Clinical Skills I Week 7 Gait PDF

Clinical Skills I Week 7 Gait (Part 1) KAREN W. SAM, PT, DPT, GCS WEST COAST UNIVERSITY Objectives for Week 7 ❑ 25. Describe the advantages and disadvantages of various types of ambulatory devices (7D27b, d, g). ❑ 26. Differentiate and perform the two-point, three-point, and four-point modifie...

Clinical Skills I Week 7 Gait (Part 1) KAREN W. SAM, PT, DPT, GCS WEST COAST UNIVERSITY Objectives for Week 7 ❑ 25. Describe the advantages and disadvantages of various types of ambulatory devices (7D27b, d, g). ❑ 26. Differentiate and perform the two-point, three-point, and four-point modified gait patterns and apply them to case scenarios on level, grades, curbs, and stairs (7D27b, d, g). ❑ 27. Choose and fit an appropriate assistive device(s) as related to weightbearing restrictions, fall risks, physical characteristics of the care recipient, and/or architectural barriers and apply them to patient scenarios (7D27b, d, g). Gait Cycle, Stride length, Step length  Step Length – the linear distance between the occurrence of one point in the gait cycle of one foot and the same point in the gait cycle accomplished by the opposite extremity (e.g., L heel strike to R heel strike).  Stride Length –the linear distance between the occurrence of one point in the gait cycle of one foot and the recurrence of that point by the same extremity (e.g., L heel strike to L heel strike).  Gait Cycle – the time period that begins with the initial contact of an extremity and lasts until that extremity strikes the ground again (contains a stance + swing phased of each LE) stance FIGURE 14-1 Gait cycle, stride length, and step length and width Gait Pattern – Phases https://youtu.be/DP5-um6SvQI?si=sZNMRI-a9pycRw4Z Other Gait-Related Terminology:  Stance Time -the period that an extremity is in contact with the ground  Single-limb support time - the period when only one extremity is in contact with the ground  Double-limb support time  Swing time - period that an extremity is off the ground during the swing phase of that extremity  Cadence  Speed - period when both feet are in contact with the ground the number of steps taken in a given unit of time (ex: steps/sec, or steps/min) - the rate at which an individual’s locomotion covers a specific distance (ex: m/s) Common Weight-Bearing Status for Lower & Upper Extremities:  “FWB RLE” = Full Weight Bearing    No restriction to weight bearing. “WBAT RLE” = Weight-Bearing As Tolerated  As tolerated, up to full body weight  Limited by weakness, pain, balance, apprehension, etc. “50% PWB RLE” = Partial Weight-Bearing  Commonly ranged from 30% to 50%. For example, “30% PWB RLE,” “40% PWB RLE.”  Need to have a defined percentage (%) in the Physician’s order  Need MD order to clarify % if not clearly stated in the order.  Depending on the facility and surgeons, PT may default to NWB if mobility needs to be initiated. Common Weight-Bearing Status for Lower & Upper Extremities (cont.)   “TTWB RLE” = Toe-Touch Weight-Bearing; or TDWB RLE = Touch-Down Weight-Bearing  Light enough to avoid crushing a potato chip (or a raw egg) underfoot.  Primarily for balance  Can promote normal gait pattern, especially if the patient will be on restricted weight bearing for weeks or longer. “NWB RLE” = Non-Weight-Bearing  Cannot put any weight through the affected limb.  This includes not resting the foot on the ground during standing or ambulation.,