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ADL > Assistive Devices and Gait, ADLs > Flashcards

Assistive Devices and Gait, ADLs Flashcards

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
Q

very stable developmental position in which patient can strengthen muscles of shoulders, neck, arms and neck

A

prone on elbows

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26
Q

stable position in which patient can have lower extremity strength or balance challenged

A

hook lying/bridging

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27
Q

table that starts in horizontal position, then can slowly raise patient to 90 degree angle (would stop by 80 though!)

A

tilt table

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28
Q

patient responses on a tilt table that require patient to be returned to more horizontal position

A

significant heart rate increase or blood pressure drop

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29
Q

devices that may be used to help keep blood flow up toward brain when attempting to tolerate upright position

A

abdominal binders, compression stockings

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30
Q

patient signs and symptoms of intolerance to upright position

A

significant heart rate increase or blood pressure drop, dizziness, nausea, loss of consciousness, vision changes, pallor, lower extremity edema, excessive perspiration

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31
Q

parallel bar activities

A

weight shifts (gait), lifting one hand then both (balance), push-ups (strength), lift 1 lower extremity, gait patterns, sidestepping/backward walking/turning

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32
Q

position of PT/PTA when working with patient in parallel bars

A

inside the bars, hand on gait belt

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33
Q

harness system to suspend patient from upright so patient can practice gait on treadmill without fear of falling

A

body weight support treadmill

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34
Q

considerations when assigning a patient an assistive device

A

strength, balance, endurance, home setup, caregiver assistance required, WB status, cognition

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35
Q

progression from most restrictive device to least restrictive device

A

parallel bars>walker>cane
walker>hemi walker>quad cane>single point cane
walker>crutches>single point cane

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36
Q

most appropriate use for single point cane (SPC)

A

incidental balance needs

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37
Q

cane with 4 points in contact with the ground

A

quad cane

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38
Q

fit for a cane or walker

A

standing if possible, handle should reach wrist crease or greater trochanter

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39
Q

placement of cane

A

opposite of affected or weaker limb

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40
Q

device for patients who weigh over 200-250 pounds

A

bariatric AD

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41
Q

used when patient lacks good hand grip strength or has WB restrictions/pain on 1 or both forearms/wrists/hands

A

platform attachments

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42
Q

amount of elbow flexion patient should have when assessing fit of walkers/canes/ crutch handgrips

A

20-30 degrees

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43
Q

assessing fit of axillary crutches

A

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
Q

assessing fit of Lofstrand crutches

A

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
Q

moment of initial contact of one lower extremity to initial contact of same lower extremity

A

gait cycle or stride

46
Q

when 1 lower extremity is in contact with the floor

A

stance

47
Q

when the lower extremity is not in contact with the floor

A

swing

48
Q

60% of gait cycle

A

stance

49
Q

40% of gait cycle

A

swing

50
Q

period when both lower extremities are in contact with the ground

A

double support

51
Q

distance of the gait cycle

A

stride length

52
Q

distance between the initial contact of one lower extremity and initial contact of other lower extremity

A

step length

53
Q

walking faster

A

less double support

54
Q

subphases of stance

A

initial contact (heel strike)
loading response
midstance
terminal stance (heel off)
preswing (toe off)

55
Q

subphases of swing

A

initial swing (acceleration)
midswing
terminal swing (deceleration)

56
Q

average stride lengths

A

men=62 inches
women=52 inches

57
Q

normal step width

A

2-4 inches

58
Q

gait problem seen with weak dorsiflexors

A

unable to clear foot from floor during swing

59
Q

gait problem seen with weak hamstrings

A

knee hyperextension during stance

60
Q

gait patterns used with walkers

A

3 point, 3 point modified

61
Q

gait patterns used with bilateral axillary crutches

A

3 point, 3 point modified, four point, 2 point

62
Q

gait patterns used with unilateral crutch or cane

A

modified 2 point, modified 4 point

63
Q

gait patterns used with bilateral forearm (lofstrand) crutches

A

four point, 2 point

64
Q

device choices for NWB status

A

walker, bilateral axillary crutches

65
Q

device choices for PWB or TTWB (TDWB)

A

walker, bilateral axillary crutches

66
Q

lower extremity to move first when ascending stairs

A

unaffected (intact)

67
Q

therapist position when guarding patient during gait training

A

on affected side and slightly behind patient

68
Q

patient swings lower extremity to point where crutches or walker tips are located on ground

A

step to

69
Q

patient advances intact lower extremity a bit beyond the tips of the AD

A

step through

70
Q

first move when patient is alone and begins to fall is

A

move assistive device(s) out of the way

71
Q

patient education on falling backwards includes

A

flex trunk, bring chin to chest

72
Q

patient education on falling forward

A

release AD, use upper extremities to break fall

73
Q

directions to patient when educating on descending stairs

A

crutches down first, followed by affected lower extremity (or simultaneously) followed by unaffected lower extremity

74
Q

directions to patient when ascending stairs

A

advance unaffected lower extremity, followed by AD, then affected lower extremity (or last 2 simultaneously)

75
Q

items to include in documentation of ADs and gait

A

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
Q

therapist position when patient is descending stairs

A

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
Q

goal when patient is losing balance during gait training( more than minor LOB)

A

slow down patient’s descent to floor

78
Q

extremity circles around to accommodate for lack of clearance during swing phase

A

circumduction

79
Q

hyperextension of knee during stance phase

A

genu recurvatum

80
Q

shuffling gait, festination, forward head, rounded shoulders, decreased arm swing, decreased or no heel strike, decreased trunk rotation

A

Parkinsonian gait

81
Q

hip drop on side opposite of weak muscle during swing

A

Trendelenburg gait

82
Q

wide BOS, abducted lower extremities, jerky/uncoordinated movements, staggering

A

ataxic gait

83
Q

shortened stance phase on affected limb; shortened step length on uninvolved side, decreased arm swing

A

antalgic gait

84
Q

series of tests that are used to determine a person’s ability for work, ADL, and other recreational activities

A

Functional Capacity Evaluation (FCE)

85
Q

basic activities of daily living (BADLs)

A

bed mobility
transfers
gait training
wheelchair training
toileting
grooming
feeding
bathing
dressing
rest/sleep

86
Q

MRADL

A

mobility-related ADLs

87
Q

IADLs

A

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
Q

MRADLS of grooming, dressing, feeding, toileting, bathing and IADLs often are addressed by

A

occupational therapists/certified occupational therapy assistants

89
Q

Provide examples of collaborations btwn OT/PT

A

See slides 5-9 of Erin’s PPT for examples

90
Q

Special considerations for both OT and PT when working with patients that have certain conditions

A

Assessment of vital signs at rest and with activity
Post-op precautions-total hip, cervical, lumbar
weight bearing restrictions

91
Q

home assessment benefits

A

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
Q

PTA’s focus when documenting ADLs

A

functional nature of interventions performed

93
Q

areas to look at/for when performing home assessment

A

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
Q

gait assessment tools

A

Timed Up and Go
Tinetti Test (Performance Oriented Mobility Assessment)
Berg Balance Scale
Dynamic Gait Index

95
Q

footwear patient should wear when gait training

A

shoes or socks with non-slip tread on soles

96
Q

position of PTA when assisting patient from sit to stand

A

on weaker side and slightly behind

97
Q

factors to consider for guarding patients

A

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
Q

NWB; AD advances simultaneously with NWB lower extremity and then unaffected lower extremity advances

A

Three point

99
Q

PWB; AD advances, followed by PWB lower extremity (or can be done simultaneously); unaffected lower extremity advances next

A

Three-one point (modified three point

100
Q

FWB or WBAT; AD and opposite lower extremity alternately advance

A

Four point

101
Q

FWB or WBAT; utilizes 1 AD; AD and opposite (affected) lower extremity alternately advance

A

Modified four point

102
Q

FWB or WBAT; AD and opposite lower extremity advance simultaneously

A

Two point

103
Q

FWB or WBAT; utilizes one AD; AD and opposite (affected) lower extremity advance simultaneously

A

Modified two point

104
Q

cane types

A

single point cane, small-based quad cane, large (wide)-based quad cane, Hurrycane (3-point cane)

105
Q

walker types

A

standard, front-wheel (FWW), four-wheeled (rollator), three-wheeled (rollator), hemi-walker

106
Q

crutch types

A

axillary, forearm (Lofstrand)

107
Q

key components of motor learning

A

practice, feedback

ADL (4 decks)

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