Gait Training and Patterns Flashcards
Considerations for safe ambulation
-use gait belt
-WB status
-strength and balance ability
-need assistance
-pt cognition and attentiveness
-alteration in coordinated movements
-lines and equipment
-type of surface ambulating on
Preparation for ambulation
-review medical chart
-assess pt (ROM, muscle performance, sensation screen, balance/coordination, cognition/attentiveness/ability to follow commands)
Pre-ambulation considerations
-assisted device to use
-amount of assistance required (ht/wt of pt)
Position for level-ground ambulation
-stand behind and slightly to one side of pt
-initially stand to the side of pt’s affected/weak side
-hold gait belt w/ forearm supinated
-other hand above or near pt’s shoulder
Dr. Z’s standing position for level-ground ambulation
general weakness - same side
surgical - opposite
What are 4 different ways to report progression of ambulation?
-level of assist decreases
-able to meet modified surface challenges
-improvement in impairments
-increase in safety awareness
3 types of gait patterns
4 point, 2 point and 3 point
Describe four-point pattern (device used, steps of pattern w/ device)
-used w/ 2 canes or 2 crutches
-3 points always on the ground
-crutch pattern: opp ft, crutch, opp ft
What is four-point pattern used for? Not used for?
-pt w/ very poor balance, pt unable to lift more than one point off ground safely
-NOT used for NWB
Describe two-point pattern (device used, steps of pattern w/ device)
-used w/ 2 canes or 2 crutches
-2 points are on the ground at all times
-crutches: R crutch and L leg, L crutch and R leg
What is two-point pattern used for? Not used for?
-approximates normal gait pattern, more stable and faster than 4-point pattern
-NOT used for NWB
Describe three-point pattern (device used, WB restriction uses)
-3 points touch ground, not in sequence
-2 crutches or a walker
-NWB: always 3 point pattern
-PWB and WBAT: use 3 point pattern
What is a pro and con of 3 point pattern?
pro: rapid ambulation
con: high energy expenditure
Describe 3 point NWB pattern
pt moves crutches or walker forward then hops to it
Describe 3 point PWB pattern
pt moves crutches or walker forward, step w/ weak and push down, then step w/ strong
How to guard pt ascending stairs
stay behind and slightly to the side, outside foot on stair where pt is standing and inside foot on step below
Describe how pt ascends stairs w/ walker
-position walker w/ closed side next to body
-front feel of walker placed on step above the step where pt stands
-step up w/ strong LE
How to guard pt descending stairs
stand in front and to the side of pt; outside foot on the step the pt is going to step on and other foot one step below
