Walking aid provision Flashcards
What is the rationale behind using this treatment (Pain/Increase ROM/strengthen etc)?
for those with decreased mobility
to help with pain/to heal
What are the physiological effect of the treatment?
improved stability and balance
reduce joint strain on the hip/ankle/knees
increased muscle endurance and strength in the arm depending on the type of walking aid used
improved posture and alignment
What structures are affected by the technique?
muscles
joints
What principles are used in carrying out the technique?
walking with crutches can require up to 2x as much energy as normal gait
there are various gait patters that aren’t all as equally demanding
need to choose the walking aid that has the least amount of support that is safe for the patient
need to inspect equipment before handing it out and also the ferrals.
emphasise that the pt doesn’t keep hold of the frame and take it with them when they sit up or down
proper fit and adjustment
training and education
surface conditions
Precautions and contraindications?
individuals with severely impaired balance
upper extremity weakness
cognitive impairment-may have difficulty using them effectively
sever sensory deficits-may be at risk for falls
What does the gait the pt adopts depend on?
the gait the pt adopts will deoend on whether they are non weight bearing, energy level, body strength, balance, coordination and the type of walking aid chosen.
How to fit the crutch and zimmer frame whilst lying down?
If the patient is lying down, make the stick go from the styloid to the bottom of the heel, making sure footwear is taken into consideration and that the crutches are the same height.
to measure the zimmerframe, use a tape and compare it to the frame
What are the different weight bearings that we have to be able to teach the patients?
PWB-check the surgical notes to see how much and the reason for it
touch WB
eggshell WB
NWB
feather WB
What is the procedure for teaching someone to use a zimmerframe?
NEED SOMEONE TO HELP YOU SUPPORT THE PT.
teach them to stand up to the frame and not into the frame
use the bed to help themselves get up, but their hands shouldn’t be on the zimmer frame
once they are up they can use the frame to lean their bw through
put the frame forward, then step forward to put one foot to the back leg and then the other leg as we want to keep a big BOS
if the patient struggles to get up, you and the other therapist can help them, but don’t let them touch the frame
for them to sit back down, they slowly move round with the zimmer frame so their back is facing the bed, they then take a step back until they can feel the bed on the back of their knees
they then start bending and lower themselves gently onto the bed with their hands (can be there to help support)
pt can also hop with the zimmer frame, but wake sure they don’t go too far into the frame-this is done when they cannot weight bear or touch weight bear
with a rollater, they just roll instead of lifting up and moving the frame but everything else is the same
What is the procedure for using/teaching pt how to use elbow crutches?
don’t stand up and sit down with the arms in crutches
instead make ‘rugby posts’ and hold on with the stronger hand, the patient then uses that hand to stand, putting only the amount of weight through the leg as the notes suggest
the crutches then go forward, they step through with the injured leg first, then the normal leg ad repeat.
with NWB they hop with them, making sure the crutches go first, then the leg but they only go to in line with the crutches.
with 4 point gait they do a normal walk but with crutches in hand, almost like they are marching with the crutches
What is step through gait and what is swing to gait (both with crutches)?
step through gait- when both crutches are always in line with the affected leg
swing to gait-when both legs move beyond the crutches which is the fastest gait pattern, but is the most unstable and requires significant upper body strength to maintain balance
What is the procedure for using/teaching the pt to use a cane/single forearm crutch-and what is it recommended for?
recommended for those who need additional support when walking and they cant weight bear as much on one side
crutch should be used in the hand opposite the weaker leg, only exception is if that arm is injured or significantly weaker-to ensure that weight is distributed-also if you wobble, you will wobble away from the side thats affected to prevent falls
if patient is equally strong or weak in both legs, then the crutch should be used in the dominant/stronger arm
2 point gait is the same as 2 crutches, but instead there is more wrist strain because of the forearm cuff
can be progressed to a step through
tell the patient to take as much weight through the stick as they need whilst maintaining an upright position
When would a gutter crutch be used and in which arm?
used if they cant weight bear through the wrist as it allows weight bearing through the forearm
used on the opposite side to the leg that’s effected.
How to teach the pt to walk up the stairs with crutches?
with crutches on the current step with the bad leg, then step up with the good leg and then place the crutches up with the good leg doing all the work
How to teach the pt to walk down the stairs with crutches?
the crutches go first this time and then the bad leg, then the good leg, weight should be taken through the arm
