Card Set Information
What are some factors that influence walking?
sensation (proprioception in feet)
external appliance (brace)
What 2 phases are included in the gait cycle?
stance and swing
What is the first phase of the gait cycle?
period of time when at least 1 foot is in contact with the ground
What are the 5 components of the stance phase in order?
What is the 2nd phase of the gait cycle?
period of time when foot is not in contact with the floor
What are the 3 components of the swing phase in order?
acceleration (limb swinging forward)
mid-swing (when foots under the greater trochanter)
deceleration (limb coming back down)
What happens right after deceleration of the swing phase?
heel-strike of the stance phase in other foot
What is a cycle?
time that 1 foot is in contact with the ground
heel-strike to heel-strike of same foot
What is base of support?
width of stance/walking base
What is stride length?
distance between heel strikes of same foot
What is step length?
measurement of heel strike of 1 foot to heel strike of other foot
What is cadence?
number of steps per unit of time
What is double support?
both feet on ground at the same time
What UE muscles are very important to strengthen?
What LE muscles are important to strengthen?
hip extensors (gluts, hamstrings)
hip abductors (gluteus medius)
knee flexors (hamstrings)
knee extensors (quads)
ankle dorsiflexors (tibialis anterior)
What are some types of gait patterns?
modified 2 point
modified 4 point
What is the general progression of assistance levels? (5)
parallel bars ->axillary crutches ->forearm crutches ->quad cane ->cane
What are some general safety precautions?
guard slightly behind and on affected side
physiologic response (vitals)
What should be included in the gait progress note?
type of assistive device
gait pattern with amt of weight bearing
level of independence
transfers (level of independence, tolerance)
What is the purpose of parallel bars, and where do you spot from?
measuring for another AD
teaching new gait pattern
spot from inside the bars; in front of pt if 1 person, if 2 people, one in front and one in back
How do you measure a pt for pbars?
15-25 degree flexion at elbow when hands are on bars 6" ant. to hips (stand with elbows straight and 6" ant. to hips, bars should rest at the wrist crease)
2" from hip to bar on each side
What is the purpose of crutches (axillary, forearm, longstrand, canadian)?
widen pts BOS for greater stability
allow us to limit weight bearing
What are the components of crutches?
Who is normally going to use longstrand crutches?
paraplegics - they're for long term use
How do you measure for axillary and forearm crutches?
feet 2-3" apart
tip of crutch 2" lat. and 4-6" ant. to toe
2-3 finger widths between armpit and pad
15-25 degree elbow flexion when hands are on grips (wrist crease should come to pad with elbows straight)
*forearm- same except arm cuff shold be 1-1 1/2" below elbow
How do you teach a patient to get out of a chair while on crutches?
hold both crutches on the affected side, and push up from the chair arm on the unaffected side
When would you use a platform crutch?
when pt is NWB on wrist.
helps rest the arm (handle to hold onto)
What are some indications that you need to use a cane?
assist with balance (dont want to rely on for WB-more for balance)
decreased balance, coordination, strength
slight decreased WB
In which hand would you hold a cane?
ALWAYS in the good sides hand (unaffected side)
What are some disadvantages to canes?
safety (hard to keep all 4 tips down at once)
hard to use on stairs
What hand do you hold a hemi cane in, and what is the disadvantage of it?
always hold in good sides hand
pt tends to lean on them
*measure same as crutches
What are disadvantages of a walker?
hard to safely use on stairs
hard to use normal gait patterns
How do you measure for a walker?
stand pt with feet at back of walker (back walker leg should be in middle of foot)
15-25degree of elbow flexion (measure wrist crease when arms are straight)
What are some types of walkers?
When ambulating with an AD, which leg should move with the device?
bad leg ALWAYS goes with device
What gait patterns require bilateral ambulation aids?
modified 3 point (three one)
What gait patterns require only unilateral AD?
modified 4 point
modified 2 point
What is the 4 point gait sequence?
always maintaining 3 points of contact
The 2 point gait can be performed more rapidly than the 4 point; what is the 2 point sequence?
right UE and left LE together
left UE and right LE together
requires more coordination and balance than 4 point
What is the sequence of the modified 4 point gait?
AD held in the uninvolved hand
AD, then bad leg, then good leg
sometimes called hemi gait or hemi pattern
The modified 2 point is the natural progression from the modified 4 point; what is the gait sequence of the modified 2 point?
AD held in uninvolved hand
AD and bad leg together, then good leg
What is the only gait pattern used for NWB?
3 point pattern
What is the gait sequence of the 3 point pattern?
both AD's forward, than hop to or swing through the device with good leg (NWB leg is held in air)
When turning with AD's, which way should you turn?
toward the good side if possible
In the modified 3 point pattern, PWB is permitted on involved leg; what is the gait pattern?
AD's and infected leg together, then uninvolved leg
What types of pts use the drag to/swing through gait patterns?
paraplegics - they're unable to use any LE musculature so they use their trunk to swing through
What is the gait pattern of the drag to/swing through gaits?
AD's forward then use trunk muscles to drag legs to/through the AD's