Gait Training Lecture 2 Flashcards
What is a two point gait pattern?
Assistive device and one LE advance and contact the floor simultaneously, followed by the other LE and device, if used
What is a three point gait pattern?
Bilateral assistive devices advance simultaneously with the WB-restricted LE, followed by the unrestricted LE
What is a four point gait pattern?
Sequential advancement of alternating devices and LEs (ex. Left cane, followed by right LE, then right cane, and finally left LE)
How can the two point gait pattern be used?
With one or two canes, one or two crutches, or a single-arm walker. Can be contralateral, ipsilateral, or bilateral
When are three point gait patterns used?
Often used when one LE has restricted WB. The devices and involved extremity are advanced together, followed by advancement of the uninvolved extremity. Some clinicians may use this descriptor when the involved LE is NWB
T/F: the four point gait pattern is faster than the two point gait pattern and provides more support
False! It is slower but yes it does provide more support
What is a step to Gait pattern?
The step by the second foot lands in line with the assistive device(s)
What is the step through gait pattern?
The step lands beyond the assistive device(s)
What is the swing to gait pattern?
Both crutches advance simultaneously followed by simultaneous advancement of LEs to level of ADs
What is the swing through gait pattern?
Both crutches advance simultaneously followed by simultaneous advancement of LEs beyond the level of ADs
When trying to navigate stairs which side does the AD generally move with?
With the involved LE
How should a PT guard a pt when going up stairs?
Guard from behind
How should a PT guard a pt when going down stairs?
Guard in front
What is a good saying to remind patients which foot they should lead with when navigating stairs?
“Up with the good, down with the bad”
For crutches when should they move when navigating stairs?
Move crutches with the involved or weaker LE
How should a patient with crutches navigate stairs if there is a railing?
Two options:
1. Two crutches held together as a T on one side and use the railing on the other
2. One crutch is held parallel to the rail while holding on
How should a patient with a cane navigate stairs?
They may move the cane to the other hand in order to use the handrail
May need to turn quad cane sideways tor secure placement
They can go step to step or step over step
How should a patient with a walker ascend a curb?
Walker must be advanced first followed by affected LE. Then patient must lean forward for effective push through UEs before lifting the LE left behind
How should a patient with a walker descend a curb?
Same as stairs. AD first then bad LE first
How to move through a doorway with an AD when the door opens towards you?
Stand close to the door, turned slightly toward the hinges. Pull door open, then push it fully open with same hand block door with crutch tip if needed and walk through the door way
How to move through a doorway with an AD when the door opens away from you?
Stand close to the door, facing door handle. Push door wide open, block with crutch tip if needed. Walk through
How should you walk on inclines with AD?
Lean forward when ascending, take slightly longer steps when ascending. Take slightly shorter steps when descending. Follow zigzag path if necessary to reduce steepness of path
What are some other ambulating challenges?
Obstacles, carrying objects, walking on yielding or unstable surfaces, walking over slick or wet surfaces, inadequate lighting, interrupted gait, and/or being bumped or jostled
What happens if a patient begins to have a collapsing fall?
Move closer and slightly on the gait belt to help the patient regain support
What happens if a patient begins to have a angular fall?
Move in close and attempt to bring the COM back over the BOS
What happens if the patient begins to fail and regaining position is not possible and no chair immediately available?
Deepen your stride and rest the patient on your forward thigh— if this is not an option carefully lower the patient to the floor
What are some ways to prevent falling with patients?
Person: balance, strength, and appropriate device
Task: effective gait training
Environment: good lighting, removing obstacles
How can we decrease the risk of injury with falling with crutches?
Drop crutches out to the side. Slightly flexing elbows of extended arms. Turn head to the side
How should patients get up after a fall if they are unable to crawl to a nearby chair?
Gather crutches, move into kneeling with both crutches on one side. Move into half kneeling (on stronger LE). Move into full standing and place a crutch on each side
