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Questions and Answers
What is the key principle behind the phrase 'up with the good, down with the bad' when using crutches on stairs?
What is the key principle behind the phrase 'up with the good, down with the bad' when using crutches on stairs?
Which of the following describes a common instruction for using a walker when transitioning from sitting to standing?
Which of the following describes a common instruction for using a walker when transitioning from sitting to standing?
How should a patient with a left hemiplegia use a cane effectively?
How should a patient with a left hemiplegia use a cane effectively?
When instructing a person on the correct use of bilateral crutches, which of the following is essential?
When instructing a person on the correct use of bilateral crutches, which of the following is essential?
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For a patient using a walker, which of these steps is NOT recommended when transitioning from standing to sitting?
For a patient using a walker, which of these steps is NOT recommended when transitioning from standing to sitting?
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Which of the following best describes the 'involved' leg when using gait devices?
Which of the following best describes the 'involved' leg when using gait devices?
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In terms of gait patterns, which of the following represents a common method of movement with crutches?
In terms of gait patterns, which of the following represents a common method of movement with crutches?
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Study Notes
PTH 105 - Unit 7 Lab - Ambulation & Gait Training
- Learner Objectives (C1, C2, C3): Describe gait patterns, discuss gait training principles (body mechanics, assistance, assistive devices, sequence, modifications for surgical precautions and weight bearing limitations), and demonstrate gait with assistive devices (sit-stand, forward/backward, turning, obstacles, stairs/inclines).
Preparation for Ambulation
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Key Muscles: Strengthen upper trunk/UE (scapular depressors/stabilizers, shoulder depressors/extensors, elbow extensors, finger flexors); strengthen lower trunk/LE (hip abductors, extensors/flexors, knee flexors/extensors, ankle dorsiflexors/plantarflexors)
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Pre-Ambulation: Review medical history, understand diagnosis and weight bearing restrictions, determine necessary equipment (parallel bars, tilt table), remove hazards, ensure proper footwear, apply gait belt, explain and demonstrate gait patterns.
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Monitoring: Monitor vital signs (pulse and blood pressure) before, during, and after treatment.
Ambulation Specifics
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Unilateral Devices: Hold device on uninvolved side (stronger side). Stand to the side and slightly behind the patient.
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Patient Positioning: Patient should look up, not down at their feet, which helps the patient move their body appropriately. Guide the patient accordingly to manage their balance.
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Instructions: Patient instructions; sit-stand, levels/surfaces (forward/backward on level surfaces, turning, avoiding obstacles or stairs/inclines).
Additional Gait Patterns (Crutches and Walkers)
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Crutch Gaits: Four-point, two-point, and three-point methods for level surfaces, including modifications for different degrees of weight bearing and levels of ambulation stability.
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Walker Gaits: Three-point gait for individuals with weight-bearing limitations.
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Stair Instructions (Crutches/Walkers): Use appropriate directions for "up with the good, down with the bad." Also includes turning the walker sideways and placing it in a straddle position.
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Turning Instructions: Instructions on turning utilizing a variety of devices (crutches/walkers) in order to maintain safety.
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Important Considerations: Safety measures including stair negotiation, safety measures for hallways and potentially hazardous areas, and avoidance of obstacles.
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