Ambulatory Aids

Question 1

Cane Measurements

Answer 1

20-30 deg elbow flexion

Measure: Greater trochanter to point 6 in lat. to toes

Question 2

Standing Crutch Measurements

Answer 2

20-30 deg elbow flexion

Ms: subtract 16 inches from pt height OR

from a point 2 in below axilla, to a point 6 in in front and 2 in lateral to foot

Question 3

Supine Crutch Measurements

Answer 3

20-30 deg elbow flexion

Ms: From axilla to a point 6-8 in lateral to heel

Question 4

Forarm Crutch Measurements

Answer 4

Cuff should cover the proximal 1/3rd of FA

1-1.5 inches below the elbow

Question 5

Body Weight Support and Motorized Treadmill

Answer 5

Initially: 40% BW progress down by 10%

BWS > 55% is contraindicated as it interferes with gait

Progress from .6-.8 mph to 2.6-2.8 mph

Question 6

Muscle required for AD

Answer 6

lower traps

pec major

lattisimus dorsi

Question 7

Guarding:

1. level surface
2. stairs
3. sit to stand
4. bariatric patient

Answer 7

Level: slightly behind, toward involved side

Stairs: below pt, toward involved side

STS: to one side and slightly behind (in front inc. assist

Bariatric: 400-700 lbs, mechanical lift, stand pole, mechanized stretcher for sitting position

Question 8

6 Key Measurements of Wheel Chairs

Answer 8

Seat Width

Seat Depth

Leg Length/Seat to Footplate Length

Seat Height

Arm Rest Height

Back Height

Question 9

WC: Seat Width

Answer 9

• Measure width of widest part of hips on pt
• Chair: add 2 inches to patient’s measurement
• Potential problems
  
  • excessive: added difficulties reaching drive wheels and propelling chair
  • too narrow: pressure/discomfort on the lateral pelvis and thighs; lateral space should allows for changes in thickness of clothing

Question 10

WC: Seat Depth

Answer 10

• Measure post buttock to popliteal fossa
• Chair: subtract 2-3 inches from patient measure
• Problems
  
  • too short: fails to support thigh adequately
  • too long: compromise post knee circulation or result in kyphotic posture, post pelvic tilt and sacral sitting

Question 11

WC: Leg Length/Seat to footplate length

Answer 11

• Measure bottom of shoe to popliteal fossa (subtract height of seat cushion if needed)
• Problems
  
  • excessive: encourage sacral sitting and sliding forward in chair
  • too short: uneven weight distribution on thigh and **excessive weight on ischial seat **

Question 12

WC Seat Height

Answer 12

• no pt measurement
• chair: min clearance b/t floor & footplate is 2 in
• add 2 inches to patient’s leg length measurement

Question 13

WC: Arm Rest Height

Answer 13

• measure from seat platform to just below elbow at 90 deg w/ shoulder in neutral
• Chair: at 1 in to patient hanging elbow measurement
• Problems
  
  • too high: shoulder elevation
  • too low: encourage leaning forward

Question 14

WC: Back Height

Answer 14

• Measure seat platform to lower angle of scapula, mid-scapula to top of shoulder depend pt needs
• height of seat cushion must be added to measure
• Problems:
  
  • too high: increase difficulty in getting chair into car/van
  • may prevent pt from hooking onto push handle for stabilization and weight relief

Question 15

WC Training: Ascending Ramps

Answer 15

forward lean of head and trunk, use shorter strokes; move hands quickly for propulsion

Question 16

WC Training: Descending Ramps

Answer 16

grip hand rims loosely, control descnet; or descend in wheelie position (steep ramp)

Question 17

WC Training: Wheelie

Answer 17

patient places hands well back on hand rims; then pulls them forward abruptly and forcefully.

Head and trunk are moved forward to keep from going over backward

*While balancing in wheelie*- chair tips toward upright when wheels are pulled back