Prosthetic gait deviations (TF)

During what phase will you observe abducted gait (TF)

-MSt

What view is best to assess abducted gait (TF)

-AP

What might be observed with abducted gait

-wide based gait (>5cm)

-PL never rtns to midline

What are potential causes of abducted gait

-prosthesis too long

-high medial wall of prosthesis

-abduction contracture

-inadequate gait training/poor habit

What part of the prosthesis is typically too long in abducted gait

-pylon

Why would a high medial wall of the prosthesis cause abduction

-it's applying pressure to the pubic ramus

-they abduct to avoid pain

During what phase will you observe excessive trunk extension/lordosis (TF)

-MSt-PSw

What view is best to assess trunk excessive ext/lordosis

-lateral

What might a pt report with excessive trunk ext/lordosis (TF)

-LBP

-feeling like they aren't traveling far

What are potential causes of excessive trunk ext/lordosis (TF)

-insufficient inital socket flexion

-hip flexion contracture

-weak hip extensors/abs

Why would insufficient initial socket flexion cause excessive trunk ext/lordosis (TF)

-the pt increases lumbar extension to promote hip extension

Why would a hip flexion contracture cause excessive trunk ext/lordosis (TF)

-pt would extend the low back to bring their COM back

During what phase will you observe medial/lateral whips

-ISw

What view is best to assess medial/lateral whips

-posterior

What would be observed with a medial whip

-heel tracks medially at the beginning of ISw

What would be observed with a lateral whip

-heel tracks laterally at the beginning of ISw

What are potential causes of medial/lateral whips

-knee axis in excessive ER (M)

-prosthesis donned in ER (M)

-knee axis in excessive IR (L)

-prosthesis donned in IR (L)

-excessive soft tissue in residual limb w/ socket too tight

What is the MOST common cause of med/lat whips

-prosthesis being donned incorrectly

During what phase will you observe pistoning (loss of suspension)

-swing

What might be observed with pistoning (loss of suspension)

-prosthesis slips as foot leaves ground

-toe catches on ground

-skin abrasions

What are potential causes of pistoning

-suspension mechanism loose/inadequate

-Not enough socks, sweaty, air leakage, weight loss