46 terms

FTP PTA ambulation

progression of devices - most stabile to least stabile
II bars > walker > rolling walker > crutches > cane > none
always guard at side or behind pt. (weak side), lelow pt. on stairs or curb, hands on gait belt until SBA
no weight on LE - requires assistive device
pt allowed to touch toe for balance NWB assistive devise required
orders will usually tell how much weight in %, use scale for accuracy assistive device required
amount of wt. pt can tolerate, minimal to full, assistive devise may or maynot be needed
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
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