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GRFC > GRFC - functional training > Flashcards

GRFC - functional training Flashcards

1
Q

Ambulation aids from most coordination needed to least coordination needed

A
  • Non-axillary crutches
  • Axillary crutches
  • Cane
  • Walker
  • Parallel bars
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2
Q

Parallel bars measurement

A

Height: level of greater trochanter, 20 degrees to 30 degrees of elbow flexion

Width: +1 inch from each greater trochanter (+2 total)

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3
Q

Ambulation aids from least stable to most stable

A 
Cane
Non-axillary crutches
Axillary crutches
Walker
Parallel bars
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4
Q

Assistive device weight transmission

A

Cane: 20% to 25% (up to 30%, NPTE)
Non-axillary crutches: 40% to 50%
Axillary crutches: 80% to 90%
Walker: 85%

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5
Q

Walker dimension measurement

A

Height: 20 degrees to 30 degrees elbow flexion, height of greater trochanter

Distance: 10” to 12” anteriorly (12” ideally)

Rubber tip height: 2” to 3”

Rubber tip diameter: 1” to 1.5”

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6
Q

Different types of walker (with indications and features)

A

Standard (collapsible) walker: For easy storage, for those who travel frequently, for those with PD with stereotypic (festinating) gait

Hemi-walker: For persons with CVA, 1 UE and 1 LE amputation; has centrally located handgrip; contraindicated for those with (R) CVA with (left) unilateral neglect

Stair-climbing walker: Has additional 2 posterior uprights

Reciprocal (reciprocating) walker: For those with RGO using reciprocal gait pattern, for those with SCI and spina bifida (at T12 - L1)

Rollating walker (rollator): with wheels, for those with PD with akinesia

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7
Q

Anterior rollating walker

A

For those with stooped posture, PD, CP, osteoporosis, for the elderly; anterior tips replaced with wheels

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8
Q

Posterior rollating walker

A

For those with CP and increased flexor tone; posterior rubber tips are replaced with wheels

NOTE: For energy efficiency and increased velocity, use posterior rollating walker with 4 wheels

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9
Q

Types of crutches

A

Axillary

Non-axillary

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10
Q

Axillary crutch dimension measurement (standing)

A

Axillary pad: 2” (2 to 3 finger) below axilla

Handgrip: 20 degrees to 30 degrees elbow flexion, level of greater trochanter

Rubber tips: 6” anterior, 2” lateral from 5th toe

NOTE: Can also be measured using patient’s height -16”

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11
Q

Axillary crutch dimension measurement (sitting)

A

(R) shoulder abducted with elbow flexed
(L) shoulder abducted with elbow extended
Axillary pad on tip of olecranon process
Rubber tip on tip of 3rd digit (2nd finger or middle finger)

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12
Q

Axillary crutch dimension measurement (supine)

A

Axillary pad over anterior axillary fold

Rubber tip 6” to 8” from lateral heel OR at side of lateral heel +2” without shoes

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13
Q

Non-axillary crutch dimension measurement

A

Forearm cuff orientation: Facing medially and anteriorly

Forearm cuff location: Proximal 1/3 of forearm (1” to 1.5” below elbow)

Handgrip: 20 degrees to 30 degrees elbow flexion, level of greater trochanter

Rubber tip: 6” anterior, 2” lateral to 5th toe

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14
Q

Platform attachment details

A

For those with arthritic hand, elbow flexion contracture, distal forearm and wrist fracture

NOTE:
Platform crutch - if attached to crutch
Platform walker - if attached to walker

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15
Q

Triceps (Canadian) crutch details

A

For those with triceps weakness

Has two cuffs:
Triceps cuff (locks elbow in extension)
Forearm cuff

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16
Q

Types of gait patterns

A

Point gait:
Four-point (most difficult to teach/ instruct)
Three-point
Two-point

Swing gait:
Swing-to
Swing-through (most advanced, most difficult to learn)

Drag gait:
Drag-to (for those with severe spasticity)
Drag-through

Simultaneous gait (for those with coordination problems)

NOTE: Always teach 2 gait patterns (1 for stability, 1 for speed)

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17
Q

Therapist position/ assistance

A

Level surface: Posterolateral, near weaker/more affected/ affected side

Stair ascent: Posterolateral, near weaker/ more affected/ affected side

Stair descent: Anterolateral, near weaker/ more affected/ affected side

NOTE:
If with handrail, use handrail (place (B) crutches, canes on one side)

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18
Q

Scapular depressors (crutch walking muscles)

A

Latissimus dorsi
Lower trapezius
Pectoralis minor

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19
Q

Shoulder adductors (crutch walking muscles)

A

Latissimus dorsi

Pectoralis major

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20
Q

Shoulder flexors, extensors, abductors (crutch walking muscles)

A

Deltoids

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21
Q

Elbow extensors (crutch walking muscles)

A

Triceps brachii

Anconeus

22
Q

Wrist extensors (crutch walking muscles)

A

Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris

23
Q

Finger flexors (crutch walking muscles)

A

Flexor digitorum superficialis

Flexor digitorum profundus

24
Q

Thumb flexors (crutch walking muscles)

A

Flexor pollicis longus

Flexor pollicis brevis

25
Q

Cane dimension measurement and indication

A

Handgrip: Beside straight leg, at level of ulnar styloid

Rubber tip: 6” lateral to tip of 5th toe

26
Q

Different types of canes

A

Standard aluminum adjustable cane

Standard aluminum offset cane - point of support is directly beneath hand

Quad cane (large-base: more stable, small-base: intended for stair ambulation) - best for antalgic gait

27
Q

Wheelchair back rest height measurement

A

From seat to base of axilla -4”
From seat to inferior angle of scapula -2”

NOTE:
For those with high level SCI: high back rest
For those wit paraplegia: low back rest

28
Q

Wheelchair back rest width measurement

A

Normal: 16” to 18”

29
Q

Wheelchair seat depth measurement

A

Normal: 16”

From back of seat to popliteal fossa -2”

NOTE:
If too long: Sacral sitting
If too short: Decreased stability, uneven weight bearing on buttocks and thighs

30
Q

Wheelchair seat width measurement

A

Normal: 18”

Widest portion of buttocks +1” each side (each greater trochanter) (total of +2”)

NOTE:
Too wide: Difficulty with propulsion
Too narrow: Pressure on greater trochanter

31
Q

Wheelchair seat height measurement

A

Normal: 20”

From popliteal fossa to heel +2”

NOTE:
Too low: Person will reach for foot rest, sacral sitting
Too high: Weight bearing on ischial tuberosities only

32
Q

Wheelchair arm rest height measurement and types

A

From seat to elbow, with elbow flexed 90 degrees

According to “removability”
Fixed
Removable: For sliding board transfer

According to width
Full: well-supported forearm [and length]
Desk: Can fit under a desk

33
Q

Wheelchair leg/calf rest length measurement and types

A

From popliteal fossa to heel +2”

Fixed
Removable/ detachable/ swing-away: For pivot transfer
Elevating: For LE edema

34
Q

Wheelchair foot plate measurement

A

Clearance of 2” from the floor

35
Q

Wheelchair wheel/tire diameter and types

A

Diameter: 22” to 24” [22” OR 24”] (ideally 24”)

Width: 1”

Pneumatic wheel
Solid rubber wheel (ideal)

36
Q

Wheelchair hand/ push rims diameter and projections

A

Diameter: 18” to 20” (ideally 20”)

Oblique (C5)
Vertical (C6)
Horizontal (C7)
Friction (C7)
Standard (C8)
37
Q

Wheelchair caster diameter and indications

A

Diameter: 5” to 8” (ideally 8”, for better propulsion)

3” for easy turning
12” for rough surfaces

38
Q

Wheelchair types, features, and indications

A

Standard (collapsible) wheelchair: For easy storage, for those who travel frequently

Hemi-wheelchair: For those with CVA; has one-arm drive (bigger for same side, smaller for opposite side), has low seat height (17.5”)

Sports wheelchair: Has solid/ rigid frame, low seat height, low back rest, increased camber (3 degrees to 9 degrees), and is lightweight

Reclining wheelchair: For those who have postural instability, for pressure relief; backrest can be reclined to 180 degrees with the horizontal, has elevating leg rests, anti-tippers

Tilt-in-space wheelchair: For those with extensor spasticity or spasm, for pressure relief; can be tilted maintaining hips and knee flexion at 90 degrees

Motorized/ electric/ power wheelchair: For those with SCI levels C1 - C4; joystick, push button, sip and puff controls

NOTE:
Outdoor wheelchair (for power) - wheels posterior, casters anterior
Indoor wheelchair (for mobility) - caster posterior, wheels anterior
39
Q

Ramp dimensions

A

1:12
1” rise
12” run

40
Q

Stair measurement

A

7:11
7” rise/ height
11” run/ length

41
Q

Handrail height

A

32”

42
Q

Toilet seat height

A

17” - 19” (ideally 19”)

43
Q

Door width

A

Minimum: 32”
Ideal: 36”

44
Q

Hallway/ corridor width

A

Minimum: 36”
Ideal: 42”

45
Q

Ramp width

A

Minimum: 36”
Ideal: 48”

46
Q

Grab bars dimensions

A

Height: Bathroom/ toilet - 33” to 36”
Diameter: 30mm (3cm OR 1.25” to 1.5”)

NOTE
Height - Ramp (handrail): 32”

47
Q

Sink height

A

17” to 24”

48
Q

Reaching forward distance

A

High: 48”
Side: 24”
Low: 15”

49
Q

Dimension needed for wheelchair turning

A

90 degrees: 36”
180 degrees: 60”
360 degrees: 60” x 60”

50
Q

Cross-brace

A

Push on seat rail to open seat

Can be used to suspend urinary catheter bladder

51
Q

Tripod stance

A

Crutch position
4” anterior
4” lateral

GRFC (5 decks)

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