AD Flashcards
What does full weight bearing (FWB) mean?
All weight put on limb
What does weight bearing as tolerated (WBAT) mean?
“allowed” to put full weight, but person may not be able to due to pain or weakness
What does partial weight bearing (PWB) mean?
Some of your weight is put on limb
May be in form of a percentage (ex: 50%)
What does touch down or tow touch weight bearing (TDWB/TTWB) mean?
- Little to no weight is put through leg
- Foot or toes are on ground more for balance than to bear weight
What does non weight bearing (NWB) mean?
- No weight is put through limb
- Limb is not touching the ground
What does therapist keep in mind when guarding during gait training?
- Determine if one or two to guard
- Stand behind and slightly to one side of patient (Position opposite to assistive device if unilateral)
- Note assist level
- Keep your base of support wide yet keep your feet out of the way
- Move in step with the patient
What precautions does therapist take when working on gait with patient?
- Appropriate footwear, safe walking surface, clear pathway, place to sit if necessary
- Response to activity (vitals, S&S, fatigue, SOB)
- Do NOT use clothing to guard or support (could rip)
What should therapist do if patient experiences loss of balance during gait training?
- Stop fall early
- React quickly and determinedly
- If cannot recover balance, slowly lower patient to floor
What is an independent level of assistance?
completes task without assistance or device
What is modified independence level of assistance?
Completes task without assistance but uses some sort of assistive device
What is supervision level of assistance?
No physical assistance is needed, but requires cueing (due to safety, cognition, etc.)
What is contact guard (CTG or CG) level of assistance?
No physical assist is needed, but hands are on the individual “just in case” or for manual cues
What is minimal assist (min A)?
Individual performs more than 75% effort
What is moderate assist (mod A)?
Individual performs 25%-74% effort
What is maximal assist (max A)?
Individual performs <25% effort
What is total assist or dependent?
Individual performs 0% (unconscious, spinal cord injury, etc.)
What are indications for using ADs?
Correct gait deviation Pain Limited weight bearing Balance issues Promote or assist with healing Sensory or coordination impairment Structural deformity Muscle weakness or paralysis Fear?
ADs provide what changes?
1) a larger “cone of stability” where the CoG can shift without loss of balance
2) a redistribution of support within that wider BoS
If NWB, TTWB or PWB, what type of device is required?
2 handed device
WBAT or FWB, what types of devices are possible?
All, including 1 or 2 handed devices
Selection of AD is dependent on what 8 things?
- Weight bearing status
- Strength (upper and lower)
- ROM (both U/L)
- Medical status (endurance, IV, O2)
- Balance
- Cognitive Status
- Overall mobility
- Home environment
When preparing for gait training, what should you do first?
- Review patient’s medical record to determine safety of ambulation and weight bearing status
- Evaluate patient’s strength, ROM, sensation/proprioception, balance, transfers, etc.
- Determine appropriate equipment, level of assistance & gait pattern based on your assessment
- Prepare the environment
- Use gait belt when necessary
- Guard or assist patient using appropriate points of control
- Maintain proper body mechanics for yourself & patient
- Adjust ambulation aid to ensure proper fit
What are two pre-ambulation devices?
- Parallel Bars
2. Tilt table
What are the pros of parallel bars? Cons? Indications?
pros: most supportive and easiest to learn, excellent for training
cons: can’t take it with you; limit mobility
indications: training, pre-gait activities