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Gait Training
| Question | Answer |
|---|---|
| What are the three requirements for gait? | Stability, mobility and dynamic stability |
| What is dynamic stabililty? | maintaing posture while shift weight |
| How do we think of gait? | Constant falling and recovering from falling. COG in BOS |
| What do you need to know before getting a pt up? | any wt bearing restrictions |
| When do you use parallel bars? | for a pt who needs support or are weak |
| How do you position the wheelchair in the parallel bars? | Make sure foot rests are off and you move the wheel chair into position so that it is locked |
| What is orthostatic hypotension? | change in body position when BP drops. Do ankle pumps and deep breathing to increase O2 return, get initial BP if not DVT! |
| What are weight shifting techniques and when are they used? | front/back, side/side, single hand, with/without challenge (pevis push or pull), used to start gait training |
| What is the open or closed chain activities for gait | hip hike and partial squats |
| Why teach foward and backwards stepping? | requires wt shift and push down on parallel bars for wt restrictions |
| Why is turning in parallel bars imporant? | turn to stronger side, ears can adjust to space, and cordination with other systems |
| What are some advance moves in the parallel bars? | Add resistance, stepping over, step up, speed, walking backwards, sidesepping, braiding,change of diection |
| What are considerations for gait training | pt level of cognition, motivation, pt readiness, general health, ablitiy to tolerate pain, saftey, vital signs, pts prior expereince, wt bearing restictions |
| What is NWB? | Non wt bearing (always 3 pt) |
| What is TTWB | Toe touch wt bearing (3 pt mod) |
| What is PWB | Partial wt bearing (always 3 pt) |
| What is WBAT | Wt bearing as tolerated |
| What is FWB | Full wt bearing (cane) |
| How do you measure for a cane? | when standing elbow bent 25-3o degrees, cane at creast of wrist, ht of greater trochanter |
| How do you use a cane? | Opposite involved leg, involved leg steps with the cane |
| List the 4 types of crutches | standard axillary crutch, ortho crutch, forarm (lofstand) crutch, plateform attachement |
| What are two different 3 point gait patterns with a crutch? | step to, step through (explain the difference) |
| What are gait patterns with a crutch | 4 point gait, two point gait, swing to, swing through |
| What are the different types of walkers and explain the differences? | standard walker,rolling walker, platform walker |
| How do you guard on stairs? | be down of the pt |
| How do you instruct the pt to go up stairs? | up with good leg, down with the bad, when bad leg moves so does the assisted device |
| How do you use a walker on the stairs? | Use it like a cane |
| How do you use crutches on the stairs? | Like a cane |
| What does documentation look like for gait? | assistive device required, transfer level, wt bearing statis, distance, speed, function, surface, level of assistance |
| planning gait | review medical record, appropriate equip, explain or demo activity, clear area, gard with gait belt, maintain body mechanics |
| safety first | appropriate foot wear, monitor vitals, pay attention, clear area |
| guard pt | stay alert, guard behind and to weak side, pt sits while alone, care for appliances |
| pregait activities | develop base of strength balance and coordination, improve use of devices, increase pt confidence |
| assistive devices | provide support, increase balance, BOS, and decrease wt bearing |
| parallel bars | most stable, not long enough/ use for gait and pre-gait activites |
| walkers | max stability with mobility/difficult to store, use on stairs, slow, to perform normal gait patterns, and use in crowded spaces |
| crutches | bi or unilateral, provide speed, less stable can damage axillary area, requires balance |
| loftstrand | cuff all the advantages of crutches, but requires balance and upper body strength, cuff makes if difficult to remove |
| canes | compensate for impaired balance or improve stability/provide limited support, not to be used for NWB |
| fit parallel bars | 2 in from trochanter, level with styloid process |
| walker and cane | even with styloid process |
| fit crutches | hold 4 in anterior to toes, 3 in or 2 fingers below auxillary fold. hand rest at styloid process |
| 4 point and mod 4 point | alternate between each stick and each leg, alternate one stick, one leg |
| 2 point and mod 2 point | affected leg and both sticks, affected leg with stick then good leg |
Created by:
llacorte
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