| Term | Definition |
|---|
| Progression of devices - most stable to least stable | // bars > walker > rolling walker > crutches > cane > none |
| Guarding | Always guard at side or behind pt. (weak side), below 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 may not 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 separately (crutch-step-crutch-step), requires bilateral ambulation devices |
| 4 point advantage | Most stable gait pattern, similar to normal gait pattern |
| 4 point disadvantage | Difficult to learn, slow, pt must be FWB |
| 4 point indicated for | Independent w/bilateral weakness, poor balance, decreased coordination |
| 2 point gait | Move opposite crutch and LE together, requires bilateral ambulatory 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 strength 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 paraplegia, LE weakness |
| Crutch types | Axillary, lofstrand/forearm, platform |
| Axillary crutches | Orthopedic problems, short term use |
| Lofstrand crutches | Neurological problems, SCI, CP, long term use, neurological problems, SCI, CP, long term use |
| Platform crutches | Arm rest on platform, wrist or hand wt. bearing problems |
| Fitting axillary crutches | 6" in front 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 olecranon fossa, hand hold at greater trochanter |
| Platform crutches | Set to pt comfort |
| One crutch | Use cane guidelines |
| 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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