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patient-care

Module 8-Amb aids + Patterns

QuestionAnswer
y may someone require assist devices? impaired balance, decreased strength, alteration in coordinated movmts, pain during WB, absence or LE, improve functional mobility, enhance body functions, assist w/fx healing
normal amb can be described as consisting of ____ patterns gait
normal gait pattern has __% swing and ____% stance phase 40 swing, 60 stance. including a brief period of double support (both feet on ground)
as a persons walking speed increase the body remains in double support longer or shorter shorter
the gait cycle is defined as the time from ___ to _____ heel contact (initial contact) of a given foot to the next heel strike (initial contact) of the same foot.
name to major subphases of gait initial contact/heel strike, loading response, midstance/foot flat, terminal stance/heel off, presweing/toe off. the swing phase is divided btwn intial swing (acceleration), midswing, terminal swing (deceleration)
what are UE used for in gait? support, stability, and movment when amb aids are used.
list the UE muscles that are involved in the primary support of body weight and assisance in propelling the body. scap stabilizers, shoulder depressors, flexors, extensors, elbow flex/exts, finger flexors
list the primary LE muscles that are involved in supporting the body weight during the weight-bearing phase? hip flexors, extensors, abductors, knee flexors, knee extensors, PFs
the ___ musculature are necessary to maintain an erect position and proper posture trunk muscles, especially the extensors
What major phase of gait does the GLUT MAX contribute to? inital contact to foot flat
What major phase of gait does the GLUT MED/MIN contribute to? TERMINAL STANCE TO PRESWING
What major phase of gait does the HIP FLEXORS/ADD contribute to? presweing to midswing
What major phase of gait does the QUADS contribute to? loading response (to absorb shock, eccentric contraction to stab knee)
What major phase of gait does the HAMS contribute to? midswing to inital contact (to decelerate limb)
What major phase of gait does the TIB ANTERIOR/PERONEALS contribute to? intial contact to midstance and preswing to intial contact (to absorb shock and elvate foot)
What major phase of gait does the GASTROC/SOLEUS contribute to? midstance, terminal stance to preswing (knee stablity @ term stance and push off)
What major phase of gait does the ERECTOR SPINAE contribute to? stabilize trunk during intial contact to intial contact
what are the top 3 things to remember for AMBULATION 1. gait belt. 2. dont leave pt unattended. 3. ensure locks engaged!s
how and why are PARALLEL BARS used? for balance trng, teach gait patterns, "splinter skills". adjust for hands out 6" in front to = height at lvl of GT, 20-25 flex in elbow, 2" room on ea of hips
how and why are WALKERS used? used when max pt stabilty and support r required. (Def- "unable, unwilling, or not allowed to put weight into 1 LE). pt needs UE strength. estimate: GT. confirm wrist crease, 20 bend in elbow.
how and why are AXILLARY CRUTCHES used? used for pts who need LESS stability or support than walker/parallel bars. allow greater selection of gait patterns and amb speed. estimate height-16" 4 axillary portion/ 77% height. confirm: 2" lat + 4-6" ant 2 toe, 2-3 fingers. 20-25 elbow FLEX 4 hand
how and why are FOREARM CRUTHCES used? chronic use. less invasive socially, however less stable than axillary. GT for hand grips. Confirm: same posit as axillary- elbow flex for hand grip + 1.5" below olecranon process
how and why are PLATFORM WALKER used? RA or NWB wrist + hands, cant graspt crutch, have bleow elbow amputation, or cant extend 1 or both elbows. same fit with wrist creases as reg walker, neutral wrist hand for injured UE and slightly ELEVATED shoulder for leverage!
how and why are ROLLING WALKER used? Balance deficit, no pushing or pulling restirctions (heart surgery, back surgery).
how and why are TILT TABLES used? pts with blood pressure regulation issues, orthostatichypotension, burn pts (for ADLs, eating, grade WB). fitting- N/a. 1 size fits all.
how and why are HEMIWALKER used? for pts with LE impairment but MUST be WB! could have balance deficit. confirm, same as cane- with it out and front a little, no right by the side.
how and why are CANE used? balance and coordination issues. must be WB! estimate with GT. confirm with wrist crease out and to the side.
what is a 4 pt gait pattern? right curtch, left foot, left curtch, then R foot. very stable. slow. used for WBAT to FWB
what is two point? uses bilateral assist devices, but u move like snow skiing. right arm and left leg, left arm and right leg. safey but a little faster than 4 pt. used for WBAT-FWB
what is two point modified? same as 2 pt, but with unilateral device, used for someone with only one functional UE or LE med condition. must be FWB
what is four point modified? same as four point, but with unilateral assist device. must be FWB
what is three pt? bilateral assistance or walker. must be able to bear FWB on 1 LE. assist device and bad LE advance at the same time. then good leg. normal crutches movement. 1 NWB extremity!
what is three pt modified? same but must be able to bear some weight on bad leg- TTWB, WBAT, PWB
what do u use for NWB? walker, bilateral crutches. three point!
what do u use for WBAT? modified 3pt, 4 pt, 2 pt, modified 4pt, modified 2 pt. (BASICALLY ALL, EXCEPT FOR 3 PT!)
what do u use for FWB? 4 pt, 2 pt, modified 4, modified 2. (not really modified 3 bc that should only be used when WB is limited. with FWB, ur not)
Created by: tpostrel