Gait Training and Patterns

Question 1

Considerations for safe ambulation

Answer 1

-use gait belt
-WB status
-strength and balance ability
-need assistance
-pt cognition and attentiveness
-alteration in coordinated movements
-lines and equipment
-type of surface ambulating on

Question 2

Preparation for ambulation

Answer 2

-review medical chart
-assess pt (ROM, muscle performance, sensation screen, balance/coordination, cognition/attentiveness/ability to follow commands)

Question 3

Pre-ambulation considerations

Answer 3

-assisted device to use
-amount of assistance required (ht/wt of pt)

Question 4

Position for level-ground ambulation

Answer 4

-stand behind and slightly to one side of pt
-initially stand to the side of pt’s affected/weak side
-hold gait belt w/ forearm supinated
-other hand above or near pt’s shoulder

Question 5

Dr. Z’s standing position for level-ground ambulation

Answer 5

general weakness - same side
surgical - opposite

Question 6

What are 4 different ways to report progression of ambulation?

Answer 6

-level of assist decreases
-able to meet modified surface challenges
-improvement in impairments
-increase in safety awareness

Question 7

3 types of gait patterns

Answer 7

4 point, 2 point and 3 point

Question 8

Describe four-point pattern (device used, steps of pattern w/ device)

Answer 8

-used w/ 2 canes or 2 crutches
-3 points always on the ground
-crutch pattern: opp ft, crutch, opp ft

Question 9

What is four-point pattern used for? Not used for?

Answer 9

-pt w/ very poor balance, pt unable to lift more than one point off ground safely
-NOT used for NWB

Question 10

Describe two-point pattern (device used, steps of pattern w/ device)

Answer 10

-used w/ 2 canes or 2 crutches
-2 points are on the ground at all times
-crutches: R crutch and L leg, L crutch and R leg

Question 11

What is two-point pattern used for? Not used for?

Answer 11

-approximates normal gait pattern, more stable and faster than 4-point pattern
-NOT used for NWB

Question 12

Describe three-point pattern (device used, WB restriction uses)

Answer 12

-3 points touch ground, not in sequence
-2 crutches or a walker
-NWB: always 3 point pattern
-PWB and WBAT: use 3 point pattern

Question 13

What is a pro and con of 3 point pattern?

Answer 13

pro: rapid ambulation
con: high energy expenditure

Question 14

Describe 3 point NWB pattern

Answer 14

pt moves crutches or walker forward then hops to it

Question 15

Describe 3 point PWB pattern

Answer 15

pt moves crutches or walker forward, step w/ weak and push down, then step w/ strong

Question 16

How to guard pt ascending stairs

Answer 16

stay behind and slightly to the side, outside foot on stair where pt is standing and inside foot on step below

Question 17

Describe how pt ascends stairs w/ walker

Answer 17

-position walker w/ closed side next to body
-front feel of walker placed on step above the step where pt stands
-step up w/ strong LE

Question 18

How to guard pt descending stairs

Answer 18

stand in front and to the side of pt; outside foot on the step the pt is going to step on and other foot one step below