Module 8-Amb aids + Patterns
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| 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
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| normal amb can be described as consisting of ____ patterns | gait
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| normal gait pattern has __% swing and ____% stance phase | 40 swing, 60 stance. including a brief period of double support (both feet on ground)
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| as a persons walking speed increase the body remains in double support longer or shorter | shorter
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| 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.
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| 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)
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| what are UE used for in gait? | support, stability, and movment when amb aids are used.
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| 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
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| 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
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| the ___ musculature are necessary to maintain an erect position and proper posture | trunk muscles, especially the extensors
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| What major phase of gait does the GLUT MAX contribute to? | inital contact to foot flat
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| What major phase of gait does the GLUT MED/MIN contribute to? | TERMINAL STANCE TO PRESWING
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| What major phase of gait does the HIP FLEXORS/ADD contribute to? | presweing to midswing
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| What major phase of gait does the QUADS contribute to? | loading response (to absorb shock, eccentric contraction to stab knee)
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| What major phase of gait does the HAMS contribute to? | midswing to inital contact (to decelerate limb)
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| 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)
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| What major phase of gait does the GASTROC/SOLEUS contribute to? | midstance, terminal stance to preswing (knee stablity @ term stance and push off)
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| What major phase of gait does the ERECTOR SPINAE contribute to? | stabilize trunk during intial contact to intial contact
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| what are the top 3 things to remember for AMBULATION | 1. gait belt. 2. dont leave pt unattended. 3. ensure locks engaged!s
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| 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
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| 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.
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| 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
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| 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
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| 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!
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| how and why are ROLLING WALKER used? | Balance deficit, no pushing or pulling restirctions (heart surgery, back surgery).
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| 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.
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| 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.
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| 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.
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| what is a 4 pt gait pattern? | right curtch, left foot, left curtch, then R foot. very stable. slow. used for WBAT to FWB
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| 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
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| 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
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| what is four point modified? | same as four point, but with unilateral assist device. must be FWB
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| 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!
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| what is three pt modified? | same but must be able to bear some weight on bad leg- TTWB, WBAT, PWB
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| what do u use for NWB? | walker, bilateral crutches. three point!
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| what do u use for WBAT? | modified 3pt, 4 pt, 2 pt, modified 4pt, modified 2 pt. (BASICALLY ALL, EXCEPT FOR 3 PT!)
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| 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)
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