SCI Gait Training Part 2

Question 1

How should PTs guard patients going up stairs or unlevel surface?

Answer 1

PT positioned behind and slightly beside patient
One hand on gait belt to guard against backward falls
One hand on shoulder to guard against forward falls
PT moves up with patient

Question 2

How should PT guard patients going down stairs or unlevel surface?

Answer 2

In front of the patient and slightly beside
One hand on gait belt to guard against backward falls
One hand on shoulder to guard against forward falls
PT moves up with patient

Question 3

What method is easier and safer when going down stairs?

Answer 3

Going down backwards

Question 4

Instructions for patients to go down stairs backwards

Answer 4

Face toward steps
Heels at edge of step
Crutches and hand stay at upper step
Head forward, hips up to clear stair rise- descend to next step
Finish with head back and hips forward (LOG behind hip joint)

Question 5

Instructions for patients to go upstairs forwards

Answer 5

Place crutch on upper step
Reach hand on rail to upper step
Head forward, hips up to clear rise- feet rise to next step
Finish with head back, hips forward, (LOG behind hip joint)

Question 6

Instructions for patients to go down stairs forwards

Answer 6

Toes at edge of step, facing down steps
Leave crutch and hand on upper step
Head forward, hips up to clear stair riser- descend to next step
Finish with head back, hips forward (LOG behind hip joint)

Question 7

Instructions to fall safely

Answer 7

Throw crutches laterally away from fall path and get tips of crutches off floor to prevent injuries from landing on a crutch

Extend arms to accept body weight on hands and allow elbows and shoulders to “give” lowering trunk to ground

Protect face and head

Question 8

Getting up from floor instructions (1)

Answer 8

Assume the prone position (with the legs adducted and internally rotated, resting on toes)

Place crutch to each side of the body (with the crutch tips pointed away from the feet and the grips placed at the level of the hips)

Place the palms on the floor next to shoulders

Question 9

Getting up from the floor instructions (2)

Answer 9

Lift pelvis from floor, by pushing down and forward with hands while tucking the head to “jackknife” the hips up

Keeping head tucked, walking hands toward the feet as far as possible raising pelvis as high as possible

Place legs in the most vertical position

Shift weight and balance on one hand and grasp a crutch with unweighted hand

Question 10

Getting up from the floor instructions (3)

Answer 10

Balance on one crutch, by positioning handle under one shoulder

Grasp second with the free hand and position it on the forearm

Question 11

Getting up from the floor instructions (4)

Answer 11

Position both crutches on arms

Support body on both crutches

Push pelvis forward, assumes a standing position

Walk crutches into “triangle position”