Gait Deviations - Amputations

Transtibial Gait Deviation:
Increased Knee Flexion

Prosthetic Cause:

• show heel too high

• too little plantar flexion

• heel cushion too sift

• socket too flexed

• cuff tabs too posterior

Anatomical Cause:

• weak quads

• flexion contracture

Transtibial Gait Deviation:
Decreased Knee Flexion

Prosthetic Cause:

• show heel too low

• too much plantar flexion

• heel cushion too soft

• socket too extended

• socket too far posterior

Anatomical Cause:

• extensor spasticity

• weak quads

• anterior distal pain

• arthritis

Transtibial Gait Deviation:
Lateral Thrust

Prosthetic Cause:

• excessive foot inset

Transtibial Gait Deviation:
Medial Thrust

Prosthetic Cause:

• excessive foot outset

Transfemoral Gait Deviation:
Abduction: stand leg

Prosthetic Cause:

• prosthetic too long

• hip joint abducted

• lateral wall inadequately adducted

• medial wall too sharp/high

Anatomical Cause:

• abduction contracture

• weak abductors

Transfemoral Gait Deviation:
Lateral bend: stance leg

Prosthetic Cause:

• prosthesis too short

• lateral wall inadequately adducted

• medial wall too sharp/high

Anatomical Cause:

• abduction contracture

• weak abductors

• short amputation limb

• instability

Transfemoral Gait Deviation:
Forward flexion: stance leg

Prosthetic Cause:

• knee unit unstable

• crutches too short

Anatomical Cause:

• instability

Transfemoral Gait Deviation:
circumduction

Prosthetic Cause:

• prosthesis too long

• knee unit locked

• insufficient friction

• suspension inadequate

• socket too small

• socket too loose

• foot plantar flexed

Anatomical Cause:

• abduction contracture

• poor knee control

Transfemoral Gait Deviation:
vaulting

Prosthetic Cause:

• prosthesis too long

• knee unit locked

• insufficient friction

• suspension inadequate

• socket too small

• socket too loose

• foot plantar flexed

Anatomical Cause:

• with fast pace

Transfemoral Gait Deviation:
hip hike

Prosthetic Cause:

• prosthesis too long

• knee unit locked

• insufficient friction

• suspension inadequate

• socket too small

• socket too loose

• foot plantar flexed

Anatomical Cause:

• weak dorsiflexors

• plantar flexor spasticity

• pes equinus

• weak hip flexors

Transfemoral Gait Deviation:
medial or lateral whip during heel off phase

Prosthetic Cause:

• socket contour faulty

• knee blot rotated internal/external

• foot malrotated

• prosthesis donned in malrotation

Anatomical Cause:

• with load depended friction unit, fast pace

Transfemoral Gait Deviation:
uneven step length

Prosthetic Cause:

• socket inadequately flexed

• socket uncomfortable

Anatomical Cause:

• hip flexion contracture

• instability

Transfemoral Gait Deviation:
wide gait

Prosthetic Cause:

• prosthetic foot too far outset

• excessive socket adduction

Anatomical Cause:

• insecurity (pt just wants to be wider)

Transfemoral Gait Deviation:
lateral shift

Prosthetic Cause:

• foot to far inset

• short prosthesis

Anatomical Cause:

• poor balance

• weak knee

• pelvic drop from weak hip adductors