A patient who has ambulated with a transtibial prosthesis for six years is observed during an unrelated exam. Which gait finding is MOST likely on the prosthetic limb?

• A. Extended stance time
• B. Shortened swing time
• C. Longer step length
• D. Increased single limb support time

Answer: (C)

In this scenario, the main idea is how a well-established transtibial prosthesis alters forward progression during gait. Over years of use, the wearer often develops a pattern where the prosthetic limb can advance farther during the step, resulting in a longer step length on the prosthetic side. This reflects adaptation to the prosthesis’ mechanics—no active push-off and limited ankle control—so the person relies on precise timing and hip flexor drive to advance the prosthetic foot. The stable prosthetic foot and socket allow a confident placement further ahead, which lengthens the distance between successive foot contacts as the gait cycle unfolds.

Other potential changes are less characteristic as primary findings in a long-term, well-fitted transtibial prosthesis gait. For example, extending the prosthetic stance time isn’t the typical dominant pattern because the prosthetic foot lacks the active push-off that would prolong stance, and a significantly prolonged stance or increased single-limb support on the prosthetic side would often indicate inefficiency or instability rather than a normal adaptation. Shortened swing time on the prosthetic limb or excessive single-limb support on the intact limb are also less likely to be the defining, most likely finding in an experienced user.