Term
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Definition
| provide enough of the right kind of assistance so that patients can achieve the greatest mobility with the least risk of injury |
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Term
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Definition
| process of assisting a patient who is walking but not necessarily providing direct education and intervention to overcome gait |
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Term
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Definition
| therapeutic intervention designed to improve some aspects of the patients gait |
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Term
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Definition
| gait deviations and their underlying causes |
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Term
| platform walker can be used when |
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Definition
| a patient is unable to bear weight through the wrist or hand but can tolerate WB through the elbow & shoulder |
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Term
| TTWB precautions over a long period of time |
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Definition
| can lead to shortening of the gatroc & soles muscles resulting in ankle plantar flexion contracture |
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Term
| do not place fingers directly under foot |
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Definition
| but rather to the side to sense weight shift |
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Term
| the purpose of assistive devices |
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Definition
| is to minimize the immobilizing effects of a patients condition (always chose least restrictive device) |
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Term
| the assistive device that allows |
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Definition
| the greatest functional mobility & quality of life without undue risk |
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Term
| the therapist must match the needs & abilities of the patient |
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Definition
| to the qualities of the device |
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Term
| assistive devices are typically used to |
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Definition
increase support of load by redirecting load from an impaired limb to another (redirect load- deweight LE)
increase stability through enlarged BoS |
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Term
| the more stability an AD provides |
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Definition
| the more it restricts mobility |
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Term
| the faster, or more mobile an AD allows a patient to be, |
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Definition
| the less stability it provides |
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Term
| NWB, TTWB, TDWB in one LE |
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Definition
allow a person to put full weigh through both arms simultaneously in a controlled manner are appropriate
(parallel bars, walkers, bilateral crutches) |
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Term
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Definition
| generally limits device selections to walkers or bilateral crutches |
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Term
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Definition
opens up all ADs
allows any unilateral of bilateral device that provides the support necessary for the patient to tolerate functional ambulation |
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Term
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Definition
| tend to increase energy expenditure (normal gait patterns are the most energy efficient) |
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Term
| if cardiopulmonary limitations exist |
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Definition
| chose an AD that will plow the patient to ambulate the greatest distance in the desired environment without compromising safety even if other aspects of gait (speed, distance, & environments) must be modified |
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Term
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Definition
| requires significantly more energy expenditure than using rolling walkers or canes |
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Term
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Definition
1. be sure patients weight falls within the weight limits of the AD
2. have patient in good posture and wearing typical footwear when fitting device
3. position of UEs as determined by hand grip very important
4. guard appropriately during fitting |
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Term
| ABC's of guarding during gait |
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Definition
1. decrease distance between the patients CoM and your CoM without interfering with the patients mobility
2. stabilize your spine, place your feet apart with one foot slightly ahead of the other, and flex you're hips and knees slightly (increase your BoS and lowers your CoM, improving your overall stability)
3. stand posteriorly and to the side of the patient (not directly behind or directly to side) |
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Term
| control points of patient during gait |
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Definition
| pelvic and shoulder girdles |
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Term
| for gait requiring hands-on-guarding |
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Definition
| one hand is typically grasping the gait belt and the other hand hovers at the contralateral shoulder |
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Term
| what side should the therapist stand on while guarding gait |
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Definition
| stand to the vulnerable side and somewhat behind the patent or "in the diagonal" |
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Term
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Definition
move closer and lift slightly on gait belt to help the patient regain support
ex: knees have buckled, drop in orthostatic BP, drop in blood sugar |
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Term
| if a patient beings to fall and regaining the position and a chair is not available |
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Definition
| deepen your stride and rest the patient on your forward thing |
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Term
| if resting on therapist thigh is not an option |
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Definition
| carefully lower the patient to the floor |
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Term
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Definition
AD and contralateral LE advance together and contact the floor simultaneously
used with 1 or 2 cans, 1 or 2 crutches or hemi-walker |
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Term
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Definition
AD and 1 weight bearing extremity remain in contact with the floor
2 Ads are advanced followed by one LE
often used when 1 LE has restricted WB precaution
the device and involved extremity (PWB or NWB) are advanced together, then stabilized, followed by advancement of the uninvolved extremity |
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Term
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Definition
| the device and involved extremity (PWB or NWB) are advanced together, then stabilized, followed by advancement of the uninvolved extremity |
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Term
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Definition
| device initiating movement, (left cane) followed by right LE, then right cane and finally left LE |
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Term
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Definition
"deliberate 2 point"
slower than a 2 point gait but provides more stability |
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Term
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Definition
| patients ambulating with loftstrand or forearms crutches would used this pattern |
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Term
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Definition
| both crutches are simultaneously advanced, followed by simulaneanous advancement of bilateral LE up to the line of the AD |
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Term
| swing-to-gait nonreciprocal pattern |
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Definition
simultaneous bilateral advancement of LEs up to the line of the AD
may rely on momentum generated by trunk to advance LEs |
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Term
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Definition
| both crutches are simultaneously advanced, followed by simultaneous advancement of bilateral LE advance anterior to the placement of the ADs |
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Term
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Definition
| simultaneous bilateral advancement of LEs beyond the line of the AD, often relies on momentum generated by trunk to advance the LEs |
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Term
| sit to stand foot placement |
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Definition
no WB precautions
the patients feet are placed as far under the body as possible while remaining in full contact with the floor |
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Term
| in no case should the patient |
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Definition
| pull up on the AD to come in to a standing position |
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Term
| exceptions for pulling up on AD to stand up |
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Definition
1. morbidly obese
2. amputees pre-prostetic |
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Term
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Definition
feel chair at back of the legs prior to sitting down
reach back for chair, one hand at a time |
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Term
| once standing- patient's gaze should be |
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Definition
| encourage the patient to look ahead rather than down at their feet |
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Term
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Definition
| encourage relaxed, upright posture and forward gaze |
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Term
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Definition
going up, guard from behind
going down, guard in front
going down, guard from behind (progress to this) |
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Term
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Definition
| the stronger or more stage leg is placed on the next step while the AD remains on the side of the weaker leg |
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Term
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Definition
| from behind and slightly to the side with his hands in position to assist with stabilizing trunk and thus the body |
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Term
| when descending the stairs |
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Definition
| the Ad & weaker LE lead followed by the stronger LE |
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Term
| ascending steps with bilateral AD |
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Definition
1. move close to edge of 1st step while keeping both Ads positioned securely on ground
2. lift one foot & the contralateral AD to the next step and raise the body up
3. as the body raises, advance the other foot and contralateral device to the step beyond the one the pt is currently standing on
4. repeat until the next floor level is reached ad proceed with gait on level surface |
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Term
| descending steps with bilateral Ad |
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Definition
1. move close to edge of 1st step while keeping both Ads positioned securely on ground
2. lift one fort and the contralateral AD and lower them to the next step
3. advance the other foot and contralateral device to the step beyond the one the patient is currently standing on
4. repeat until next floor level is reached and proceed gait on level surface |
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Term
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Definition
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Term
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Definition
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Term
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Definition
DF: 11-14 degrees
PF: 20-31 degrees |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| walking on inclines with AD |
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Definition
take slightly longer steps when ascending
take slightly shorter steps when descending
zigzag path if necessary to reduce steepness of path |
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Term
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Definition
| provide stability and unloading of LE |
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Term
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Definition
| require more energy to use than rolling walkers |
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Term
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Definition
| are less stable but allow more normal gait speed and rhythm |
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Term
| up and down curbs with walker |
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Definition
when ascending, walker must be advanced first followed by stronger LE
patient must lean forward for effective push through UEs prior to lifting weaker LE |
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Term
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Definition
allow greater mobility
provide less stability
allow unloading of 1 LE |
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Term
| sit-to-stand with axillary crutches |
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Definition
have both crutches to one side (holding on inside)
push down on armrest and crutch grips
stand and balance
transfer a crutch under each arm |
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Term
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Definition
| provide less stability and more mobility than axillary crutches |
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Term
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Definition
| can be used singly (typically opposite the involved LE) or bilaterally |
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Term
| up and down steps with a cane |
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Definition
may move dance to other hand in order to use handrail
may need to turn quad cane sideways for secure placement |
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Term
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Definition
| cane will typically be placed on involved side as it does not provide optimal force distribution and typically prevents the person from using a reciprocal gait |
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