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PT9111 - Test 4 > Lecture 59 - Mobility Aids > Flashcards

Lecture 59 - Mobility Aids Flashcards

1
Q

Benefit of gait aids

A

Increased participation in everyday activities

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2
Q

4 Limitations of gait aids

A
  1. Physical characteristics of the gait aid
  2. Environment
  3. Personal reluctance
  4. Stigma
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3
Q

T or F: Gait aids are only for older adults

A

F, for everyone

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4
Q

Purpose of gait aids

A

To enable independent walking

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5
Q

Short-term use of gait aids

A

Reduced weight-bearing ability on a lower extremity after an injury or surgery
* e.g., ankle fracture, total hip joint replacement

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6
Q

Long-term use of gait aids

A

To compensate for a relatively permanent
impairment

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7
Q

What are 5 things gait aids compensate for

A
  1. Decreased balance
  2. Decreased strength
  3. Decreased coordination
  4. Relieve pain during ambulation
  5. Decreased ability to put full
    weight through a lower extremity
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8
Q

What 2 physical benefits do gait aids provide

A
  1. Increases the base of support
  2. Provides haptic cues
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9
Q

What are 4 gait aid recommendations for practice

A
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10
Q

What are 3 main categories of gait aids

A
  • Canes
  • Crutches
  • Walkers
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11
Q

What are the objective and 2 considerations for prescription of canes

A
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12
Q

How to fit canes

A
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13
Q

Pros and cons of the 3 types of canes

A
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14
Q

What is the objective of crutches and 4 considerations for prescription

A
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15
Q

How to fit crutches

A
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16
Q

Pros and cons for the 2 types of crutches

A
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17
Q

What is the objective and 4 considerations for prescription of walkers

A
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18
Q

How to fit a walker

A
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19
Q

Pros and cons of the 3 types of walkers

A
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20
Q

What are the 4 advantages provided by gait aids

A

1) Increased stability
2) Decreased loading through lower extremity
3) Provide enhanced haptic cues
4) Improve quality of walking

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21
Q

How do gait aids increase stability

A

Increase the base of support and allow stabilizing forces to be generated through the hands

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22
Q

Should canes be placed on same side as affected side?

A

No, Cane should be placed on opposite side of affected side

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23
Q

Decreased loading through gait aids is helpful for people with

A

joint pain or weakness

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24
Q

Can a walker decrease more loading than a cane

A

Yes, fewer wheels on walker provides opportunity for greater off-loading and reduced weight-bearing for a single lower limb problem

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25
Q

Haptic cue

A

Somatosensory information at the hands

26
Q

T or F: Gait patterns in older adults who use gait aids are more irregular and unstable than older adults who have independent mobility

27
Q

Do older adults who use a gait aid have better performance with or without their gait aid

28
Q

What are 6 disadvantages of using gait aids

A
  1. Increased attentional and neuromotor demands
  2. Destabilizing biomechanical effects
  3. Interference with recovery from loss of balance
  4. Strength demands and loading of upper extremities
  5. Increased physiologic and metabolic demands
  6. Environment
29
Q

How does increased attentional and neuromotor demands impact the use of gait aids

A

If the demands of executing multiple simultaneous tasks exceeds the cognitive capacity of
the individual, then there will be a decrease in performance on one or multiple of the tasks

30
Q

How do gait aids cause destabilizing biomechanical effects

A
  1. Cause decrease in BOS when device is advanced
  2. Requires additional anticipatory postural adjustments
  3. causes collisions with feet and objects in environment
31
Q

What are 4 methods to recover from loss of balance

A
  1. Ankle strategy
  2. Hip strategy
  3. Stepping
    If these fail then:
  4. Grasp with upper extremity
32
Q

How does gait aid get in the way of stepping strategies to recover from loss of balance

A

Change in support strategies with
foot can be hindered by aid
* Gait aid gets in the way of making
stepping strategies

33
Q

How does gait aid get in the way of grasping strategies to recover from loss of balance

A

Aid prevents change in support
strategies with hand
* In the presence of a loss of balance, we tend to continue to hold onto what we were grasping then letting go and
seeking other suppor

34
Q

Does the number of upper limbs available influence the gait aids we chose?

A

Yes, if less than full weight-bearing in lower extremities a person needs to have sufficient upper body strength to support themselves

35
Q

Do gait aids increase physiologic and metabolic demands on the person

A

Yes and even more so those with chronic health conditions

36
Q

How does the environment affect the use of gait aids

A

If there is snow you cannot get around as easily

37
Q

Weight-Bearing As Tolerated (WBAT)

A

Patient allowed as much weight as they feel comfortable with
* Gait aid use at discretion of therapist

38
Q

Protected Weight-Bearing (PTWB or PWB)

A

Weight bearing as tolerated but gait aids are mandatory at all times

39
Q

50% Weight-Bearing (50%WB)

A

Up to half the person’s body weight is allowed
* Two crutches or standard walker are mandatory at all times

40
Q

Feather Weight-Bearing (FeWB)

A

Minimal weight allowed

41
Q

Non-Weight-Bearing (NWB)

A

No weight allowed through the lower extremity

42
Q

What are 9 considerations or factors that impact whether a person is an appropriate candidate for a gait aid and the type of aid that would be recommended:

A
  1. Cognition
  2. Overall function
  3. Vestibular function
  4. Vision
  5. Physical endurance
  6. Upper body strength
  7. Living environment
  8. Prognosis for increase/decrease ambulation abilities
  9. Expected or desired ambulation activities by the person
43
Q

Assessment steps for gait aids

44
Q

Flow chart for prescribing gait aid

45
Q

How to choose which gait aid to use

46
Q

Normal gait cycle without gait aid

47
Q

The selection of the gait pattern to be used with a gait aid will depend on (6)

A
  1. Weight-bearing status*
  2. Balance
  3. Strength – upper and lower extremity
  4. Coordination
  5. Functional needs
  6. Energy level demands of gait aid
48
Q

Describe the 4-point gait pattern

49
Q

Describe the 2-point gait pattern

50
Q

Describe the 3-point gait pattern

51
Q

Describe the modified 4-point gait pattern

52
Q

Describe the modified 2 point gait pattern

53
Q

Describe the 3-1 Point gait pattern

54
Q

Steps to train a patient to perform a gait aid

55
Q

Should we correct and encourage the client when practicing with a gait aid and monitor their physiological status?

56
Q

What are 7 tasks to evaluate with a cane and/or crutches

57
Q

What are 9 tasks to evaluate with a walkers

A
  1. Sit to stand
  2. Ambulation on a level surface
    * Up to 50m to evaluate endurance
  3. Gait with pivot turn to approach chair and sit
  4. Walking while performing task of horizontal head
    turns
  5. Walking while performing a concurrent cognitive
    task
  6. Walking while negotiating obstacles
  7. Walking through an open doorway
  8. Open, walk through and close a door that opens
    away from the person
  9. Open, walk through and close a door that open
    towards the person
    ***If community-dwelling consider evaluating
    curbs
58
Q

What 2 areas are assessed related to safety

A
  1. Physical performance:
    * Prescription of the mobility aid is to compensate for deficits in strength, gait, balance
    * Does the aid effectively compensate or are there ongoing deficits
  2. Interaction with equipment:
    * This covers whether the aid is used in a safe manner (e.g., use of brakes)

NOTE: The SUMAC has two scores
* one for physical performance with the aid
* one for interaction with the equipment

59
Q

What are 5 important considerations to focus on when assessing gait aids

A
  1. Their independence with gait aid
  2. Their ability to use gait aid safely
  3. Does gait aid improve quality of gait
  4. Assess in real world conditions
  5. Need to educate maintenance and features of equipment
60
Q

What are 5 effects of gait aid training

A

1) Inconsistent effects on gait velocity
2) No effect on gait instability in people with mobility problems
3) No effect on falls risk (Included people with Parkinson’s disease and Alzheimer’s dementia)
4) No research on falls prevention or balance performance
5) Effects on safety and adherence to use of aid not clear

PT9111 - Test 4 (14 decks)

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