ASSISTIVE DEVICES Flashcards
indications for AD
- to compensate for impaired balance, dec strength, alteration in coordinated movements, pain during WB on one or both extremities, absence of an LE, or altered stability
- improve functional mobility
- enhance body functions
- assist c fx healing
ADs can:
- improve an individual’s stability by expanding the BOS
- reduce WB on one or both LE
- permit mobility
Pre-ambulatory ADs include
- tilt tables
- parallel bar
- supported suspension ambulatory aid
AD used to check pt’s standing and ambulation balance and tolerance
parallel bars
AD that provides 100% stability
parallel bars
AD that provides 75% stability
walkers
AD with the least stability
canes (25%)
AD that provides 50% stability
crutches
how to measure parallel bars height?
- bar at the level of the greater trochanters/wrist crease/ulnar styloid process
- each bar should provide 20-30 degrees of elbow flexion
- 2-4 inches of space between the bars and each hip
used when max pt stability and support are required
walkers
types of walkers
- child
- bariatric
- reciprocal
- stairclimbing
- wheeled
- folding
- hemiwalker
give 1 disadvantage of walkers
- difficult to store/transport
- difficult or impossible to use on stairs
- reduces ambulation speed
- may be difficult to perform a normal gait pattern
- can be difficult to maneuver in narrow/crowded spaces
how to measure appropriate walker height in supine
tape measure from pt’s greater trochanter to the heel c shoes on, c knee and hip straight
how to measure appropriate walker height in standing
height of the hand grip is at the level of the greater trochanters/wrist crease/ulnar styloid process
used for pts who need less stability/support than is provided by parallel bars or walkers
axillary crutches
disadvantages of axillary crutches
- less stable than walkers
- can cause injury to axillary vessels & nerves if used or measured improperly
- require good standing balance
- elderly pts may feel insecure c them
- functional strength of the UE and trunk muscles is required
how to measure axillary crutch height
- 77% of pt’s height
- pt’s height minus 16 inches
- in supine: anterior axillary fold to a point ~ 6-8 inches lateral to the heel
- in sitting: (B) UE abducted to 90 degrees, 1 elbow flexed & 1 extended, measure from olecranon of the flexed elbow to tip of middle finger of the opposite extremity
Other names for forearm crutches
lofstrand/canadian crutches
when are forearm crutches. used
when stability and support of an axillary crutch is not required but still needs more stability and support that can be provided by a cane
advantage of forearm crutches vs axillary crutches
- eliminate the danger of injury to axillary vessels
- more functional on stairs and in narrow, confined spaces
nerve that can be injured from axillary crutches
radial nerve
disadvantage of forearm crutches
- provide less stability and support than axillary crutches, walkers, or parallel bars
- require functional standing balance and functional upper body & UE strength for many gait patterns
- forearm cuff can make it difficult to remove the AD
- elderly pts may feel insecure with them
forearm cuff should be located approximately ___ distal to the _____ when the pt grasps the hand piece
1-1.5 inches; olecranon process
indication for crutches c platform attachment
- pts who are unable to bear weight through their wrists and hands
- pts c severe wrist/finger deformities which make grasping the handpiece of a crutch difficult
- elbow amputees
- pts who are unable to extend one or both elbows
disadvantages of platform attachment
- pt loses the use of the triceps to elevate & maintain the body during the swing phase
- another person may need to apply/remove them
- less effective on stairs
each hand piece/platform attachment should be adjusted to provide _____
90 degrees of elbow flexion
these are used to compensate for impaired balance or to improve stability and are more functional on stairs and in narrow, confined spaces; provides the least stability
canes
types of canes
- J
- T
-pistol grip - offset shaft
- thee/four-legged
- walk cane
canes provide limited support because of?
its small base of support compared to other assistive devices
how to measure cane height in supine
tape measure from pt’s greater trochanter to the heel c the hip and knee straight
ambulation patterns for NWB pts
three-point
ambulation pattern wherein AD and opposite foot advance alternately
four-point
pattern wherein AD and opposite foot advance simultaneously
two-point
pattern wherein AD and NWB extremity advance simultaneously, then the FWB extremity steps through/to the level of the AD
three-point
AS and PWB LE advance simultaneously, then the FWB LE steps through the aids
three-one-point
pattern wherein only 1 AD is used: affected LE -> non-affected LE -> singe AD
modified four-point
pattern wherein only 1 AD is used:
unaffected LE -> AD & affected UE
modified two-point
