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1. Improving stability and mobility,
2. Compensate for decreased balance, strength, coordination, pain or weight bearing,
3. Expanding the base of support (BOS),
4. Enhance body functions, &
5. Assist with fracture healing.
The purpose of ambulation aids include:
c. Improving muscle strength.
All of the following are the purposes of ambulatory device use except:
a. Improving stability and mobility.
b. Expanding the base of support (BOS).
c. Improving muscle strength.
d. Assist with fracture healing.
The ability to walk without the need for any assistance.
What is ambulation?
False.
Parallel bars, tilt tables, supported suspension, and AlterG are all ambulation devices.
True or False?
True.
Parallel bars, tilt tables, supported suspension, and AlterG are all preambulation devices.
True or False?
Tilt table.
What preambulation device would you use to get a patient to physiologically acclimate to an upright standing position?
1. Know medical record,
2. Assess & determine patient goals,
3. Gait pattern taught by PT,
4. Tell or show patient what you will do, &
5. Apply gait belt.
What things must the OT know before ambulating a patient?
Patient's footwear,
Monitor vitals,
Hand placement,
Assess area,
Guarding patient,
Protect IV's/Catheters (appliances), &
Never leave patient unattended.
What are some precautions an OT should take for Ambulation?
Cognitive level,
Safety,
Functional abilities,
Vestibular function,
Vision,
Physical endurance,
Upper Body strength, &
Living Environment.
Considerations for the appropriate candidates include:
Non-weight bearing; 0% body weight.
What weight-bearing status does "NWB" stand for? How much weight should they put on their feet?
Toe-Touch Weight bearing; 10-15% body weight.
What weight-bearing status does "TTWB" stand for? How much weight should they put on their feet?
Partial Weight bearing; 30-50% body weight.
What weight-bearing status does "PWB" stand for? How much weight should they put on their feet?
50%.
How much weight should a patient put on their feet if they are "weight bearing?"
Full Weight Bearing; 75-100% body weight.
What weight-bearing status does "FWB" stand for? How much weight should they put on their feet?
Weight Bearing As Tolerated; 75-100% body weight.
What weight-bearing status does "WBAT" stand for? How much weight should they put on their feet?
Hemi walker (HW).
What type of walker is this?
Standard walker (SW).
What type of walker is this?
Front wheeled walker (FWW).
What type of walker is this?
Four wheeled walker (4WW).
What type of walker is this?
Standard walker (SW).
What walker would a patient who wants the most stability use?
Front wheeled walker (FWW).
What walker would be ideal for cardiac patients who needs to conserve energy.
Hemi walker (HW).
What walker would a patient who suffered a head injury use?
Four wheeled walker (4WW).
The elderly and long term users tend to prefer this type of walker:
True.
All 4 feet of the walker must be on the ground before a step is taken.
True or False.
Flat side.
What side of a hemi (quad) cane should face toward the patient's leg?
Left hand.
Which hand holds the cane if the right leg is affected?
Locked Knee aka "Trick knee."
A condition in which the knee is fixed in either a flexed or an extended position, often caused by longitudinal splitting of the medial meniscus.
Wrist crease.
Standing with elbow flexed at 20-25 degrees, what part of the body should the handle(s) of a cane, walker, or crutch line up?
Measure from Greater Trochanter (hip) to base of Heel (foot).
If patient is supine, how is a cane or walker adjusted for the correct height?
Forearm crutch.
What type of crutch is this?
Standard (axillary) crutch.
What type of crutch is this?
No.
Should the elderly be recommended crutches?
Forearm crutch.
What type of crutch should someone with Spina Bifida use for long term?
2.
To correctly fit crutch length, how many fingers should fit between the armpit and crutch when patient is standing with "tip" of crutch 2 inches lateral and 4-6 inches anterior to toes and angled at 45 degrees?
1 to 1.5 inches below Olecranon.
Where should the forearm cuff of a forearm crutch be worn?
Walkers.
The most supportive of ambulation aids are:
Straight canes.
The least supportive of ambulation aids are:
c. Bilateral cane.
Which of these offer the least support?
a. Bilateral crutches.
b. Single crutch.
c. Bilateral cane.
c. Bilateral cane.
Which type of cane offers the most support?
a. Straight cane.
b. Quad cane.
c. Bilateral cane.
d. Hemi cane.
Move ambulation device in front of patient, put gait belt on patient.
In sit-to-stand transfers from a chair, what should the OT do first?
Move to front of seat, leaning with "nose over toes."
In sit-to-stand transfers from a chair, what should the patient do first?
Push up from arm of chair (never ambulation device!).
In sit-to-stand transfers from a chair, what should the patient do second?
Guard patient from weaker side of patient with gait belt.
In sit-to-stand transfers from a chair, what should the OT do as the patient tries to stand?
False.
When assisting a patient up a set of stairs, OT's feet should be on the same step.
True or False?
Behind patient.
When assisting a patient up a set of stairs, where should OT be standing in relation to the patient?
In front of patient.
When assisting a patient down a set of stairs, where should OT be standing in relation to the patient?
Affected leg.
When assisting a patient down a curb, after moving the ambulation device first, which leg moves next?
Healthy leg.
When assisting a patient up a curb, after moving the ambulation device first, which leg moves next?
