FUNDAMENTALS LECTURE 7: GAIT TRAINING & AMBULATION (EXAM II)

_____ is mobility activity (walking)

Ambulation

____/_____ ____: sequence of movements of the LE to permit ambulation

Gait/gait pattern

____ ___ is the process of teaching a patient to ambulate (service provided by a trained professional)

Gait training

____ ____ is initial contact of one limb to initial contact of the same limb

Gait cycle

____ ____ is initial contact of one extremity to initial connect of other extremity

Step length

____ ____ is R step & L step

Stride length

Ask the patients _____ if their gait is normal

Family

Stance is ____% of gait cycle

60%

Swing is ____% of gait cycle

40%

____ ____ ___ is when both feet are on the ground at the same time

Double limb support

There are ____ periods of double limb support in each gait cycle

2

_______ is time spent in stance, swing, double limb support, gait speed (temporal)

Time

____ is step/stride length, distance between feet, toe in/out (spatial)

Distance

You may need a ____ walker with someone with toe out

Wider

Gait is a ____ ____

Vital sign

____ ____:

- parallel bars

- walkers

- crutches

- canes

Assistive devices

Indications for ____ ____:

- structural deformity, amputation, injury, or disease resulting in decreased ability to bear weight through LE

- muscle weakness or paralysis of the trunk or LE

- inadequate balance and/or coordination

Assistive devices

Rolling walkers are more ____

Mobile

Hemi walkers are more ____

Stable

Patient needs good ___ __ to use a rollator

Grip strength

Reverse walkers allow for more ____ posture

Upright

You weight bear on ____ side with a knee walker

One

Ring walkers are good for someone who needs more ____ support

Trunk

Watch for sore underarms and brachial plexus injuries with ____ crutches

Axillary

_____/____ crutches allow the crutch to stay with you

Forearm/loftstrand

____ cane can stand on its own

Quad

____-____ degrees of elbow flexion should be seen when fitting an AD

15-25

Fitting an ____ ____:

- ask patient about height

- set height of AD

- stand patient & ambulate or sit patient down to make adjustments

Assistive device

Weight bearing status is typically provided by the ____ ___

Referring physician

____ ____ ____ is the amount of weight that can be borne on an extremity

Weight bearing status

Weight bearing status from ___ restrictive to _____ restrictive:

- NWB

- TTWB

- PWB

- WBAT or WBTT

- FWB

Most; least

_____ ____ are selected sequence of movements for the AD & LEs

Gait patterns

____ ____ are determined by the PT

Gait patterns

____ ____ are selected based on:

- WB status

- strength

- ROM

- balance

- stability

- coordination

- general cognition

- living environment

Gait patterns

____ ____:

- 3 point

- 4 point

- 2 point

- swing to

- swing through

Gait patterns

Things to consider during ____ ___:

- sit to stand

- overall posture

- equal step length

- symmetrical timing

- overall speed

- position of AD

Gait training

Goal of ____ ____:

- help the patient walk as normally as possible

Gait training

____ point gait:

- impairment of 1 LE

- step to & step through

- AD is 1 point

- each LE is 1 point

- AD, step, step

- advance AD first

- follow with involved LE then uninvolved LE

3

___ point gait:

- impairments of limiting WB, strength, pain, balance, stability, coordination, or reconditioning

- 2 AD required

- WB status must be nearly FWB or FWB

- each AD is 1 point

- each LE is 1 point

- AD, step, AD, step

- advance AD first

- opposite arm & leg

- repeat opposite side

4

____ point gait:

- impairments of limited WB, strength, pain, balance, stability, coordination, or reconditioning

- 2 AD required

- WB status must be nearly FWB or FWB

- advanced 4 point gait

- AD + opposite LE is 1 point

- opposite AD & LE is 1 point

- symmetrical weakness, BLEs, trunk

2

____ ____/____ ___:

- both LE advance together

- must be able to bear weight on one LE

Swing to/swing through

____ ___ is when you land at the same point as the AD

Swing to

____ ____ is when you land past the AD

Swing through

Perform swing ___ before swing ____

To; through

____ to ____:

- wheelchair locks on

- scoot to edge of the chair

- at least one hand on the wheelchair

Sit to stand

____ to ____:

- back of knees touching the edge of the chair

- one hand reaches back for armrest

- sit back as far as possible

Stand to sit

Always use a ___ ___ on a patient

Gait belt

The PT should be on the patients ____ side

Involved

PT should stand to the side and slightly ____ the patient

Behind

The patient must always have on non skid _____ during ambulation

Footwear

______:

- near the patient and able to provide verbal or physical assistance as needed

Supervision

____ ___:

- close to the patient with hands on the patient or on the gait belt able to provide immediate physical assistance as needed

Contact guard

_____ assist:

- patient able to perform > 75% of activity

Min

____ assist:

- patient able to perform 50-74& of activity

Mod

____ assist:

- patient able to perform 25-49% of activity

Max

_____:

- able to complete activity/function without assistance

Independent

_____ ____:

- independent with modifications (AD, increased time, bedrail)

Modified independent

_____ ____ ____:

- near patient and able to provide verbal or physical assistance as needed

Stand by assist

______:

- patient does not perform any of the activity

- 100% on the therapist

Dependent

Stability provided by device ____ to ____ stable:

- parallel bars

- walker

- axillary crutches

- forearm (lofstrand) crutches

- 2 canes

- 1 cane

Most to least

Patient coordination required to use AD ____ to ___ stable:

- parallel bars

- walker

- 1 cane

- 2 canes

- axillary crutches

- forearm (lofstrand) crutches

Least to most

As the amount of WB permitted is reduced and number of involved limbs increases, _____ external support is needed

More

As strength decreases and the number of limbs involved increases, ____ external support is needed

More

As balance impairment increases, ____ external support is needed

More

As WB status changes, ____ ___ also changes

Gait pattern

As patient performance and confidence in the AD improve, the ____ ____ may change

Gait pattern

Selection of ____ ____ is based on:

- WB status

- strength

- number of limbs involved

- severity of balance impairment

Gait pattern