Prosthesis and Gait

Gait Deviation	Prosthetic Cause	Amputee Cause
Abducted Gait	• Prosthesis may be too long • High medial wall • Poorly shaped lateral wall • Prosthesis positioned in abduction • Inadequate suspension • Excessive knee friction	• Abduction contracture • Improper training • Adductor roll • Weak hip flexors and adductors • Pain over lateral residual limb
Circumducted Gait	• Prosthesis may be too long • Too much friction in the knee • Socket is too small • Excessive plantar flexion of prosthetic foot	• Abduction contracture • Improper training • Weak hip flexors • Lacks confidence to flex the knee • Painful anterior distal stump • Inability to initiate prosthetic knee flexion
Excessive knee flexion during stance	• Socket set forward in relation to foot • Foot sett in excessive dorsiflexion • Stiff heel • Prosthesis is too long	• Knee flexion contracture • Hip flexion contracture • Pain anteriorly in residual limb • Decrease in quadriceps strength • Poor balance
Vaulting	• Prosthesis may be too long • Inadequate socket suspension • Excessive alignment stability • Foot in excess plantar flexion	• Residual limb discomfort • Improper training • Fear of stubbing toe • Short residual limb • Painful hip/residual limb
Rotation of Forefoot at Heel Strike	• Excessive toe-out built in • Loose fitting socket • Inadequate suspension • Rigid SACH heel cushion	• Poor muscle control • Improper training • Weak medial rotators • Short residual limb
Forward trunk flexion	• Socket is too big • Poor suspension • Knee instability	• Hip flexion contracture • Weak hip extensors • Pain with ischial weight bearing • Inability to initiate prosthetic knee flexion
Medial or Lateral whip	• Excessive rotation of the knee • Tight fitting socket • Valgus in the prosthetic knee • Improper alignment of toe break	• Improper training • Weak hip rotators • Knee instability
Lateral Bending	• Prosthesis may be too short • Improperly shaped lateral wall • High Medial Wall • Prosthesis aligned in abduction	• Poor balance • Abduction contracture • Improper training • Short residual limb • Weak hip abductors on prosthetic side • Hypersensitive and painful residual limb