Gait and Ambulation Flashcards
Gait Training vs Ambulation
Gait Therapy
* Requires assessment by PT (rhythm, cadence, step, stride and speed)AND
* Skilled intervention designed to create a change in gait / function / skill.
Ambulation
* Nonskilled – can be done by rehab aide, family, other caregivers
* “Maintenance” therapy
* “Pt walked 100 ft with walker. No balance problems”
Qualitative - Gait analysis
Observational Gait Analysis
Lab Based Gait
Quantitative - Gait Analysis
Walking distance
Walking speed
Walking endurance
Standardized Assessments
How far can they walk without sitting down?
Observational Gait Analysis Terms
Phases of Gait
- Stance and swing
Gait Cycles Terminology
- Stride length
- Step length
- Cadence
- Velocity
- Width of base of support
Objective Outcomes Measures: Acute and Beyond
- Physiologic Indicators: Pre and Post
– BP, HR, Respiration, Pulse O2 - Perceived exertion or VAS rating of fatigue
- Gait speed (with age related norms)
- Functional Reach (full WB)
- Performance-Oriented Mobility Assessment (POMA)
how do they tolerate activity?
Ex: BP went way up
Objective Outcome Measures: Sub-acute care
Activities-Specific Balance Confidence (ABC); Must be full weight bearing to get accurate reading
Dynamic Gait Index (Full WB)
Functional Gait Assessment (Full WB)
Name 2 gait speed / velocity standardized assessments
TUG, 6 minute walk test, 10 meter walk test
Allows you to be able to test to see if they can be a community ambulator.
WB Restrictions and Gait
- Restrictions can affect gait if UE or LE are compensating
Monitoring WB
Bathroom Scales
– Having patient shift weight from one scale to the other provides feedback about static WB equality
Limb-Load Monitor (LLM)
– Audible feedback to patient and clinician regarding WB during gait is provided.
– Sensitivity can be adjusted according to patient’s WB restrictions.
- NEVER PLACE FINGER UNDER SHOE
Explain step-to vs step-through gait pattern.
- Step to: B crutches go forward; feet step to be in line w crutches
- Step through: B crutchrs go forward; feet step beyond/thru the crutches, most similar to regular gate
Explain swing-to vs swing-through gait pattern.
Swing to: swing to the crutches; NOT BEYOND
Swing through: swing beyond the crutches.
Which of these 4 gait patterns most closely represents a normal gait pattern?
Step through
Mobility Distances
- Ability to ambulate 0 to 50 feet = single direction household ambulator (needs rest breaks between trips)
- Ability to ambulate 50 to 150 feet = full household ambulator (can easily walk between rooms for tasks without rest)
- Ability to ambulate > 150 feet = able to leave the home (out to the car or from car into clinic / store)
These also apply for wheelchair mobility
Community Ambulation Requirements
- Walk >330 meters continuously (1088 feet)
– Based on mean distance measured:
— eg, supermarket, drugstore, bank, MD office, post office, department store. - Negotiate curbs (up to 7 inches in height)
- Use gait speed > 1.3 m/s
– eg, cross street
This applies to someone who is very independent.
Preparation for Gait
- Assess transfers
- Assess standing tolerance
- Assess standing mobility in place
* Note swing limb clearance
* Note stance limbstability
* Determine best device
Guarding during Gait
- Typically behind and slightly to the weaker side
- Control points: pelvic and shoulder girdles
- For gait requiring hands-on guarding, one hand is typically grasping the gait belt and the other hand hovers at the contralateral shoulder.
- Clinician should walk on the weaker side to better be able to guard.
Gait Patterns
Won’t be tested but good to know for documentation
