EEI 10/11a Supportive Devices/Gait Training Lab

Question 1

Two-point gait pattern

Answer 1

• Bilateral assistive devices: canes, crutches
• WBAT
• One ambulatory device and the opposite LE move forward simultaneously. Each step is one point and a complete cycle is two points.

Question 2

four point gait pattern

Answer 2

-Bilateral assistive devices: canes, crutches
-WBAT
-One ambulatory device is moved forward and placed on the floor, followed by the opposite LE. The other ambulatory device is moved forward and placed on the floor, followed by the opposite LE.
Left cane, right foot, right cane, left foot left cane…

Question 3

modified 4-point gait pattern

Answer 3

• Unilateral assistive devices: cane, crutches
• WBAT
• Cane (or crutch) in one hand advances, contralateral LE advances, ipsilateral extremity advances, cane advances, contralateral LE advances…

Question 4

3 point gait pattern

Answer 4

• Bilateral crutches or a walker
• NWB
• Crutches or walker advances, patient hops forward on uninvolved LE keeping involved LE non-weight bearing

Question 5

modified 3-point gait pattern

Answer 5

• Bilateral crutches or a walker
• TTWB, PWB, WBAT
• Crutches or walker advances, patient steps forward with involved LE placing it down with as much weight as allowed, then steps with uninvolved LE

Question 6

step to gait pattern

Answer 6

• Bilateral crutches or walker
• NWB
• Crutches or walker advances, LEs advance only to the point of the assistive device

Question 7

step through gait pattern

Answer 7

• bilateral crutches
• NWB
• Crutches advance, both LE simultaneously swing beyond the point of the assistive device

Question 8

basic guarding

Answer 8

• establish a wide stance
• stand to the side of the patient and a bit behind them
  1. Place or ready one hand at the patient’s low back
  2. Place or ready your other hand on the anterior aspect of the patient’s shoulder closest to you

Question 9

levels of weight bearing

Answer 9

Full Weight Bearing (FWB)  no restrictions

Weight Bearing as Tolerated (WBAT)  allowed to put as much weight on extremity as patient can tolerate; usually needs an AD due to pain and/or weakness

Partial Weight Bearing (PWB)  allowed to but some but not all weight on an extremity; defined by a percentage (i.e. 25%, 50%)

Toe Touch Weight Bearing (TTWB)  no weight through the limb; big toe on the
ground (helpful input for balance)

Non-Weight Bearing (NWB)  limb does not touch the ground or weight bearing
surface

Question 10

levels of assistance

Answer 10

Independent (I)  No assistance or cuing required. Performs safely without assistive device, modification or aides, within a reasonable time.

Modified Independent (mod I)  The presence of another is not required.
One or more of the following may be true:
Patient requires an assistive device/aide
Requires an increased amount of time to complete
There are safety / risk considerations

Supervision (S): (set-up, or stand-by assist)  Patient requires cuing, coaxing, and/or set-up for successful/safe performance. No manual/physical touch or contact of another required.

Contact Guard (CG)  Patient requires occasional or constant manual contact as a protective safeguard for balance / stability.

Minimal Assist (minA) Hands on assist where patient is able to perform 75% -99% of the work. Therapist provides no more than 25%.

Moderate Assist (modA) Patient requires more physical assist. Patient able to perform 50-75% of the work. Therapist provides no more than 50%.

Maximal Assist (maxA)  Therapist provides > 50% of the work load

Question 11

benefits of axillary crutches

Answer 11

Can be used for all levels of unilateral LE WBing
Easier to negotiate in crowded or narrow areas.
Easier to use on uneven terrain than walker.
Able to be used on stairs.
Wider variety of gait patterns, including 2 that incorporate modified UE swing.

Question 12

limitations of axillary crutches

Answer 12

Require a much higher level of balance and coordination than walkers.
Requires good UE and trunk strength and control.
More difficult to for patients to free their hands for carrying objects.

Question 13

fitting axillary crutches

Answer 13

Height: 3 finger width space between the top of the axillary pad and the patient’s armpit

• hand grips 15-30 degree bend at elbows
• Ideal positioning: The patient stands upright, shoulder relaxed with hands on hand grips with the tips of the crutches placed approx. 2 inches in front of and 6 inches to the side of the patient’s feet