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Lower Limb

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chandlerrice's version from 2016-12-17 17:25

Terminology

Question Answer
Coxa VaraFemoral neck shaft angled inward
Coxa ValgaFemoral neck shaft angled outward
AnteversionFemoral neck rotated forward
RetroversionFemoral neck rotated posteriorly or backward
Internal Tibial TorsionDistal aspect of tibia rotated or twisted medially, as compared with its proximal end
Genu Varum"Bow legged" Tibia is angled medially causing the knees to be apart
Genu Valgum"Knock Kneed" Tibia is angled laterally causing the knees to come together or almost touch
EquinusThe toe is in a down position, dorsiflexion limitation of the ankle
CalcaneusThe heel-down position, plantar flexion limitation of the ankle
Talipes EquinovarusAnkle and foot are down and in (Clubfoot)
Pes CasusHigh arched or supinated foot
Pes PlanusLow arched foot or pronated or flat foot
Valgus HeelThe rear foot is deviated toward the outside resulting in a pronated heel
Hallux ValgusFirst metatarsal has an abduction deformity "Bunion"
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Gait Analysis

Question Answer
Heel Strike (Stance Phase) Initial ContactHeel contact with the ground
Foot Flat (Stance Phase) Loading ResponsePlantar surface of the foot contacts ground
Midstance (Stance Phase) MidstancePoint at which the body passes over the weight-bearing limb
Heel Off (Stance Phase) Terminal StanceHeel leaves the ground, while ball of foot and toes remain in contact with the ground
Toe Off (Stance Phase) PreswingToes leave the ground, ending stance phase
Acceleration (Swing Phase) Initial SwingFrom when the toes leave the ground until the foot is directly under the body
Midswing (Swing Phase) MidswingWhen the non-weight bearing limb is directly under the body
Deceleration (Swing Phase) Terminal SwingWhen the limb is slowing down in preparation for heel strike
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Stance Phase Deviations

Question Answer
Lateral Bending of the TrunkWeak gluteus medius (Trendelenburg gait)
Backward Lean of the TrunkWeak gluteus maximus, trouble going up stairs or ramps
Forward Lean of the TrunkWeak quadriceps or hip/knee contracture
Excessive hip flexionWeak hip extensors or tight hip/knee flexors
Limited hip extensionTight or spastic hip flexors
Limited hip flexionWeak hip flexors or tight hip extensors
Antalgic GaitSecondary to increased pain while ambulating. Stance time is shortened on involved limb, resulting in uneven gait pattern
Excessive Knee FlexionWeak quadriceps or by knee flexion contracture. Pt has difficulties going down stairs or ramps
Hyperextension of the KneeWeak quadriceps, plantar flexion contracture, or extensor spasticity
Toe First (toes contact floor at heel strike)Weak dorsiflexors, spastic or tight plantar flexors, or a shortened leg length
Foot SlapWeak dorsiflexors or hypotonia. Pt may compensate with stoppage gait or excessive hip/knee flexion
Foot FlatWeak dorsiflexors, limited ROM or immature gait pattern
Varus FootWeak personals and/or spastic anterior tibialis. At foot contact, lateral side of the foot makes contact first.
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Swing Phase Deviations

Question Answer
Insufficient Forward Pelvic Rotation (Pelvic Retraction)Weak abdominal muscles or weak flexor muscles
Insufficient Hip and Knee FlexionWeak hip and knee flexors. Pt will have inability to lift leg and bring it forward
CircumductionWeak hip and knee flexors. Extremity will swing out to the side
Hip HikingWeak hit and knee flexors or extensor spasticity. Action of the quadratus lumborum
Steppage Gait (Excessive hip and knee flexion)Weak dorsiflexors. Shorten the length of a leg
Insufficient Knee FlexionExtensor spasticity, pain, decreased ROM or weak hamstrings
Excessive Knee FlexionFlexor spasticity or flexor withdrawal reflex
Foot Drop (Equinus)Weak or delayed contraction of dorsiflexors or spastic plantarflexors
Varus or Inverted FootSpastic investors (ant. tib), weak peroneals
EquinovarusSpasticity of the posterior tibialis and/or gastrocnemius/soleus
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Prosthetic Deviations

Question Answer
Lateral BendingProsthesis may be too short Improperly shaped lateral wall High medial wall Prosthesis aligned in abduction
Abducted GaitProsthesis may be too long High medial wall Poorly shaped lateral wall Prosthesis positioned in abduction Inadequate suspension Excessive knee friction
Circumducted GaitProsthesis may be too long Too much friction in the knee Socket is too small Excessive plantar flexion of prosthetic foot
Excessive Knee Flexion During StanceSocket set forward in relation to foot Foot set in excessive dorsiflexion Stiff heel Prosthesis too long
VaultingProthesis may be too long Inadequate socket suspension Excessive alignment stability Foot in excessive plantar flexion
Rotation of Forefoot at Heel StrikeExcessive toe-out built in Loose fitting socket Inadequate suspension Rigid SACH heel cushion
Forward Trunk FlexionSocket too big Poor suspension Knee instability
Medial or Lateral WhipExcessive rotation of the knee Tight socket fit Valgus in the prosthetic knee Improper alignment of toe break
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Types of AFO's

Question Answer
Solid AnkleNo movement
Posterior Leaf SpringBuilt-in dorsiflexion assist
Spiral Ankle AFOPrimarily for medial lateral stability
Knee-Ankle-Foot-Orthosis (KAFO)Shoe attachment, ankle control, uprights, knee joint and bands or shells for the thigh and calf.
Knee Orthosis (KO)Controls knee motion or provides stability
Milwaukee Brace (CTLSO)Cervical, thoracic, lumbosacral orthosis used to control scoliosis
Boston Brace (TLSO)A molded brace for scoliosis or other back problems below T7-T9. More cosmetic/worn under clothes
Cervical Orthosis (CO)Meant to control or limit cervical motion. Halo brace attaches to the skull by screws and provides maximal orthotic control
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Section 7

Section 8

Section 9

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