trans tibial gait deviations

what are the prosthetic causes of drop off gait

short toe lever

excessive dorsiflexion

socket flexion

what are the patient causes of drop off gait

internally rotated hips

how to notice drop off gait ?

falling into sound side

What are the pressure tolerant areas in a transtibial amputation?

1) Patellar tendon (most pressure tolerant area)
2) Pretibial muscles and lateral flat aspect of fibula
3) Medial tibial flare
4) Popliteal fossa/gastrocnemius and soleus muscles

what are the prosthetic causes of delayed heel off?

toe lever too long

foot too plantarflexed

what are the patient causes of delayed heel off?

lower shoe height than original

how to notice delayed heel off gait?

standing on prosthetic side too long

heel looks stuck on the ground

what are the prosthetic causes of vaulting gait?

long prosthesis

poor suspension

excessive plantarflexion

what is a patient cause for vaulting gait?

fear of catching the toe

weak hip flexors on residual limb

improper initiation of those hip flexors

what does vaulting look like?

a toe walker

jumping up to clear the toe in swing

what are the prosthetic causes of circumduction gait?

long prosthesis

excessive plantarflexion

ineffective suspension

what are the patient causes of circumduction gait?

lack of confidence for knee flexion

abduction contracture

weak hip flexors

habit of hip and pelvis to initiate gait

what are the prosthetic cause of trendelenburg gait?

prosthesis too short

foot too outset

socket too big/small

what are the patient cause of trendelenburg gait?

weak gluteus medius

poor gait originally

how to notice circumduction gait?

circling of the foot - prolongs gait cycle

how to notice trendelenburg gait?

all weight on prosthesis side

looks like stepping into a hole

wide base of support

what are the prosthetic causes of uneven step length?

socket pain

excessive foot platarflexion

long toe lever

insufficient socket flexion

what are the patient causes of uneven step length?

lacking overall gait confidence

hip contracture

how to notice an uneven step length gait?

short step length

pain when stepping

foot stuck in plantarflexion

what are the prosthetic causes of a varus moment gait?

foot too inset

socket not adducted enough

short prosthesis

what are the patient causes of a varus moment gait?

poor balance

weak knee

narrow gait

how to notice a varus moment?

knee buckling out

thrusting at knee

what are the prosthetic causes of a valgus moment gait?

foot too outset

excessive socket adduction

what are the patient causes of a valgus moment gait?

wide base for stability

weak ml knee control

how to notice a valgus moment gait?

medial thrust

knee buckles into other knee

how would you reverse a valgus moment gait?

increase trim lines

supracondylar socket fit

what are the prosthetic cause of toe drag gait?

long prosthesis

poor suspension

excessive foot plantarflexion

poor socket flexion

what are the patient cause of toe drag gait?

weak hip extensors on sound side

weak hip abductors on sound side

poor posture

poor gait originally

how to notice toe drag gait?

not flexing enough at hip

toe hitting ground during midswing

what are the prosthetic causes of a wide base of support gait?

foot too outset

excessive socket adduction

what are the patient causes of a wide base of support gait?

increasing base for stability

weak ml knee control

hip abduction contracture

how to notice a wide base of support gait?

prosthetic leg is extended our of range of shoulders

what are the prosthetic causes of narrow base of support gait?

foot too inset

excessive socket abduction

what are the patient causes of narrow base of support gait?

poor gait originally

hip adductor contracture

how to notice a narrow base of support gait?

almost stepping on opposite foot

compensating with the trunk

what are the prosthetic cause of a knee instability gait?

foot too dorsiflexed

heel bumper too stiff

heel level too long

what are the patient causes of a knee instability gait?

knee flexion contracture

weak quadricep muscles

how to notice knee instability gait?

similar to drop off gait in terminal stance

excessive knee flexion in stance phase

looks like an average limp

never gets to full hip extension in swing

what are the prosthetic causes of medial whip gait?

foot too externally rotated

what are the patient causes of medial whip gait?

improper donning

external rotation of knee at toe-off

how to notice a medial whip gait?

toes are externally rotated

heel kicking contralateral heel after heel off

what are the prosthetic causes of lateral whip gait?

foot too internally rotated

what are the patient causes of lateral whip gait?

improper donning

internal rotation of knee at toe off

how to notice a lateral whip gait?

kicking heel of prosthesis out to lateral side

what are the factors that contribute to prosthetic gait?

prosthetic alignment

socket fit

foot type

physical therapy