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PCM II > assistive devices - exam 1 > Flashcards

assistive devices - exam 1 Flashcards

1
Q

when are tilt tables used?

A

when patients need to acclimate to upright position
elevated gradually
vital signs measured before, during and after

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2
Q

what are parallel bars used for?

A

balance training
teaching specific gait patterns
support while measuring an AD

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3
Q

what is the proper way to use parallel bars?

A

20-25 deg elbow flexion with 2 inches wider than either greater trochanter
top of bar even w greater trochanter or wrist crease in standing w UE at sides

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4
Q

what are ambulatory ADs?

A

devices that provide external support during gait training in an upright posture

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5
Q

what are major indications for use of an AD?

A

structural deformity, amputation, injury or disease resulting in inability to bear weight through LEs
muscle weakness or paralysis in trunk or LEs
balance deficits

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6
Q

what do ADs do?

A

increase BOS
provide a method for redistributing weight normally borne through LEs to UEs
creates an additional force that keeps the pelvis level in the face of gravity’s tendency to adduct the hip during unilateral stance

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7
Q

what causes trendelenberg gait?

A

large adductor moment due to the natural placement of the COM

Weak abductors

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8
Q

how do pts w trendelenberg gait compensate?

A

lean over the weaker side
decreases the adductor moment

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9
Q

a cane’s force substitutes for _____ ________
how?

A

hip abductors
transmits part of the body weight to the ground –> decreasing the muscular force required for balancing

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10
Q

walkers provide ??

A

large degree of stability

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11
Q

walkers are chose for patients with ?

A

generalized weakness
debilitating conditions
need to reduce WB on one or both LEs
poor balance/coordination
inability to use crutches

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12
Q

what are the 8 types of walkers?

A

standard
wheeled (2 or 4)
stair climbing walkers
ring walkers (peds)
knee walkers
reverse walkers (peds)
hemiwalkers
reciprocal walkers

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13
Q

axillary crutches
provide _____
require ______
takes ______

A

moderate stability
more coordination than walkers
substantial amount of energy

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14
Q

axillary crutches are chosen for patients with ?

A

weakness in one or both LEs
impaired balance
need for trunk support
permits 80-100% WB support

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15
Q

what are forearm crutches good for?

A

providing more ease of movement but less trunk support than axillary crutches
frees hands without having to drop the crutch

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16
Q

who are forearm crutches recommended for?

A

same patients that require axillary crutches but do not require trunk stability

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17
Q

canes chosen for patients with?

A

minimal LE weakness
require slight WB reduction
impaired balance

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18
Q

quad canes are used by patients with?

A

limited or no use of one UE as with hemiparesis
similar impairments as pts who require SPCs but usually greater deficits

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19
Q

what are drawbacks of quad canes?

A

slightly heavier
somewhat awkward with all 4 points on the ground

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20
Q

what is NWB?

A

involved LE not to be WB or touching floor

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21
Q

what is toe touch weight bearing (TTWB)?

A

pt can rest toes on the floor for balance but cannot WB

22
Q

what is PWB?

A

limited about of WB tolerated

23
Q

what is weight bearing as tolerated?

A

pt allowed to place as much or as little weight through the involved LE depending on tolerance

24
Q

what are some ways you can monitor the amount of weight being placed in the LE?

A

scale
weight shifting
put hand on floor and have them step on it (for PWB mostly)

25
Q

how do you choose the proper AD?

A

match the needs and abilities of the pt with the qualities of the device

26
Q

list ADs in order from providing mostly stability to providing mostly mobility

A

parallel bars
walker
bilateral axillary crutches
bilateral canes
hemi walker
quad cane
single point cane
no device

27
Q

what AD are good choices for increasing the BOS?

A

parallel bars
walkers

28
Q

what AD are good choices for PWB?

A

parallel bars
walkers
bilateral crutches

29
Q

what AD are good choices for NWB and TTWB?

A

parallel bars
walkers
bilateral crutches

30
Q

what AD are good choices for WBAT?

A

parallel bars
hemiwalkers
single point cane or crutch

31
Q

improper fit or use of an AD will lead to:

A

decreased stability
decreased function
decreased safety
increased energy expenditure

32
Q

how do you fit someone for a walker?

A

pt in standing or supine
shoes should be worn
hand grip at level of pts:
- wrist
- ulnar styloid process
- greater trochanter

33
Q

how do you fit axillary crutch height if you know the patients height?

A

multiply by 77% or subtract 16 inches from height

34
Q

how do you fit axillary crutch height with patient in supine?

A

use a tape measure to measure the distance from axillary fold to 6-8 inches lateral to heel

35
Q

how do you fit axillary crutch height with patient in seated?

A

UEs abducted at shoulder level
one elbow extended, one flexed to 90 deg
measure distance between middle finger of extended elbow and olecranon process of flexed elbow

36
Q

how can you confirm the axillary crutch height?

A

with patient in standing
tips should be 2 inches laterally and 4-6 inches anterior to toe of shoes

37
Q

how do you fit the hand piece height of axillary crutches with pt in supine?

A

greater trochanter, wrist crease, or ulnar styloid process to heel of shoe
use this number to measure from rubber tip to hand piece

38
Q

what is an alternate method of measuring the hand piece height of axillary crutches

A

from ant axillary fold to greater trochanter or ulnar styloid process
use this to measure from the axillary rest to the hand piece

39
Q

how should the crutches properly fit when in a tripod position?

A

should have approx 20-30 deg elbow flexion w relaxed shoulders
two fingerbreadths should be present between axillary rest and bottom for the axilla

40
Q

how do you fit canes in standing?

A

place cane parallel to femur and tibia with foot of cane on the floor or at the bottom of the heel of shoe
hand piece should reach wrist crease, greater trochanter, or ulnar styloid process

41
Q

how do you fit canes in supine?

A

use a tape measure to measure from greater trochanter to heel w hip and knee straight

42
Q

how do you confirm the fit of a cane?
(same from fitting forearm crutches for height of hand piece)

A

in standing
tips should be positioned 2 inches laterally and 4-6 inches anterior to toe of shoes

43
Q

how do you fit the forearm cuff when fitting forearm crutches?

A

top of the cuff should be 1-1.5 inches distal to olecranon process when the pt grasps the hand piece with wrist in neutral

44
Q

where should you stand when guarding?

A

slightly to one side and behind pt (where pt is most likely to fall)
stand in stride stance - outside foot behind AD & the pt’s foot; other foot trails when you walk
underhand grip w gait belt. other hand on pts shoulder or chest

45
Q

how should you guard a pt on level surfaces?

A

stand behind pt and slightly to the weaker side
one hand on gait belt w supinated grip
other hand lightly resting on pt’s shoulder
staggered stance
advance front foot w AD, trailing foot moves when pt moves

46
Q

true or false. if a pt is falling, stop the fall!

A

false
slow it down to give time for important structures to be protected

47
Q

what do you do when guarding a pt and they lose their balance forward?

A

pull back on gait belt
other hand pulls trunk upward and back
may need to push forward on pelvis as pull back on trunk

48
Q

what do you do when guarding a pt and they lose their balance backward?

A

push forward on pelvis and trunk

49
Q

what do you do when guarding a pt and they lose their balance to one side away from PT?

A

pull gait belt towards you

50
Q

what do you do when guarding a pt and they lose their balance to one side toward PT?

A

turn body so that you face the pt’s side
widen BOS
use body to support pt

51
Q

what do you do when guarding a pt and they lose their balance forward WITH AD?

A

instruct pt to let go of AD and reach for floor
firmly, but slowly pull back on gait belt
step forward w outside foot to help control descent
if possible, instruct pt to cushion fall by bending their elbows and rolling to one side
instruct pt to turn head to one side to avoid injury to face

PCM II (5 decks)

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