Gait Training Flashcards
How do you determine if a patient is ready to ambulate
WB tolerance
Balance assessment
Orientation
Strength assessment
What activities will you need to make sure the patient can do before ambulation
Bridge and bed mobility Get themself to edge of bed Keep their WB status Pre gait activities Follow directions
Activities
Assess capabilities Assess limitations Obtain consent Explain procedure Remove items in the way Select device and confirm measurement Demonstrate Footwear - SHOES Apply GAIT BELT
Step length
Measure from heel to heel
Stride length
heel to same heel contact
Assistive devices - parallel bars
helping them learn WB status
balance use
gives most support of the assistive devices
Assistive devices - walker and wheeled walker
second mos tlevel of support
Wide BOS
Wheeled walker - better when need to conserve energy
Assistive devices - crutches
axillary
Forearm (more for CP, spinal cord injuries)
Assistive devices - canes
Large base and small base quad canes
Straight cane - just if need a little balance support
Safety
Use of a gait/safety belt Guarding during gait Use of assistive device Community barriers Home barriers
Possible home barriers
Remove rugs, caution waxed floors Check crutch nuts, wings, and tips Rearrange furniture Narrow hallways, doorways, bathroom Grab bars installed
Possible community barriers
Ramps
Crosswalks
Curbs
Two point gait
two points of contact
crutch forward with the opp leg at same time
pt has WBAT or FWB
Three point gait
can step through or step to
two crutches and leg coming fown at same time with a hop
NWB or PWB
Four point gait
If they are in a crowded area will use this or an obstacle in the house
Crutch, leg, crutch, leg…
Everything is separate
WBAT or FWB
Surfaces
Level Curb/Step Stairs Uneven (grass,gravel, etc) Slopes
A
Assistance
amb
ambulation
II
parallel bars
SBA
stand by assist - no point of contact
CGA
contact guard - you are touching
max, mod, min
max = you are providing 75% of the assist mod = 50/50 min = you are providing about 25% of assist for them
LBQC
large based quad cane
SBQC
short basaed quad cane
w/walker
wheeled walker
FWW
front wheeled walker
Independent
patient does not require any physical supervision or assistance from another person to perform activity
Modified Independent Assisted
Patient uses adaptive or assistive equipment
Assisted
Patient requires assistance from another person to perform the activity safely in an acceptable time frame
Minimal Assistance
Patient performs 75% or more of the activity; assistance is required to complete the activity
Moderate Assistance
Patient performs 50-75% of the activity; assistance required to complete activity
Maximal assistance
Patient performs 25% to 50% of the activity; assistance is required to complete the activity
Standby (supervision) assistance
Patient requires verbal or tactile cues, directions, or instructions from another person positioned close to, but not touching, the person to perform the activity safely and in acceptable time frame
Dependent Assistance
Patient requires total physical assistance from one or more persons to accomplish the activity safely; special equipment or devices may be used
Guarding (close, contact)
Patient requires guarding during the performance of the activity for safety
Close guarding
Caregiver is positioned close to, but not touching, the patient; similar to standby assists; likelihood the patient will require protection during the performance is minimal
Contact guarding
caregiver is positioned close to the patient with hands on the patient or safety belt; it is very likely that the patient will require protection during the performance of the activity
