Gait Changes with a BK prosthetic

1. even stride length/ swing through
2. weight shift
3. even cadence

With a BK:
1. smooth rollover from heel strike to push off
2. slight lateral socket displacement at mid-stance

all components capable of adjustment and modification for optimum fit

used to establish: height, foot rotation, socket position (flexion/extension, ab/adduction, AP pos'n, ML pos'n)

use TKA (trochanter/Knee/Ankle) to identify the relative alignment between the center of socket weight line, the rotation point of the knee and the functional rotation point of the ankle/foot

- allows for minute adjustments to the prosthesis
- customizes alignment of prosthesis to the patients' needs and requirements
- ensures maximum activity and stability resulting in achieving the highest possible outcome

prosthetic
1. short toe lever
2. excessive socket flexion
3. excessive DF
4. incorrect foot type

amputee
1. gait habit
2. IR of hip at toe off/hip flexion (affecting the toe lever arm)

P
1. long prosthesis
2. poor suspension or change in limb fit
3. excessive PF of foot
4. excessive knee resistance or stability

A
1. gait habit, fear of catching toe
2. weak hip flexors on residual limb
3. improper initiation of hip flexors on residual limb

P
1. prosthetic foot too far outset
2. excessive socket adduction

A
1. insecurity, wants to widen base in attempt to increase stability
2. weak ML knee control

P
1. foot too far inset
2. insufficient socket adduction
3. short prosthesis

A
1. Inadequate balance
2. weak knee
3. narrow gait base (significant lateral stress at the knee)

1. pt. reports lower back pain
2. pt. reports they feellike they are walking up a hill
3. noticeable rise and drop of shoulder on the effected side
4. hesitation in gait timing from prosthetic mid-stance to sound side heel strike

1. pt. reports low back pain
2. pt. reports they feel like they are stepping into a hole
3. noticeable rise and drop of shoulder on sound side
4. uneven arm motion to accommodate uneven stride length
5. appears like pt. may be vaulting

1. patient wants foot to match sound side
2. IR of knee at toe off
3. induces "medial whip" (heel rotates when walking)
4. drop off at end of stance phase
5. low back pain
6. skin irritation due to rotational stress in socket