GAIT ANALYSIS OF THE BELOW KNEE (BK) AMPUTEE

All GAIT deviations except those at the mid-stance phase are best observed from the prosthetic side.
Mid-stance deviations are best seen from rear.

1) Between heel-strike and mid-stance;-

I. Excessive knee flexion; at normal speed and gait the knee flexion after the heel
strike is from 150 to 200 . The BK amputee may exceed this rage of knee flexion on
amputated side for any of the following reasons;- a) excessive dorsiflexion of the
Foot or excessive anterior tilt of
the stump socket.

b) Excessive stiff heel cushion

or plantar-flexion bumper.

c) Excessive anterior displace

ment of the stump socket over

the foot.
 d) Flexion contracture or poster

ior displacement of the suspen-

sion TABS.

II. Absent or insufficient knee flexion;- the BK amputee may walk with absent or
insufficient knee flexion on the amputated side for one or more of the follwing
reasons;- a) Excessive plantar-flexion
of the foot.
b) Excessively soft heel cushion
or soft plantar-flexion bumper.
c) posterior displacement of the
socket over the foot.
 d) Anterior distal discomfort of
the stump.
e) weakness of the quadriceps
muscles
f) habit

2) At mid-stance;-
A) Excessive lateral thrust of the prostheses ;- the medial socket brim presses against
the femoral condyle while the lateral brim tends to GAP.the amputee may complain
of uncomfortable pressure on the medio-proximal aspect of the knee, and damage
to the skin and to the ligaments may result
Excessive lateral thrust may be caused by such factors;-
  Excessive medial placement of
the prosthetic foot.
 Abducted socket

3) Between mid-stance and toe-off

1) Early knee flexion (drop-off) just prior to heel –off during normal gait, knee is
extending. At heel –off or immediate there after, knee motion reverses and flexion
begins. This knee flexion coincides with the passing of C.O.G. over the
metatarsophalageal joints. If the body weight is carried over these joints too soon,
results the lack of anterior support would allow premature knee flexion or Drop-off.
Possible causes of this lack of anterior support are as follws;-
a. Excessive anterior displacement of the socket over the foot.
b. Posterior displacement of the toe- break or the keel.
c. Excessive dorsiflexion of the foot or excessive anterior tilt of the socket.
d. Soft dorsiflexion bumper
 2) Delayed knee flexion this is the reverse situation of the situation described above
and occurs if the body weight must be carried forward an unusually long
distanceperiod. remain in extension during the latter part of the stance phase, and
the amputee may complain of a “walking up-hill” sensation, since his C.O.G. would
be carried up and over the extended knee. This excessive anterior support can be
brought about by the following;
a. excessive posterior displacement of the socket over the foot
b. Anterior displacement of the toe-break or the keel.
c. Excessive plantar-flexion of the foot or excessive posterior tilt of the socket
d. Hard dorsiflexion bumper.
e. Soft heel cushion.

By j. muli

s. lecturer