Prosthetic knee flexion and prosthetic leg swing

29 years old patient - LT AKA and multiple complex fractures in RT foot bones

The patient was asked to lift his prosthetic leg from the first to the second stair. He first needs to shift his weight over his other leg, so that his prosthetic knee will unlock and bend. To lift his prosthetic leg, he uses circumduction instead of hip flexion.

To avoid the circumduction, the PT instructs the patient to take his prosthetic leg a little backwards before flexing the knee. The patient does so, but now uses a lumbar side flexion (hiking) to lift his leg. The PT corrects him again and asks him to try and flex his hip as much as he can before compensating with lumbar side flexion.

The PT instructs the patient to put only one hand on the handrail. This increases the level of difficulty as he now needs to work harder to stabilize himself, by using the muscles around his right hip and pelvic. The patient looks down at his feet to compensate for his lack of sensation by using his sight.

Patient’s description: The patient is 29 y.o after a car accident. LT Above Knee Amputation (AKA). Multiple complex fractures in RT foot bones and RT Fibula fracture that led to RT ankle lack in ROM. The RT foot was re-constructed in a slight supine, which makes the patient bear more weight on the foot’s lateral side. Skin grafts in the right foot led to allodynia, hyperalgesia, and sensitivity to friction and pressure.