Gait Flashcards
What is the best predictor for future risk of falling?
History of previous falls
What can be used to prevent falls?
- Balance, Strength, Appropriate Device
- Gait Training and Fall Training
- Good lighting, removing obstacles, etc.
Collapsing Fall, what to do?
Sit back onto you
PT:
* Move closer and lift slightly on the gait belt to help the patient regain support.
* After the fall take vitals, make sure they are okay, make them comfortable why they are there, why they think they fell.
Angular Fall, what to do?
Pt. tips straight back or to the side
PT
* Move in close and attempt to bring Center of Mass (CoM) back over Base of Support (BoS)
If a patient begins to fall, what to do?
If regaining position is not possible and a chair is not immediately available, deepen your stride and rest the patient on your forward thigh.
If resting on your thigh is not an option, carefully lower the patient to the floor.
Falling with Crutches
Decrease risk of injury in a fall by:
* Dropping crutches behind and out to the side
* Slightly flexing elbows of extended arms
* Turning head to the side (High risk of injury of spinal cord if falling down)
Getting Up After a Fall: If Unable to Crawl to a Nearby Chair
Without KAFOs
- Gather crutches.
- Move into kneeling with both crutches on one side.
- Move into half-kneeling (foot of stronger LE forward).
- Move into full standing and place a crutch on each side.
Getting Up After a Fall: If Unable to Crawl to a Nearby Chair
With KAFOs
- Stand one crutch up and use it to push up from the floor, with balls of feet in contact with the floor.
- Quickly pick up the other crutch and stand it erect.
- Reposition crutches for ambulation.
Patients with Spina Bifida or SCI
What to consider with patient fatigue
- W/c follow
- Pre-plan for rest breaks
- Consider using 4ww with seat
Patients who are impulse, what to consider:
- Guard appropriately
- Provide calm verbal and tactile cues
- Cease unsafe activity / assist to seated position
– Spend time on education about weight bearing status and proper gait
– Consider demonstration - May place foot ahead of walker to slow velocity
Patients with a TBI or younger population
What to do when patients no longer maintain WB restrictions
- Take a rest break
- Re-educate
- Use Limb-Load Monitor
What to do with patients develop nausea or increased pain
- Continue guarding
- Sit down and grab emesis bag / basin OR try to continue to bathroom
- Pre-plan (emesis bag in pocket)
- Inform nurse after session
Have a baseline of pain before a session and assess throughout activity. Are you okay with continuing with activity?
What to do when pt’s incorrectly use the gait device
- Stop and re-educate
- Try another device
- Elicit feedback
- Demonstrate
Form first before preceding