Gait Training Lecture 2

Question 1

What is a two point gait pattern?

Answer 1

Assistive device and one LE advance and contact the floor simultaneously, followed by the other LE and device, if used

Question 2

What is a three point gait pattern?

Answer 2

Bilateral assistive devices advance simultaneously with the WB-restricted LE, followed by the unrestricted LE

Question 3

What is a four point gait pattern?

Answer 3

Sequential advancement of alternating devices and LEs (ex. Left cane, followed by right LE, then right cane, and finally left LE)

Question 4

How can the two point gait pattern be used?

Answer 4

With one or two canes, one or two crutches, or a single-arm walker. Can be contralateral, ipsilateral, or bilateral

Question 5

When are three point gait patterns used?

Answer 5

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

Question 6

T/F: the four point gait pattern is faster than the two point gait pattern and provides more support

Answer 6

False! It is slower but yes it does provide more support

Question 7

What is a step to Gait pattern?

Answer 7

The step by the second foot lands in line with the assistive device(s)

Question 8

What is the step through gait pattern?

Answer 8

The step lands beyond the assistive device(s)

Question 9

What is the swing to gait pattern?

Answer 9

Both crutches advance simultaneously followed by simultaneous advancement of LEs to level of ADs

Question 10

What is the swing through gait pattern?

Answer 10

Both crutches advance simultaneously followed by simultaneous advancement of LEs beyond the level of ADs

Question 11

When trying to navigate stairs which side does the AD generally move with?

Answer 11

With the involved LE

Question 12

How should a PT guard a pt when going up stairs?

Answer 12

Guard from behind

Question 13

How should a PT guard a pt when going down stairs?

Answer 13

Guard in front

Question 14

What is a good saying to remind patients which foot they should lead with when navigating stairs?

Answer 14

“Up with the good, down with the bad”

Question 15

For crutches when should they move when navigating stairs?

Answer 15

Move crutches with the involved or weaker LE

Question 16

How should a patient with crutches navigate stairs if there is a railing?

Answer 16

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

Question 17

How should a patient with a cane navigate stairs?

Answer 17

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

Question 18

How should a patient with a walker ascend a curb?

Answer 18

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

Question 19

How should a patient with a walker descend a curb?

Answer 19

Same as stairs. AD first then bad LE first

Question 20

How to move through a doorway with an AD when the door opens towards you?

Answer 20

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

Question 21

How to move through a doorway with an AD when the door opens away from you?

Answer 21

Stand close to the door, facing door handle. Push door wide open, block with crutch tip if needed. Walk through

Question 22

How should you walk on inclines with AD?

Answer 22

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

Question 23

What are some other ambulating challenges?

Answer 23

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

Question 24

What happens if a patient begins to have a collapsing fall?

Answer 24

Move closer and slightly on the gait belt to help the patient regain support

Question 25

What happens if a patient begins to have a angular fall?

Answer 25

Move in close and attempt to bring the COM back over the BOS

Question 26

What happens if the patient begins to fail and regaining position is not possible and no chair immediately available?

Answer 26

Deepen your stride and rest the patient on your forward thigh— if this is not an option carefully lower the patient to the floor

Question 27

What are some ways to prevent falling with patients?

Answer 27

Person: balance, strength, and appropriate device
Task: effective gait training
Environment: good lighting, removing obstacles

Question 28

How can we decrease the risk of injury with falling with crutches?

Answer 28

Drop crutches out to the side. Slightly flexing elbows of extended arms. Turn head to the side

Question 29

How should patients get up after a fall if they are unable to crawl to a nearby chair?

Answer 29

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