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Questions and Answers
What is the guideline for going upstairs using crutches?
What is the guideline for going upstairs using crutches?
The involved leg is always the one that should lead when using crutches for ambulation.
The involved leg is always the one that should lead when using crutches for ambulation.
False
During ambulation with a walker, which position should the device be placed before standing?
During ambulation with a walker, which position should the device be placed before standing?
In front of the patient
The phrase 'up with the ______, down with the ______' is used for stairs with crutches.
The phrase 'up with the ______, down with the ______' is used for stairs with crutches.
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Which of the following describes the proper order of movements while using crutches on stairs?
Which of the following describes the proper order of movements while using crutches on stairs?
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When instructing a patient on the use of a walker, the device should be moved before the patient stands up.
When instructing a patient on the use of a walker, the device should be moved before the patient stands up.
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What is the primary purpose of using ambulation devices like crutches and walkers?
What is the primary purpose of using ambulation devices like crutches and walkers?
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The phrase 'up with the good, down with the ______' is used for navigating stairs with crutches.
The phrase 'up with the good, down with the ______' is used for navigating stairs with crutches.
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Match the ambulation device with its type:
Match the ambulation device with its type:
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What is a key consideration when using a cane on the right side for a patient with left hemiplegia?
What is a key consideration when using a cane on the right side for a patient with left hemiplegia?
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Canes are considered bilateral devices for ambulation training.
Canes are considered bilateral devices for ambulation training.
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Study Notes
PTH 105 - Unit 7 Lab - Ambulation & Gait Training
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Learner Objectives:
- Describe different gait patterns.
- Discuss gait training principles:
- Proper body mechanics
- Patient guarding techniques and assistance
- Appropriate assistive device selection
- Correct gait sequence
- Modifications for surgical precautions and weight bearing limitations
- Describe and demonstrate gait with assistive devices (e.g., sit-to-stand, forward/backward on level surfaces, turning, stairs/inclines, obstacles)
Preparation for Ambulation
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Key Muscles for Strengthening:
- Upper Trunk and UE: Scapular depressors and stabilizers, shoulder depressors, extensors, and flexors; elbow extensors, and finger flexors. (Strengthening exercises like wall pushups may be used).
- Lower Extremities (LE): Hip abductors, extensors, and flexors; knee flexors and extensors; ankle dorsiflexors and plantarflexors. (Isometric contractions of hamstrings, quadriceps, and gluteals, and ankle pumps).
- Lower Trunk: Trunk flexors and extensors.
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Pre-Ambulation Considerations:
- Review medical history, understand diagnosis and weight bearing restrictions, and the patient's level of ability (A).
- Determine necessary equipment/assistive devices (parallel bars, tilt tables, suspensory systems).
- Remove any hazards from the area.
- Ensure appropriate footwear (non-skid shoes) and gait belt usage.
- Explain and demonstrate the gait pattern before asking the patient to do it.
- Monitor vital signs (pulse rate (PR), blood pressure (BP)) before, during, and after treatment.
Ambulation Specifics
- Unilateral Device Use: Hold the device on the uninvolved (stronger) side.
- Patient Guarding: Stand slightly behind and to the side of the patient (usually on the involved / weaker side).
- Patient Instructions: Encourage looking ahead, not at their feet.
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Patient Instruction Examples (Crutches/Walkers):
- Sit to stand (using either crutches or walkers)
- Gait patterns for level surfaces (four-point, two-point, three-point)
- Stair climbing
- Stair descending
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Crutch Gaits - Level Surfaces:
- Four-point gait: Four distinct points of contact: left crutch, right foot, right crutch, left foot. (Maximum stability; suitable for individuals with significant weakness/limitations)
- Two-point gait: Two points of contact: left crutch/right foot together, (then) right crutch/left foot together. (a more advanced/faster gait)
- Three-point gait: Three points of contact (two crutches together followed, by one leg). Often used when one leg is weight-bearing non-weight-bearing (NWB).
- Gait Sequences: Device followed by involved leg(bad) and then uninvolved leg(good)
- Modified Gait Patterns: Adaptations for specific conditions/limitations (e.g., amputees, paraplegics).
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Description
This quiz covers Unit 7 of the PTH 105 course, focusing on ambulation and gait training principles. Learners will explore various gait patterns, body mechanics, assistive devices, and specific exercises for strengthening relevant muscle groups. Prepare to demonstrate proper techniques in a clinical context.
