O And P - 9 - Tf Gait Deviations

Front 1

Swing phase

increased knee flexion (excessive heel rise)

Back 1

Prosthetic cause:
1. Insufficient knee friction

Amputee cause:
1. Too strong hip flexion

Front 2

Swing phase

increased knee extension (terminal impact)

Back 2

Prosthetic cause:
1. Insufficient knee friction

Amputee cause:
1. Too vigorous hip flexion followed by strong hip extension
2. Security to insure knee extension

Front 3

Swing phase

medial whip

Back 3

Prosthetic cause:
1. excessive external rotation
2. Too tight socket
3. excessive valgus of prosthetic knee
4. scilesian belt too tight laterally

Amputee cause:
1. improper donning of prosthesis
2. excessive adipose tissue with poor muscle control

Front 4

Swing phase

lateral whip

Back 4

Prosthetic cause:
1. excessive internal rotation
2. too tight socket
3. excessive valgus of prosthetic knee

Amputee cause:
1. improper donning of prosthesis
2. excessive adipose tissue with poor muscle control

Front 5

Swing phase

circumduction

Back 5

Prosthetic cause:
1. too long prosthesis
2. too thick medial brim
3. too much knee stability (alignment or resistance)
4. improperly aligned pelvic band

Amputee cause:
1. abduction contracture
2. insecurity knee control

Front 6

Swing phase

pelvic rise

Back 6

Prosthetic cause:
1. too long toe lever arm
2. too much knee stability (alignment or resistance)

Front 7

Swing phase

pelvic posterior rotation

Back 7

Amputee cause:
1. inadequate transverse pelvic rotation

Front 8

Swing phase

decreased stride length on prosthetic side

Back 8

Prosthetic cause:
1. anterior leaning pylon
2. prosthesis too short
3. inadequate suspension

Amputee cause:
1. pain in the sound limb
2. hip flexion contracture on sound side

Front 9

Swing phase

increased stride length on prosthetic side

Back 9

Prosthetic cause:
1. painful socket
2. prosthesis too long

Amputee cause:
1. compensation for decreased stride with sound limb
2. insecurity during prosthetic stance
3. hip flexion contracture on prosthetic side
4. knee flexion contracture on sound side

Front 10

swing phase

decreased toe clearance

Back 10

Prosthetic cause:
1. prosthesis too long
2. pistoning (inadequate suspension, insufficient socks, socket too large)

amputee cause:
1. loss of weight
2. muscle atrophy
3. improperly donned
4. weak hip or knee flexors

Front 11

swing phase

increased toe clearance

Back 11

Prosthetic cause:
1. insufficient knee friction

amputee cause:
1. excessive hip flexion
2. vaulting

Front 12

single limb support

abducted gait

Back 12

Prosthetic cause:
1. prosthesis too long
2. too high medial wall
3. improper relief for distal femur on lateral wall
4. foot too much outset

amputee cause:
1. abduction contracture
2. fear or habit

Front 13

single limb support

pelvic lateral tilt

Back 13

Prosthetic cause:
1. inadequate adduction of the socket

amputee cause:
1. weak gluteus medius stance limb
2. poor balance

Front 14

single limb support

pelvic drop off (during late stance on the prosthetic side)

Back 14

Prosthetic cause:
1. toe lever too short
2. anterior leaning pylon foot too dorsiflexed
3. socket set too anterior to foot

Front 15

single limb support

pelvic posterior rotation

Back 15

amputee cause:
1. inadequate transverse pelvic rotation

Front 16

single limb support

lateral bending of trunk

Back 16

Prosthetic cause:
1. inadequate adduction of the socket
2. prosthesis too short
3. too high medial wall causing pain
4. outset foot

amputee cause:
1. weak hip abuctors
2. abduction contracture
3. painful residual limb
4. very short residual limb
5. inability to weight-bear
6. habit or fear

Front 17

single limb support

trunk lordosis

Back 17

Prosthetic cause:
1. insufficient socket flexion
2. posterior wall promotes anterior pelvic tilt

amputee cause:
1. tight hip flexors
2. weak hip extensors
3. weak abdominals
4. habit

Front 18

single limb support

trunk flexion

Back 18

Prosthetic cause:
1. too much socket flexion

amputee cause:
1. flexion contraction
2. poor proprioception
3. habit

Front 19

single limb support

decreased stance time

Back 19

Prosthetic cause:
1. pain from socket

amputee cause:
1. inadequate weight bearing
2. poor balance
3. insecurity

Front 20

single limb support

increased stride width

Back 20

prosthetic cause:
1. prosthesis too long
2. outset foot
3. socket too abducted
4. medial wall pressure
5. medial leaning pylon

Amputee cause:
1. poor balance
2. abduction contracture
3. adducted sound limb
4. habit

Front 21

weight acceptance phase (IC to loading response)

external rotation of the prosthesis

Back 21

prosthetic cause:
1. anterior or medial bring pressure
2. too stiff heel cushion or plantar flexion bumper
3. too long a heel lever
4. too much built-in toe-out

Amputee cause:
1. extension force too great
2. poor residual limb muscle control
3. improperly donned prosthesis

Front 22

weight acceptance phase (IC to loading response)

knee flexion or instability

Back 22

prosthetic cause:
1. knee axis too far ahead of the TKA line
2. insufficient socket flexion
3. too long heel lever arm
4. too stiff heel cushion or plantar flexion bumper
5. too much dorsiflexion

Amputee cause:
1. weak hip extensors
2. severe hip flexion contracture
3. altered height of shoes

Front 23

weight acceptance phase (IC to loading response)

foot slap

Back 23

prosthetic cause:
1. too soft heel cushion or plantar flexion bumper
2. too short a heel lever

Amputee cause:
1. too forceful driving of prosthesis to the ground insuring knee stability