Intro to AD

A person uses ADs to compensate for impaired _______, decreased ________, alteration of ______, pain during ______, absence of a _________ or altered _______

• impaired balance

• decreased strength

• alteration of coordinated movements

• pain during WB

• altered stability

A person also uses ADs to improve ________, enhance _______ and assist with _______ healing.

• improve functional ability

• enhance body functions

• assist with fracture healing

How does an AD assist in improving a persons stability.

Expands the BOS

2 classifications of ADs

• Preambulatory ADs

• Ambulatory Device (AD)

Types of preambulatory AD:

• Tilt Table (not an AD but a PAD)

• Parallel bar

• Supported suspension ambulatory aid

Types of ambulatory device:

• Walkers

• (B) crutches

• single crutches

• (B) canes

• quad canes

• hemi canes

• single canes

The AD that gives the most stability

Used to check patient standing and ambulation balance

Parallel bars

Parallel bars are used for what stage of ambulation training?

initial ambulation training

Measuring parallel bars:

• Elbows should be flexed ______ degrees

• Hight of the bar at the level of the ______ (3 answers)

• ______ inch of space between each hip
  

Measuring parallel bars:

• Elbows should be flexed 20-30 degrees

• Hight of the bar at the level of the greater trochanter, wrist crease or ulnar styloid

• 2-4 inch of space between each hip

If the patient has ________ we mainly use elbow flexion to measure the parallel bars

pelvic obliquity

Used when maximum patient stability and support are required for ambulation

For patients with debilitating conditions that preclude crutches

Walker

walkers provide greater ___________ stability

Lateral and anterior stability

Walkers provide at least how many percent of support?

75%

Measurement of walkers

same with parallel bars

This walker facilitates mobility in the community, also can be used for pts who drive cars

Folding walker

Has two posterior extensions and additional hand grips off of rear legs for use on stairs

Stair Climbing walker

Facilitate continuous movement sequence

Rolling walker

Rolling walkers are contraindicated for patients with _______

parkinson’s

Walkers that are hinged and allows advancement on one side of the walker at a time

Reciprocal walker

Prerequisite for a reciprocal walker:

Iliopsoas grade of 3/5

Modified walker for one hand use, for stroke patients

Hemiwalker

If fitting of the walker/parallel bar is too high, it can promote trunk _________

Trunk extension

Trunk flexion if too low

Used to increase BOS, provide moderate degree of stability, or relieve weight bearing on LE

Crutches

Crutches provide at least how much percentage of support

50%

Fitting of the crutches is important because it can damage nervous and vascular tissue, what specific blood vessel and nerve can be injured?

Radial nerve and axillary artery

Measurement of crutches in standing:

• Multiply patient’s height by _____

• Subtract patient’s height by _____

Measurement of crutches in standing:

• Multiply patient’s height by 77%

• Subtract patient’s height by 16 inches

Measurement of crutches in supine:

• Anterior ______ to a point ______ lateral to the heel

Measurement of crutches in supine:

• Anterior axillary fold to a point ~ 6-8 inches lateral to the heel

Measurement of crutches in sitting:

• (B) UE 90 degree _______

• 1 elbow flexed to ______ one extended

• measure from __________ of flexed elbow to the tip of the long finger of the extended elbow

Measurement of crutches in sitting:

• (B) UE 90 degree abduction

• 1 elbow flexed to 90 degrees one extended

• measure from olecranon process of flexed elbow to the tip of the long finger of the extended elbow

Handpiece height of crutches:

same as parallel bars and walkers

Crutches of forearm cuff should be located approximately ___________ inches distal to the olecranon process when the patient grasps the handpiece

1 to 1.5 inches

This type of crutch has less stability, more ease of movement and can free your hands without dropping the crutches.

Forearm crutch

This crutch allows WB on the FA and is used for patients who can’t WB on hands

Forearm platform crutch

for forearm platform crutches, the platform attachment should be adjusted to provide _________ degrees of elbow flexion

90 degrees

AD mainly used for pain relief or movement in narrow spaces

Provides limited stability

Has a C-shaped handle which helps redistribute pressure

Canes

canes provide how much percent of support

25%

Types of canes:

• Wood/Aluminium canes

• Standard single point cane

• Quad cane

Cane measurement in supine:

• Distance from the _____ to the ______ with hip and knee straight

Greater trochanter to the heel

For canes and walkers, when measuring while standing, position the tip ____ lateral and ______ anterior to the toe of the shoes

2 inches lateral, 4 to 6 inches anterior to the toe of the shoe

Ambulation pattern if pt is indicated for WBAT with one crutch or one cane

Modified four point, modified two point

WBAT with axillary crutches or bilateral canes

Four point, two point, three-one point

FWB with one crutch or one cane

Modified four point, modified two point

NWB with walker or bilateral crutches

Three point

WBAT to FWB with reciprocal walker, bilateral crutches or bilateral canes

Four point, two point

PWB with walker or bilat crutches

Three one point