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PT102 > Ambulation Aids, Patterns, Activities > Flashcards

Ambulation Aids, Patterns, Activities Flashcards

1
Q

Why are the selection of proper ambulation devices and gait patterns important?

A

Provides:
Optimal Security
Safety
Function with least expenditure of energy

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2
Q

How would you prepare for ambulation?

A

review med info, determine limitations, determine equipment, obtain consent, explain pattern, clear the area, check safety & fit of equipment, gait belt, check mental/ physical capability of patient, explain/ demonstrate pattern, check points of control and body mechanics

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3
Q

how would you choose best assistive device

A

based on goals, assessment, medical record

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4
Q

what are the points of control on the patient when ambulating?

A

the gait belt and patients shoulder (book)

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5
Q

what are the precautions for ambulation activities

A

footwear, monitor physiological appearance, avoid guarding or grasping clothing/ UE, expect unexpected, guard patient, do not leave patient unattended, practice protect appliances, make sure environment is clear

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6
Q

how should you guard patient

A

standing behind, slightly to one side and maintain grip on safety belt until patient can ambulate independently and safely

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7
Q

how do ambulation aids improve a person’s stability?

A

expand base of support, reduce WB on one or both LE, permit mobility OOORRRR
compensate for decreased balance, strength, coordination, decreased ability to bear weight, and relieve pain

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8
Q

list the order of ambulation aids from greatest to least amount of stability

A

parallel bars, walkers, bilateral crutches(axillary –> forearm), single crutches, bilateral canes, crab canes, and single canes

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9
Q

criteria to consider before changing the ambulation aid

A

info on refererral, mental/physical capabilities, environment which they will ambulate, expected ambulation activities, prognosis

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10
Q

when would you use a tilt table?

A

person who needs to physiologically accommodate to an upright position.

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11
Q

what are indicators of intolerance of position on tilt table

A

increase/ decrease of bp, pulse rate, sweating, edema in LE, decrease in pedal pulse, nausea, numbness, pale face, tingling in LE, dizziness

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12
Q

what degree of tilt table is usually sufficient?

A

70- 80 degrees, 15-20 minutes– past 80, COG shifts forward, anteroposterior curve negated by table

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13
Q

when would you use parallel bars? for what

A

requires max support, stability, safety— for balance training and gait pattern initiation, and fit of ambulation aid

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14
Q

how should you adjust parallel bar?

A

patients hips and trunk pass thru on each side and height is at greater trochanter

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15
Q

when are walkers used?

A

used for max stability, support, and mobility required

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16
Q

what are disadvantages of the walker?

A

difficult to store/transport, difficult for stairs, reduce speed of ambulation, difficult to perform normal gait pattern, difficult in crowded areas

17
Q

what are the types of walkers?

A

standard: adjustable, nonadjustable
reciprocal, stair climbing, wheeled, folding
and hemiplegic (one handed)

18
Q

when would you use axillary crutches

A

need less stability/ support than what is provided by bars/ walker

19
Q

benefits of axillary crutches?

A

allow greater gait patterns, increase speed, provide stability and support, easily adjusted, used in narrow environment/ stairs

20
Q

disadvantages of axillary crutches?

A

less stable than walked, injure axillary vessels/ nerves, require good balance, elderly may feel insecure, functional strength of trunk/ UE required

21
Q

what are the types of axillary crutches?

A

standard (adjustable, nonadjustable), offset, and triceps (elbow extension)

22
Q

when are forearm crutches used?

A

“lofstrand/Canadian” when stability and support of axillary crutch is not required, but more stability and support than can is needed

23
Q

benefits of lofstrand crutches?

A

eliminate danger of axillary nerve/ vessel damage, used in narrow area and stairs, can reach for something while crutch remains attached to forearm

24
Q

disadvantages of forearm crutches?

A

less stability/ support than axillary crutches, walker, parallel bars, require functional balance, upper body, and UE, forearm cuff makes difficult to remove, elderly may feel insecure

25
Q

when would you use a platform attachment?

A

unable to bear weight thru wrists/hands
sever deformities of wrists and fingers
below elbow amputation
unable to extend elbows

26
Q

disadvantages of platform?

A

loses use of triceps to elevate body during swing phase, another person may need to apply them, less effective on stairs

27
Q

what muscle is needed to elevate body during swing phase

A

triceps

28
Q

if platform is attached to crutch or walker what is it called?

A

trough, shelf

29
Q

when is a cane used?

A

impaired balance or to improve stability, more functional on stairs

30
Q

disadvantages of cane?

A

limited support bc small BOS

2 canes do not provide sufficient stability for 3 point

31
Q

fit of parallel bars

A 
20-25 degree elbow flexion
grasp 6 in anterior to hip
bar 2 in wider than hip
greater trochanters centerd between bars
wrist crease/ ulnar styloid process beside bar
32
Q

fit of cane

A

handgrip at level of GT or wrist crease/ ulnar styloid

cane parallel to femur, foot of cane on floor or at heel

33
Q

fit of forearm crutch

A

hand piece at GT, ulnar styloid/ wrist crease
arm cuff 1-1.5 distal to olecranon process
grasp cuff with wrist in neutral flex/extension

34
Q

3 ways to fit of axillary crutch

A
  1. subtract 16 in from height
  2. pt supine axillary fold to 6-8 in lateral to heel
  3. sit, arms abducted, elbow extended and bent, measure from OP of flexed to long finger of hand opposite side
35
Q

how should axillary crutch fit?

A

20-25 degrees elbow flexion
hand piece at GT/ wrist crease/ styloid process
2 fingers between axilla rest/ axilla
2-4 in lateral, 4 to 6 in anterior

36
Q

errors in fitting axillary crutches

A

pt hunches shoulders, flex trunk, flex/extend wrist, no shoes, no axillary pads, patient is measured not in tripod position

37
Q

fit of walker

A

handgrip at wrist/ styloid process, GT

38
Q

what does improper fit cause

A

increase energy expenditure
decreased stability
decreased function
decreased safety

PT102 (3 decks)

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