Choosing and Fitting Assisted Devices Flashcards
what are assisted devices
mechanical devices that provide external support for musculoskeletal system
used to maintain an upright posture for ambulation
permit safe gait training for pt w/ impairments
indications for AD use
weight-bearing relief for deformity, amputation, injury or disease
support for muscle weakness/paralysis
stability for inadequate balance
AD can provide patients
FUNCTIONAL INDEPENDENCE
safety
reasonable energy expenditure w/ ambulation
appropriate assistance
achieve the greatest level of mobility
decrease fall risk
How does an AD support a patient
enlarging BOS
redistributing weight from LE to UE
encourages normal gait pattern
determining factors of AD
weight-bearing status
strength
ROM
Balance/stability
coordination
general condition
goals
comorbidities
living environment
cosmetics
Common AD (in order from most stable to least stable)
parallel bars
walker
bilateral Ax. crutches
lofstrand crutches
bil. canes
hemiwalker
quad cane
single axis cane
No AD
in order from least to most coordination required
parallel bars
walker
SAC
crutches
measuring an AD consists of
grip level
measure to the height of…
measuring grip level
bilateral supported stance
shoulders relaxed
toes slightly out
hip, knee and ankle in neutral
what do you measure an AD to the height of
greater trochanter
ulnar styloid process
parallel bars pros
can accommodate wheelchair
maximum support
correct LE can be taught
AD can be used inside of P.B.
parallel bar cons
not portable
artificial
types of walkers
standard
rolling
reciprocal
posterior
tripod
rollator
what are walkers used for
impairs balance
generalized weakness
decreased weight bearing
pros to walkers
high stability
large BOS
low coordination needed
cons to walkers
slow ambulation
can’t be used on stairs
unable to perform normal gait
difficult to use in crowded/tight areas
walker attachments
gliders (SKIS)
folding seats
tray tables
wide hand grips
forearm platforms (for UE comorbidity)
storage units
measuring a walkers
same as cane/crutches
assure 4 legs are even
20-30 degrees of elbow flexion
types of crutches
axillary
lofstrand
platform
pros of crutches
greater mobility
lateral stability
able to use with every weight-bearing restriction
maneuverability
variety of gait patterns
cons of crutches
provide less stability than walkers
great energy expenditure
neuro injury possible in axilla if used incorrectly
requires UE strength and trunk control
measuring crutches
place tips forward 4-6 inches at 45 degree angle anterior and lateral to small toe
pt should have 2-3 finger gap b/w top of crutch and axilla
grip same as cane and walker
quick way to measure crutches
ATNR
measure from elbow to tip of finger
pros of a cane
inexpensive
least cumbersome
easy on stairs
cones of a cane
limited stability and weight bearing
used for slight weakness in LE, slight weight reduction d/t pain/ weakness and balance
cannot be used pwb and nwb
types of quad canes
wide base
narrow base
quad cane characteristics
4 pronged
provide wider BOS
wider angle of prongs away from pt
all 4 feet should be on the ground at the same time
may need to turn sideways on stairs
hemiwalker (walkcane)
broad (4 points)
one hand use
CNA or Hemiplegia
unable to use on stairs
reasons for measurement errors
not accounting for footwear
not confirmed in standing
optimal standing position not maintained during the measurement
crutches/cane too far/close to LE
feet are too far ant/post in walker
effects of poor AD fit
decreased stability
increased energy expenditure
decreased functional ability
decreased safety
safety w/ AD
ensure all screws are tightened
replace worn parts
clean dirt and gravel in tracks
sit to stand w/ AD
wheels locked
pt moves to front of seat
both feet flat w/ one knee great than 90 degrees
hands on arm rests
pt leans forward and pushes on armrests
stand to sit w/ AD
pt approaches from edge and turns away
backs up leading w/ uninvolved LE until back of legs touch seat
pt reaches ack for arm rest w/ uninvolved side hand first
