PPT 3.3: Module 1c: Gait Deviations for Transfemoral Amputations

What are common gait deviations in stance phase for TFA?

1. Excessive lordosis

2. Excessive abduction

3. Lateral trunk bend

4. Forward trunk flexion

What is the prosthetic cause of excessive lordosis in stance phase for TFA?

Inadequate socket flexion

What is the anatomic cause of excessive lordosis in stance phase for TFA?

Weak extensors

What is the prosthetic cause of excessive abduction in stance phase for TFA?

1. Long prosthesis

2. Inadequate lateral wall adduction

3. Sharp or high medial wall

What is the anatomic cause of excessive abduction in stance phase for TFA?

1. Ab contracture

2. Weak ABD

3. Instability

What is the prosthetic cause of lateral trunk bend in stance phase for TFA?

1. Short prosthesis

2. Inadequate lateral wall adduction

3. Sharp or high medial wall

What is the anatomical cause of lateral trunk bend in stance phase for TFA?

1. Ab contracture

2. Weak ab

3. Hip pain

4. Short residual limb

What is the prosthetic cause of forward trunk flexion in stance phase for TFA?

Unstable knee unit

What is the anatomic cause of forward trunk flexion in stance phase for TFA?

Hip flexion contracture

What are common gait deviations during swing phase for TFA?

1. Circumduction

2. Vaulting and hip hike

3. High heel rise

4. Terminal impact

5. Medial/lateral whip

What is the prosthetic cause of circumduction during swing phase for TFA?

1. Locked knee unit

2. Long prosthesis

3. Inadequate suspension

4. Small socket

5. Loose socket

What is the anatomic cause of circumduction during swing phase for TFA?

1. Abd contracture

2. Poor knee control

What is the prosthetic cause of vaulting/hip hike during swing phase for TFA?

1. Locked knee unit

2. Long prosthesis

3. Inadequate suspension

4. Small socket

5. Loose socket

*same as circumduction*

What is the anatomic cause of vaulting/hip hike during swing phase for TFA?

1. Abd contracture

2. Poor knee control

*same as circumduction*

What are common gait deviations in early swing for TFA?

High heel raise

What is the prosthetic cause of high heel raise in early swing for TFA?

1. Inadequate friction

2. Slack extension aid

What is a common gait deviation in terminal swing for TFA?

Terminal impact

What is the prosthetic cause of terminal impact in terminal swing for TFA?

1. Inadequate friction

2. Taut extension aid

What is a common gait deviation in terminal stance for TFA?

Medial/lateral whip

What is the prosthetic cause of medial/lateral whip in terminal stance for TFA?

1. Fault socket contour

2. Foot malrotated

3. Prosthesis donned in malrotation

What are general prosthetic causes of gait deviations for TFA?

1. Socket fit (comfort)

2. Socket fit/alignment (stance phase socket stability)

3. Socket fit/alignment (swing phase issues)

4. Prosthetic alignment (accommodation/treatment)

5. Prosthetic component choice and appropriateness

6. Confidence and balance (patients trust in their device)