| Term | Definition |
|---|
| progression of devices - most stabile to least stabile | II bars > walker > rolling walker > crutches > cane > none |
| guarding | always guard at side or behind pt. (weak side), lelow pt. on stairs or curb, hands on gait belt until SBA |
| NWB | no weight on LE - requires assistive device |
| TTWB | pt allowed to touch toe for balance NWB assistive devise required |
| PWB | orders will usually tell how much weight in %, use scale for accuracy assistive device required |
| WBAT | amount of wt. pt can tolerate, minimal to full, assistive devise may or maynot be needed |
| FWB | full wt. on LE, assistive devise may be used for balance |
| gait patterns | 4 point, 2 point, 3 point, swing to |
| 4 point gait | pt. moves each crutch and each step seperately (crutch-steo-crutch-step), requires bilateral ambulation devices |
| 4 point advantage | most stable gait pattern, similar to normal gait pattern |
| 4point disadvantage | difficult to learn, slow, pt must be FWB |
| 4 point indicated for | independent w/bilateral weakness, poor balance, decreased coordiantion |
| 2 point gait | move opposite crutch and LE together, requires bilateral amb. devise |
| 2 point advantage | stable gait pattern, faster than 4 point, relieves some wt on LE |
| 2 point disadvantage | relatively slow, pt. must be FWB |
| 2 point indicated for | individual with bilateral weakness, poor balance |
| 3 point gait | advance both crutches/walker, then step legs to or through crutches (affected LE leads), requires bilateral ambulation devices or walker, cannot use two canes |
| 3 point advantage | faster, used when pt. is NWB on one LE |
| 3 point disadvantage | requires good balance and coordination, sufficient UE strangth needed, requires a good amount of energy |
| 3 point indicated for | LE fracture, amputations, NWB on one LE, indiv. PWB > FWB, decreased balance |
| swing to/ swing through gait | advance both crutches simultaneously, then bring both legs through crutches, used with patients who have bilateral LE involvement and unable to adv legs. rely on UE momentum |
| swing to advantage | fast gait pattern |
| swing to disadvantage | requires good balance, UE and trunk strength, high energy use |
| swing to indicated for | individual with parapelegia, LE weakness |
| walker types | standard walker, roller walker, hemi-walker, platform walker, stair climber walker |
| standard walker | most stable walker |
| roller walker | likelihood for more reciprocal gait pattern, good for pt. unable to lift walker |
| hemi-walker | handle comes out of center of front bar, use with only one UE, used for pt. with unilateral UE use (stroke) |
| platform walker | unilateral or bilateral available, forearm rest on platform, good for pt with arthritis, wt. bearing restrictions of wrist |
| stair climber walker | splin in middle to allow use on stairs |
| walker adjustment | 20* - 30* elbow flexion, walker handles approx. at greater trochanter level, ulnar styloid |
| walker gait patterns level surface | affected leg first, pt should not hop |
| walker gait patterns stairs and curbs | place walker sideways with 2 legs where you are and 2 legs where you are going, middle bar closest to pt, use walker as hand rail, bad leg first when coming down stairs |
| crutch types | axillary, lofstand/forearm, platform |
| axillary crutches | orthopedic problems, short term use |
| lofstrand crutches | neurological problems, SCI, CP, long term use |
| platform crutches | arm rest on platform, wrist or hand wt. bearing problems |
| fitting axillary crutches | 6" infront and to the side of feet, 20* - 30* elbow flexion, 2 -3 fingers between axilla and crutch, handrest at greater trochanter |
| fitting lofstrand crutches | 20* - 30* elbow flexion, 2 - 3 fingers between cuff and elecranon fossa, hand hold at greater trochanter |
| platform crutches | set to pt comfort |
| one crutch | use cane guidelines |
| cane type | straight, quad |
| cane adjustment | place cane 6" infront of pt., 20* - 30* elbow flexion, top of can at greater trochanter |
| cane patterns and procedures | pt. must be FWB, 2pt. or 3pt. gait, cane held opposite injured LE |
| ascending stairs | good leg first, bad leg, device, therapist guard below pt. |
| descending stairs | device, bad leg, good leg |
Combine with other sets
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