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ADL > Assistive Devices and Gait, ADLs > Flashcards

Assistive Devices and Gait, ADLs Flashcards

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1
Q

a disturbance in motion that increases the chance of a breakdown in the [human movement system]

A

perturbation

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2
Q

patient is positioned in supine with bilateral knees flexed and feet flat on the floor or bed

A

hook lying

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3
Q

patient is allowed to put as much weight as possible through the extremity and is only limited by his or her pain tolerance

A

weight bearing as tolerated

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4
Q

patient is not allowed (generally due to physician order) to bear any weight on the extremity

A

nonweightbearing

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5
Q

patient is allowed to place full weight through the extremity and is not limited by pain

A

full weightbearing

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6
Q

patient is allowed to bear some weight on the extremity, but the amount is often dictated by the physician

A

partial weight bearing

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7
Q

manner or style of walking, stepping or running

A

gait

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8
Q

patient is allowed to only put weight through the tippy toes, sometimes limited to 10% of weight or less, to maintain balance only (not a functional WB status)

A

toe-touch or touch-down weightbearing

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9
Q

devices patients cannot use when NWB

A

canes, hemi-walkers, Lofstrands

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10
Q

only restrictions for weight bearing as tolerated

A

pain, mobility

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11
Q

devices patients cannot use when PWB

A

canes, hemi-walkers, Lofstrands

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12
Q

patient can use any device that meets his/her mobility needs

A

FWB status

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13
Q

biofeedback device used to alert patient of placing too much weight on extremity

A

weight-bearing monitor

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14
Q

safety maintenance

A

brakes locked, gait belt, hand on gait belt at all times if contact guard or more assistance required

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15
Q

sit to stand from chair with crutches

A

place both crutches in one hand, push up from armrest with other hand

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16
Q

stand to sit in chair with cruthces

A

back all the way until patient feels chair behind knees, place both crutches in one hand, reach back for armrest with other hand, lower slowly into chair

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17
Q

position of hands for sit to stand when using walker for gait

A

both hands push up from chair

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18
Q

position of hands for stand to sit when using walker

A

reach back for chair armrests to lower into chair

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19
Q

injury or poor posture leads to more or less efficient gait

A

less efficient gait

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20
Q

quadruped

A

on all fours; less stable than prone or hook lying; requires more strength and balance to maintain

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21
Q

exercise that involves contraction of muscles without any movement in the surrounding joints

A

isometric hold

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22
Q

position in which patient is fully upright without upper extremity support

A

plantigrade

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23
Q

position in which patient is on 2 feet with upper extremities supported on table top or parallel bars

A

modified plantigrade

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24
Q

postures that offer a chance to strengthen certain muscle groups while challenging balance to prepare for fully upright gait training

A

developmental postures

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25
very stable developmental position in which patient can strengthen muscles of shoulders, neck, arms and neck
prone on elbows
26
stable position in which patient can have lower extremity strength or balance challenged
hook lying/bridging
27
table that starts in horizontal position, then can slowly raise patient to 90 degree angle (would stop by 80 though!)
tilt table
28
patient responses on a tilt table that require patient to be returned to more horizontal position
significant heart rate increase or blood pressure drop
29
devices that may be used to help keep blood flow up toward brain when attempting to tolerate upright position
abdominal binders, compression stockings
30
patient signs and symptoms of intolerance to upright position
significant heart rate increase or blood pressure drop, dizziness, nausea, loss of consciousness, vision changes, pallor, lower extremity edema, excessive perspiration
31
parallel bar activities
weight shifts (gait), lifting one hand then both (balance), push-ups (strength), lift 1 lower extremity, gait patterns, sidestepping/backward walking/turning
32
position of PT/PTA when working with patient in parallel bars
inside the bars, hand on gait belt
33
harness system to suspend patient from upright so patient can practice gait on treadmill without fear of falling
body weight support treadmill
34
considerations when assigning a patient an assistive device
strength, balance, endurance, home setup, caregiver assistance required, WB status, cognition
35
progression from most restrictive device to least restrictive device
parallel bars>walker>cane walker>hemi walker>quad cane>single point cane walker>crutches>single point cane
36
most appropriate use for single point cane (SPC)
incidental balance needs
37
cane with 4 points in contact with the ground
quad cane
38
fit for a cane or walker
standing if possible, handle should reach wrist crease or greater trochanter
39
placement of cane
opposite of affected or weaker limb
40
device for patients who weigh over 200-250 pounds
bariatric AD
41
used when patient lacks good hand grip strength or has WB restrictions/pain on 1 or both forearms/wrists/hands
platform attachments
42
amount of elbow flexion patient should have when assessing fit of walkers/canes/ crutch handgrips
20-30 degrees
43
assessing fit of axillary crutches
crutch tips 2 inches lateral and 4-6 inches anterior to toes; 2-3 fingers between axilla and top of axillary rest; 20-30 degrees elbow flexion; hand grip at wrist crease
44
assessing fit of Lofstrand crutches
crutch tips 2 inches lateral and 4-6 inches anterior to toes; cuff 1-1.5 inches below olecranon process;20-30 degrees elbow flexion; hand grip at wrist crease
45
moment of initial contact of one lower extremity to initial contact of same lower extremity
gait cycle or stride
46
when 1 lower extremity is in contact with the floor
stance
47
when the lower extremity is not in contact with the floor
swing
48
60% of gait cycle
stance
49
40% of gait cycle
swing
50
period when both lower extremities are in contact with the ground
double support
51
distance of the gait cycle
stride length
52
distance between the initial contact of one lower extremity and initial contact of other lower extremity
step length
53
walking faster
less double support
54
subphases of stance
initial contact (heel strike) loading response midstance terminal stance (heel off) preswing (toe off)
55
subphases of swing
initial swing (acceleration) midswing terminal swing (deceleration)
56
average stride lengths
men=62 inches women=52 inches
57
normal step width
2-4 inches
58
gait problem seen with weak dorsiflexors
unable to clear foot from floor during swing
59
gait problem seen with weak hamstrings
knee hyperextension during stance
60
gait patterns used with walkers
3 point, 3 point modified
61
gait patterns used with bilateral axillary crutches
3 point, 3 point modified, four point, 2 point
62
gait patterns used with unilateral crutch or cane
modified 2 point, modified 4 point
63
gait patterns used with bilateral forearm (lofstrand) crutches
four point, 2 point
64
device choices for NWB status
walker, bilateral axillary crutches
65
device choices for PWB or TTWB (TDWB)
walker, bilateral axillary crutches
66
lower extremity to move first when ascending stairs
unaffected (intact)
67
therapist position when guarding patient during gait training
on affected side and slightly behind patient
68
patient swings lower extremity to point where crutches or walker tips are located on ground
step to
69
patient advances intact lower extremity a bit beyond the tips of the AD
step through
70
first move when patient is alone and begins to fall is
move assistive device(s) out of the way
71
patient education on falling backwards includes
flex trunk, bring chin to chest
72
patient education on falling forward
release AD, use upper extremities to break fall
73
directions to patient when educating on descending stairs
crutches down first, followed by affected lower extremity (or simultaneously) followed by unaffected lower extremity
74
directions to patient when ascending stairs
advance unaffected lower extremity, followed by AD, then affected lower extremity (or last 2 simultaneously)
75
items to include in documentation of ADs and gait
type of AD if you fit for device pt education on gait pattern and which one WB status level of assist cues required distance (on level ground) or number of stairs/rails other barriers navigated gait deviations noted-abnormal ROM/ms weakness/spasticity pain caregiver ed if applicable loss of balance any progressions-either attempted or planned
76
therapist position when patient is descending stairs
in front of patient with hand on gait belt/other hand at patient's shoulder or on rail, straddling 2 steps for increased stability
77
goal when patient is losing balance during gait training( more than minor LOB)
slow down patient's descent to floor
78
extremity circles around to accommodate for lack of clearance during swing phase
circumduction
79
hyperextension of knee during stance phase
genu recurvatum
80
shuffling gait, festination, forward head, rounded shoulders, decreased arm swing, decreased or no heel strike, decreased trunk rotation
Parkinsonian gait
81
hip drop on side opposite of weak muscle during swing
Trendelenburg gait
82
wide BOS, abducted lower extremities, jerky/uncoordinated movements, staggering
ataxic gait
83
shortened stance phase on affected limb; shortened step length on uninvolved side, decreased arm swing
antalgic gait
84
series of tests that are used to determine a person's ability for work, ADL, and other recreational activities
Functional Capacity Evaluation (FCE)
85
basic activities of daily living (BADLs)
bed mobility transfers gait training wheelchair training toileting grooming feeding bathing dressing rest/sleep
86
MRADL
mobility-related ADLs
87
IADLs
cooking, completing household chores, driving, manageing medications, managing finances, taking care of pets, caring for children, skills generally considered a part of person's role in the community
88
MRADLS of grooming, dressing, feeding, toileting, bathing and IADLs often are addressed by
occupational therapists/certified occupational therapy assistants
89
Provide examples of collaborations btwn OT/PT
See slides 5-9 of Erin's PPT for examples
90
Special considerations for both OT and PT when working with patients that have certain conditions
Assessment of vital signs at rest and with activity Post-op precautions-total hip, cervical, lumbar weight bearing restrictions
91
home assessment benefits
allows therapy staff to see pt's home and observe any challenges or obstacles pt may encounter when pt goes home and make recommendations about modifications prior to patient returning home (accessibility, safety, fall prevention)
92
PTA's focus when documenting ADLs
functional nature of interventions performed
93
areas to look at/for when performing home assessment
accessibility of home stairs--number? rails? door widths rugs, pets items within reach bathroom-tub/shower-grab bars? toilet-height, grab bars --does walker fit into bathroom? around bed? flooring type adequate lighting-also at night furniture-walk between? sit to stand from furniture?
94
gait assessment tools
Timed Up and Go Tinetti Test (Performance Oriented Mobility Assessment) Berg Balance Scale Dynamic Gait Index
95
footwear patient should wear when gait training
shoes or socks with non-slip tread on soles
96
position of PTA when assisting patient from sit to stand
on weaker side and slightly behind
97
factors to consider for guarding patients
pt weight, height, abilities (also your own), cognition --do you need a second person? is patient connected to catheter, IV, chest tube, oxygen? WB limitations-can patient maintain WB? clear path for gait training patient footwear vital sign monitoring correct fit of device gait belt, loss of balance potential
98
NWB; AD advances simultaneously with NWB lower extremity and then unaffected lower extremity advances
Three point
99
PWB; AD advances, followed by PWB lower extremity (or can be done simultaneously); unaffected lower extremity advances next
Three-one point (modified three point
100
FWB or WBAT; AD and opposite lower extremity alternately advance
Four point
101
FWB or WBAT; utilizes 1 AD; AD and opposite (affected) lower extremity alternately advance
Modified four point
102
FWB or WBAT; AD and opposite lower extremity advance simultaneously
Two point
103
FWB or WBAT; utilizes one AD; AD and opposite (affected) lower extremity advance simultaneously
Modified two point
104
cane types
single point cane, small-based quad cane, large (wide)-based quad cane, Hurrycane (3-point cane)
105
walker types
standard, front-wheel (FWW), four-wheeled (rollator), three-wheeled (rollator), hemi-walker
106
crutch types
axillary, forearm (Lofstrand)
107
key components of motor learning
practice, feedback

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