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Basic Eval II > Assistive Devices > Flashcards

Assistive Devices Flashcards

1
Q

What is a FWB device?

A
  • Full Weight Bearing

- Used only for balance

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2
Q

What is a WBAT device?

A
  • Weight Bearing as Tolerated

- Determined by the patient-ranging from full to minimal WB

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3
Q

What is a PWB device?

A
  • Partial Weight Bearing

- Minimal WB permitted if specific amount not indicated (5 lbs)

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4
Q

What is a TTWB device?

A
  • Toe Touch Weight Bearing

- Toe rested on ground for BALANCE ONLY

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5
Q

What is a NWB device?

A
  • Non Weight Bearing

- Not Touching Ground at all

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6
Q

What can help determine the amount of weight being borne through an extremity?

A

Bathroom scales.

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7
Q

What is a dependent level of assistance?

A

100 % of work done by someone or something else. No patient work done.

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8
Q

What is a maximal assist assistance level?

A

More than 60 % of work done by something or something else.

Patient does less than 1/2 of work

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9
Q

.What is a moderate asst level of assistance?

A
  • 25 - 50 % of work done by something or someone else.
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10
Q

What is a minimal assist level of assistance?

A
  • 25 % of work done by someone or something else.
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11
Q

What is contact guard level of assistance?

A
  • Hands on assist by someone for balance and/or safety.

- Pt. does 100 % of work

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12
Q

What is a supervision/ stand-by guard level of assistance?

A
  • Close or distant supervision

Close: close enough for verbal cues or visual assist.

Distant: Within visual range

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13
Q

What is independent level of assistance?

A

Pt 100 % independent.

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14
Q

What needs to be considered at all levels of assistance?

A
  • Assistive device and amount of verbal and tactile cues.
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15
Q

How is the gait belt positioned and gripped during ambulation of a patient?

A
  • Supinated grip at forearm level with grip at level of pelvis near Pt.’s COM
  • Other arm near shoulder to control movement and direction of patient’s trunk..
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16
Q

How is the therapist directed during ambulation when guarding with gait belt?

A
  • Close to patient
  • Generally on affected side; may change depending on which way patient may fall.
  • Wide base of support
  • Posteriorly and to side of Pt.
  • CoM in line with patient’s CoM
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17
Q

What are 5 indications for use of an assistive device?

A
  • Decreased ability WB on LE
  • Muscular weakness/ trunk paralysis
  • Poor balance in upright posture
  • Pain/ antalgic gait
  • Safety
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18
Q

What environmental factors must be considered when using assistive devices?

A
  • Avoiding wet or slippery floors/ sidewalks
  • Be aware of walking from one surface type to another
  • Remove throw rugs and other obstacles
  • Avoid revolving doors and escalators
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19
Q

How can the Pt. take precautions for interaction with their environment?

A
  • Be slow, and take time to survey
  • Look straight ahead, not at feet
  • Wear proper footwear (non-skid soles)
  • Monitor AD for signs of wear
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20
Q

Where does gait training always first begin?

A

At parallel bars

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21
Q

How soon should the patient progress to ambulation outside of parallel bars?

A

As soon as safely possible.

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22
Q

What are 3 indications for use of a walker?

A
  • Need for increased lateral and anterior stability
  • Need to reduce WB through one or both LEs
  • Patients with debilitating conditions or poor balance with LE injury that cannot use crutches
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23
Q

What are 2 negative features of the use of walkers?

A
  • No reciprocal arm swing

- Increased kyphosis/ trunk flexion

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24
Q

How are walkers fitted to the patient?

A
  • 20 - 30 degrees of elbow flexion

- Measure from greater trochanter to point 6 inches lateral to toes (height)

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25
Q

What features distinguish a rolling walker?

A
  • 2 to 4 wheels
  • Often have auto-braking features
  • May have seat
  • May have hand brakes
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26
Q

What are 2 benefits of rolling walkers?

A
  • Encourages continuous gait movement

- Increased speed

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27
Q

What posture does a posterior walker promote?

A
  • Upright posture
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28
Q

What patients are typically prescribed posterior walkers?

A
  • Pediatric patients

- Patients with CP

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29
Q

What patients are typically prescribed hemi walkers?

A
  • Pt’s post CVA
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30
Q

What features distinguish a stair climber walker?

A
  • 2 posterior extensions

- Additional hand grips off rear legs for use on stairs

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31
Q

What movement does a hinged reciprocal walker facilitate?

A
  • Advancement of one side of walker at a time

- Reciprocal gait patterns/ orthroses

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32
Q

What are 3 indications for the use of crutches?

A
  • Decrease WB on LEs
  • Need for moderate stability
  • Need for increased BOS
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33
Q

What are benefits of axillary crutches?

A
  • Increased UE WB in comparison to forearm crutches
34
Q

What are negative aspects of the use of axillary crutches?

A
  • Difficult to use in small areas

- Prolonged use can result in axillary artery/ brachial plexus (radial nerve) damage.

35
Q

What diameter are rubber crutch tips, and how do they minimize slippage?

A
  • 1.5” in diameter
  • Provide suction
  • Rubber –> increased grip
36
Q

What are advantages of the use of forearm crutches?

A
  • Frees hands for use while still having access to crutch

- Light and easy to maneuver

37
Q

What is a disadvantage of forearm crutches?

A
  • Slightly less stable than axillary crutches
38
Q

To what type of patients are forearm crutches typically prescribed?

A
  • Long term use patients
39
Q

What re 2 other names for forearm crutches?

A
  • Loftstrand

- Canadian

40
Q

What is the advantage of forearm platform crutches, and to whom are they typically prescribed?

A
  • Allow WB through forearms

- Prescribed for pt’s who cannot WB through hands.

41
Q

What are 3 methods of crutch measurement?

A
  • 20 - 30 degrees elbow flexion; wrist neutral
  • Subtract 16” from Pt.’s height
  • Measure from a point 6” anterior and 2” lateral to the foot
42
Q

How can a Pt’s crutch measurements be estimated from supine?

A
  • Axilla to a point 6 - 8” lateral to heel
43
Q

How much of the forearm should a loftstrand crutch cuff cover?

A

Proximal 1/3rd of forearm. 1 - 1.5 “ below elbow.

44
Q

What are 3 indications for the use of a cane?

A
  • Widened BOS to improve balance
  • Limited stability and unweighting (unloads involved extremity 30%)
  • Relief of pain; antalgic gait
45
Q

What cane approximate normal gait the closest?

A

Standard cane.

46
Q

How many points of support are provided by a standard cane?

A

One.

47
Q

What advantage and disadvantage are their when using a quad cane in comparison to a standard cane?

A
  • Increased stability

- Slows gait

48
Q

What type of quad canes are useful for stairs?

A

Small based quad-canes.

49
Q

What type of canes do not fit on stairs?

A

Large based quad-canes.

50
Q

In what hand is the Cane held?

A

Contralateral to involved LE.

51
Q

What LE advances with the cane?

A

The involved LE.

52
Q

What 2 measurements fit a cane to a Pt.?

A
  • 20 - 30 degrees elbow flexion

- Great trochanter to point 6 inches to side of toes.

53
Q

What 6 non-biomechanical factors must be considered when choosing ADs?

A
  • Device with least amount of assistance
  • Lowest cost
  • Determine if extra energy expenditure to device is worth WB relief
  • Determine if patient will be distracted by device
  • Determine if patient’s self-esteem will be affected
  • Determine if device is practical in a public setting
54
Q

What are general hand grip principles for all ADs?

A
  • Stand upright; shoulders relaxed
  • Grip height at level of ulnar styloid/ wrist
  • Grip at level of greater trochanter
  • 20 - 30 degrees elbow flexion
55
Q

How are the fit of axillary crutches determined?

A
  • 6”/ 2-3 finger breadths below axilla

- 45 degree angle from 5th metatarsal

56
Q

How are platform crutches fitted?

A
  • Directly in line with shoulder; 3” from midfoot
  • Shoulder in neutral
  • Elbow flexed 90 degrees
57
Q

Which side of a quad can should face the Pt.?

A
  • The flat side.
58
Q

What are the 5 basic AD gait patterns?

A
  • Swing-to
  • Swing-through
  • Four-point
  • Three-point
  • Two-point
59
Q

What devices may utilize a 4-point gait pattern?

A
  • 2 canes

- 2 crutches

60
Q

What 4 impairments may indicate a 4-point gait pattern?

A
  • Bilateral LE Ms weakness
  • BL LE pain
  • Poor balance
  • BL PWB
61
Q

What is the main use of a 4-point gait pattern?

A

Learning tool towards 2-point gait pattern.

62
Q

What is the slowest AD gait pattern?

A

4-point

63
Q

What ADs may utilize 2-point gait pattern?

A
  • 2 canes

- 2 crutches

64
Q

What 4 patients may utilize 2-point gait pattern?

A
  • Ms weakness
  • Pain
  • Decreased balance
  • BL PWB
65
Q

What is the action of 2-point gait?

A

AD and contralateral LE advance at the same time allowing for natural arm and leg motion.

66
Q

What ADs may utilize 3-point gait?

A
  • 2 crutches
  • 2 canes
  • Walker
67
Q

What impairment indicates 3-point gait pattern?

A
  • Unilateral LE impairment (fx, ms weakness, NWB, etc…)
68
Q

What is the action of 3-point gait?

A
  • Both crutches, or canes moved forward simultaneously.
  • Unaffected leg forward
  • WB onto AD
  • Swing uninvolved leg past (or to) crutches/canes
  • WB onto uninvolved LE
  • Repeat cycle
69
Q

What ADs utilize swing-to gait?

A
  • 2 crutches

- Walker

70
Q

What impairment indicates swing-to gait?

A
  • BL LE impairment
71
Q

What is the action of swing-to gait with crutches?

A
  • Both crutches/ walker advance simultaneously
  • WB onto crutches
  • Swing both LEs foward to crutches.
  • WB onto one or both LEs
  • Repeat
72
Q

What is the action of swing-to gait with walker?

A
  • Walker and affect leg advance
  • WB onto walker
  • Swing uninvolved leg to walker
  • WB on uninvolved
  • Repeat
73
Q

What ADs may utilize swing-through gait?

A
  • 2 crutches
74
Q

What is the action of swing-through gait?

A
  • Crutches advance simultaneously
  • WB onto crutches
  • Swing both LEs beyond crutches to floor
  • Repeat
75
Q

What is an advantage and disadvantage of swing-through gait?

A
  • Faster

- Not as safe

76
Q

What 5 factors should be considered when choosing a gait-pattern?

A
  • WBing status
  • Uni or Bilateral
  • Strength/ ROM
  • Balance impairment
  • Cognition
77
Q

Which LE leads ascending and descending stairs?

A
  • Good leg leads going up

- Bad leads going down

78
Q

Which side is guarded when a patient is ascending or descending stairs?

A

Always the downward facing side.

79
Q

What are 6 steps that should be followed if a patient falls?

A
  • Try to lower the patient slowly to the floor
  • Check for serious injury
  • Move to prone or quadruped
  • Crawl to stable furniture or support
  • Pt. climbs onto surface
  • File accident report
80
Q

** Check AD pdf **

A

** Check AD pdf ***

Basic Eval II (7 decks)

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