Gait Flashcards
what do you need to have in order to have capacity for mobility
rom, muscles innervated
how can you determine a patient’s stability/static control?
can pt. sit on edge of bed?
controlled mobility using crutches
can you go crutches, right, left, crutches, right, left
choose the
least restrictive device
pre-gait activities
sitting balance; just start walking
what is functional walking?
smooth progression of CoG over BoS; adaptable to be funtional
Rancho Phases of Stance
initial contact loading response mid-stance terminal stance pre-swing
Traditional Phases of Stance
heel strike foot flat mid-stance heel off toe-off
Rancho Phases of Swing
initial swing
mid-swing
terminal swing
Traditional Phases of Swing
acceleration
mid-swing
deceleration
parameters of gait
step/stride length stride width (base of support) walking velocity step/stride time single limb support single/double limb support time cadence line of progression coordination
step length
one foot to other foot
stride length
same foot to same foot
non-weight bearing
no weight on that limb; that foot should not touch the floor
toe-touch or touch-down WB
touching with toes for balance
5% BW
hop with walker
why would you instruct someone to hop with the walker when practicing/performing toe-touch or touch-down WB?
old motor learning pattern; do not have toe touch pattern
partial weight bearing
provide external target
percentage is a generalization
check with physician
weight bearing as tolerated is limited by
pain
what mobility devise requires the most energy consumption?
standard walker
what should you consider when choosing the least restrictive mobility device?
- be safe
2. least restrictive vs. stability
stability vs mobility trade offs
reduced LE weight bearing
LE weakness
impaired balance
parallel bars are the _____ ________ and used in _____ ____
most restrictive; early gait
what is a negative factor of using a rollater?
creates an abnormal gait pattern; used by those with poor balance
sit to stand transfer
patient slides to edge of chair
stronger foot posterior to weaker foot
keep affected leg extended
push down on armrests
sit-to-stand after THA
cannot do traditional
involved foot out front
give a visual–>pregnant lady; lead with your hips
parallel bars
most stable; lest mobile
great for training
how high should parallel bars be?
handle of device to wrist/greater trochanter
hands in functional position with slight flexion
where should you guard during gait?
guard on the side the patient is most likely to fall (weaker side)
how do you quickly move a wheelchair?
pick it up and wheel it on the casters
what is the least mobile type of walker?
standard walker
requirements for a rollater
manage breaks
ability to stand/turn
when might you use a platform walker?
help with posture
cannot put weight through hand or loss of function
can’t grip walker
advantages and disadvantages of a hemi walker
used with strength only on one side
promote increased lateral sway and more weight bearing on strong side
used with hemiparesis
better ideas => platform walker
how high should a cane be?
come to ular styloid process
fitting walker, crutch, cane
elbow with 15-20˚ flexion
elbow position determines forearm positition
forearm position determines line of force
guarding techniques
requires a gait belt unless nearing independence–not patient’s pants
gait belt should be snug and held with a supinated grip
guard behind and slightly to the side to which the patient is most likely to fall (weak side)
wide BoS–lateral and A-P
tips for axillary crutches
stand upright
look straight ahead
do not hang on the axillary pads
what side should a singular cane/crutch go on?
the contralateral side to off-load
a 2-point gait pattern is
reciprocal gait, simultaneous
3-point gait pattern
crutches, R, L
crutches w/ NWB
4-point gait pattern
2 crutches, 2 legs, opposite leg, opposite crutch
also known as a deliberate 2-point gait
cannot do with one extremity
step-to gait
step to crutches
more stable–>more time in double stance phase
step-through gait
step through crutches
uninvolved goes past
during swing phase of gait
swing-to/swing-through gait pattern
both legs move together cannot step tri-pod power of advancing legs comes from momentum of hips and trunk typically land on both feel =>foot-flat
cutches and injured leg always go
together
when using a walker to go up or down stairs, which leg goes first?
the walker always goes first
to safely fall forward when using crutches
push crutches away to the side (ER)
flex elbows slightly
turn head
falling backward with crutches
push crutches to the side
tuck chin toward chest
reach forward with both upper extremities (slow fall and move center of gravity forward)
progressive gait training
ambulate on uneven surfaces ambulate on unsteady surfaces directional changes vary gait speed and incline increase environmental obstacles and distractions walk backwards side-stepping braiding (grapevine) tandem walk on toes/heels have patient practice opening and closing doors and ambulating over the threshold
