Gait

Overview

This document serves as a comprehensive guide based on the transcript of a class session discussing upcoming exams, laboratory sessions, and practical applications related to gait aids and patient mobility. Key points include the exam schedule, a detailed explanation of the practical assessments, and terminology related to aiding patient mobility as well as their respective gait patterns.

Exam Schedule Overview

The exam has been structured with specific sessions for skills and practical assessments.

Final Exam Details

  1. Date and Time:

    • Wednesday, December 10 from 08:30 to 10:20 in the lab.

  2. Preparation:

    • Students will be in the lab during the final exam, with an emphasis on reviewing scenarios during the exam.

    • Each student will be assigned a time, e.g., Beta at 11:15, with a 10-minute reading period for scenarios on an 8.5" by 11" paper.

  3. Scenario Structure:

    • Each student will encounter a different scenario. It’s crucial to avoid discussing scenarios with peers to ensure integrity during the exam.

  4. Materials Required:

    • Students must bring the OTP tape set and other designated items related to their practical exercises.

Anatomy Exam

  1. Date: Tuesday preceding the practical exams.

  2. Content: Focus on vital organs including the brain, heart, lungs, emphasizing a BellRinger style of practical.

  3. Review Date:

    • This Friday’s class will be dedicated to labeling and discussing models related to anatomy.

Practical Exam with High School Students

  1. Date: Scheduled for week 14, during anatomy time.

  2. Purpose: Students will teach 15 high school students about vital signs, specifically focusing on blood pressure and heart rate monitoring.

  3. Evaluation: This teaching experience contributes to the practical exam marks, emphasizing the demonstration of knowledge and competence.

    • A comprehensive guide will be provided for this instruction, similar to the skills guides previously used.

Patient Mobility and Gait Aids

Importance of Gait Aids

Gait aids are crucial for individuals needing assistance with mobility. They help promote safety, stability, and mobility for patients with varying levels of strength, coordination, and balance.

Types of Gait Aids and Their Uses

Crutches

  1. Types:

    • Axillary Crutches: Commonly used; require upper body strength.

    • Forearm Crutches: More ergonomic and allow for free use of hands; ideal for long-term use.

    • Gutter Crutches: Useful for individuals with wrist limitations (e.g., rheumatoid arthritis).

  2. Considerations:

    • Assess the user’s upper body strength and coordination before prescribing crutches.

    • Proper sizing and fitting of crutches are critical to avoid discomfort and injury.

Canes

  1. Types:

    • Single Point Cane: For minor balance issues.

    • Quad Cane: Provides more stability and is suitable for individuals with significant balance impairments.

  2. Usage Guidelines:

    • Should be used oppositely to the affected leg for optimal support (i.e., if the left leg is weak, hold the cane in the right hand).

Walkers

  1. Types:

    • Standard Walker: Offers maximum stability, often used during recovery, especially post-surgery.

    • Two-Wheeled Walker: Provides slightly more mobility but less stability than a standard walker.

    • Four-Wheeled Walker (Rollator): Incorporates a seat for resting and is used for individuals with greater mobility needs.

  2. Functionality:

    • Necessary to properly adjust the height to ensure efficiency and safety.

    • Techniques for sitting down and standing up with a walker are crucial for safety, emphasizing initiation from the non-affected side.

Weight Bearing Status Terminology

Understanding weight-bearing statuses is critical for guiding rehabilitation and mobility strategies for patients.

  1. Full Weight Bearing (FWB): Patient can stand and walk with no restrictions.

  2. Non-Weight Bearing (NWB): Patient cannot place any weight on the affected limb.

  3. Partial Weight Bearing (PWB): Patient can put some weight on the affected limb, often specified in percentage (often 50%).

  4. Toe Touch Weight Bearing (TTWB): Patient may only rest toes on the ground for balance.

  5. Feather Weight Bearing (FWB): Similar to TTWB, but more emphasis on minimizing contact with the ground.

  6. Pain Bearing With Tolerance: Patients can weigh as much as they can withstand, usually represented in terms of comfort levels.

Gait Patterns

Gait patterns describe how a patient uses gait aids in conjunction with walking. Understanding these is crucial for clinical practice. Common patterns include:

  1. Four-Point Gait: Two crutches/canes move separately, maintaining three points of contact at all times.

  2. Modified Four-Point: Only one gait aid is used, alternating with legs.

  3. Three-Point Gait: Most applicable for non-weight bearing scenarios, utilizing crutches while the affected leg stays elevated.

  4. Two-Point Gait: Moving a crutch/cane and the opposite leg simultaneously; offers greater mobility for patients without significant restrictions.

  5. Swing-To and Swing-Through Patterns: Particularly utilized with crutches where both limbs are swung forward to the crutches or through the crutches.

Practical Notes

  • Ensure that the setting for teaching or practicing these skills is safe and conducive to learning.

  • Encourage peer interaction for practicing explanations of weight-bearing statuses and gait patterns.

  • Address potential challenges associated with different gait aids, providing tailored recommendations based on patient needs.

Conclusion

Effective use of gait aids, understanding patient mobility, and applying rehabilitation strategies are crucial aspects of patient care in physical therapy and rehabilitation settings. The proper education and demonstration of skills were emphasized throughout this session, preparing students for their practical exams and real-world applications. Follow-up discussions will further clarify practical applications and examination techniques in upcoming classes.