walking and mobility aids Flashcards
what are the purposes of using a walking aid?
- pain relief
- relief of WB from the affected leg
- assist with balance
- provides support in case of weakness
- psychological support
what does the type of walking aid depend on?
- age of patient
- disability?
- physical status
describe the basic walking frame (with the 4 legs) -** how does patient use it** and what are the advantages?
- **large amount of support and very stable **
- patient** lifts frame forwards,** transfers weight onto frame, takes 2 steps up to the frame - bad leg first, good leg second
- all 4 points of the frame must be on the ground at the same time before taking a step
what are examples of other type of walking frames, apart from the basic one?
- wheeled walking frame
- foldable frame
- forearm walker
- reciprocal walking aid
- walkers
what are the important considerations for walking frames?
- adjustable height
- correct height
- weight of patient
- diameter of walking frame - is it suitable for home?
- weight bearing status - is the patient NWB or PWB?
- safety / balance
how do you measure the correct height of the walking frame for a patient?
- measure from the ulnar styloid to the ground with the patient standing erect, shoulders relaxed with elbows flexed 15-20 degrees
- when standing, the patient elbows should be slightly bent
what are the 3 types of crutches?
- axillary (underarm)
- elbow
- forearm bearing
what weight bearing status are axillary crutches used for?
NWB gait
how does a patient use axillary crutches?
- the crutches rest against the axillary wall
what is the risk of using axillary crutches?
- there may be a risk of neurovascular damage - ie to the axillary nerve
what weight bearing status are elbow crutches used for?
- both NWB and PWB
under what circumstance are elbow crutches unsuitable?
- unsuitable for patient if they have restricted elbow and wrist ROM
what are the advantages of elbow crutches?
- easily adapted
- lightweight
- handgrip variation
- height is adjustable
in what situation would a patient use a forearm/gutter crutch?
- if the patient is unable to use a normal handgrip
what are the advantages of a knee walker / scooter?
- dont have to carry around crutches etc
- provide patients with freedom of movement if they have problems with foot ankle etc
what weight bearing status are walking sticks used for?
- PWB
compare a** tripod vs a quadripod** walking aid
- tripod - 3 point base, good stability, good base of support
- quadripod- 4 point base, good stability and base of support
which gait pattern is good to start with for a patient?
3 point - if they are able - then can adjust gait pattern
what are the different** gait patterns**?
- two point - contralateral or ipsilateral
- three point
- four point
- reciprocal two point
what is a contralateral two point gait with 1 stick/crutch?
example - left leg is bad leg
- stick / crutch is in right hand and bad leg is left leg
- left leg and stick in right hand move at the same time
- then good leg is moved
what is an **ipsilateral 2 point gait **with one stick?
example - bad leg is left leg
- crutch or stick in left hand and bad leg is left leg
- bad leg and crutch/stick move at the same time - both on same side
- then move good leg
what does a 3 point gait involve?
NB - 2 cructhes for this pattern
- 2 crutches
- crutches first, then bad leg, then good leg
- good to start with this pattern - eg first day after op
what is the 4 point gait pattern?
- right crutch forward followed by left leg
- left crutch forward followed by right leg
- slower speed
- normal gait pattern
- pre FWB stage
what is the** reciprocal 2 point gait**?
- 2 crutches
- right leg and left crutch stick together
- followed by left leg and right stick together
what is ‘swing to gait’?
- both crutches are put down first
- then weight is transfered to crutches
- limbs lifted and swung forward to the crutches
what is the ‘swing through gait’?
- crutches are put forward
- lower limb lifted
- limbs swing forward** past the crutches **
how do you go up the stairs with crutches?
- unaffected leg first
- affected leg
- crutches
- NB - 1 crutch and hold hand rail
how do you go down the stairs with crutches?
- crutch first
- affected leg next
- then unaffected leg
what is an orthotic?
- a device that is applied directly and externally to the patients body
- aims to support, correct or compensate for an anatomical deformity or weakness eg muscular dystrophy, polio
- prevents the unwanted motion or replaces the action of weak or dysfunctional muscles
what are examples of orthoses?
- foot orthoses
-
AFO- ankle foot orthoses - controlling mvt of ankle
* KAFO - knee ankle foot orthoses- controlling mvt of ankle and knee
what is a foot orthosis?
a functional foot orthosis is a device that is contoured to the entire foot and used to reduce abnormal motion or** abnormal position of the foot **
what is an AFO - ankle foot orthosis?
- device used to support the foot in a** stable and neutral position **
- also** provides stability to the ankle**
- used for neurological patients eg MS and spastic paralysis (damage to upper motor neurons) eg head injury or cerebrovascular accident (eg stroke)
what is a KAFO - knee ankle foot orthosis?
- used to treat symptoms due to spina bifida, cerebral palsy, paraplegia, neuromuscular dystrophy
- reduces stress on leg, stabilises knee and limits knee mvt
what is a HKAFO used for? - hip, knee, ankle, foot orthosis?
commonly used to treat symptoms due to spina bifida, paraplegia, neuromuscular dystrophy etc
what is a supportive knee orthosis used for?
- **relief of pain **
- **stability **in arthritis
- sports bracing for ligamentous damage
- **post operative **- limits movement and provides stability
