opposite side - ABD contracture - pain at anterior- distal stump |
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what are the prosthetic considerations for a lateral trunk bending in stance
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- prosthesis too short
- high medial wall - lateral distal socket counterpressure on tender area - inadequate lateral wall contact - socket too loose - inadequate lateral tilt of socket - ML diameter of socket is too wide |
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what could cause rotation of forefoot on heelstrike
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- soft tissue permits passive rotational mobility
- weak hip rotators |
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what are the prosthetic considerations for rotation of the forefoot on heelstrike
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- heel cushion too rigid (SACH)/ stiff PF bumper
- inadequate suspension - too much toe-out built into prosthesis - loose socket - foot set too posterior |
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what could cause heel whips
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- soft tissue permits passive rotational mobility
- weak hip rotators |
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what are the prosthetic considerations for heel whips
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- incorrect alignment of prosthetic knee axis (lat --> IR; med --> ER)
- toe break not set at right angle to line of progression - knee axis not set horizontally to the ground |
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what could cause uneven heel rise
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- decreased hip extension
- weak hip extensors |
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what are the prosthetic considerations for uneven heel rise
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- unsufficient prosthetic knee joint friction
- extension aid too loose |
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what could cause terminal swing impact
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- short stump causing poor lever control
- weak hip flexors - weight of prosthesis forced the patient to accelerate the prosthesis more forcefully than necessary |
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what are the prosthetic considerations for terminal swing impact
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- unsufficient knee friction
- increased tension in the extension aid |
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what could cause forward trunk flexion
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- hip flexion contracture
- weak hip flex/ext - painful ischial seating - decreased proprioception |
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what are the prosthetic considerations for forward trunk flexion
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- knee instability
- too much flexion in the socket - tight suspension belt |
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what could cause lumbar lordosis with excessive hip flexion
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- tight hip flex
- weak hip ext/abs - pain at ischial seat level with weight bearing |
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what are the prosthetic considerations for lumbar lordosis with excessive hip flexion
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- prosthesis too heavy
- reduced knee friction |
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what could cause prosthetic knee instability
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- weak hip extensors
- hip flex contracture - decreased proprioception - painful distal stump |
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what are the prosthetic considerations for prosthetic knee instability
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- PF resistance too great causing knee to buckle at heelstrike
- excessive DF - socket set too far post./ knee axis set too far anterior - prosthetic knee center located anterior to TKA line |
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what could cause the inability to initiate prosthetic knee flexion
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- weak hip flex
- anterior distal stump pain - decreased hip ROM |
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what are the prosthetic considerations for inability to initiate prosthetic knee flexion
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- too much knee stability
-stiff prosthetic foot - toe break too far anterior - foot too large |
