Gait

Question 1

Movement system

Answer 1

motion
energy
force
motor control

Question 2

motion

Answer 2

ability of a joint or tissue to be moved passively

Question 3

energy

Answer 3

ability to perform sustained or repeated movements or sustaining motor performance over a long time

Question 4

force

Answer 4

ability of contractile and non contractile structures to produce movement and provide dynamic stability around joints

Question 5

motor control

Answer 5

ability to plan execute and adapt goal directed movements such that they are accurate, coordinated, and efficient

Question 6

FWB

Answer 6

Full weight bearing
No restrictions on WB
100% of BW can be borne on LE

Question 7

NWB

Answer 7

Non-weight bearing
No weight is borne on involved limb
foot/toes make no contact with floor/ground surface

Question 8

PWB

Answer 8

Partial weight-bearing
Only a portion of weight can be borne on extremity
sometimes expressed as percentage of body weight
eg 25% or 50%

Question 9

TTWB/TDWB

Answer 9

Toe touch weight bearing or touch down weight bearing
only toes of affected extremity contact the floor to improve balance, NOT to support BW

Question 10

WBAT

Answer 10

weight bearing as tolerated
WB is limited by patient tolerance of weight borne on extremity
usually between 50-100% of weight is tolerated

Question 11

Stability precedes

Answer 11

mobility

Question 12

Maintaining precedes

Answer 12

attaining

Question 13

Large boS precedes

Answer 13

Small BoS

Question 14

Low CoG precedes

Answer 14

High CoG

Question 15

What factors must be considered for pt handling?

Answer 15

weight
mental status
physical status
environment
footwear

Question 16

Gait belt precautions

Answer 16

not against skin
avoid incisions or ostomy bags
use supinated grip

Question 17

Types of transfers

Answer 17

lateral and vertical

Question 18

General procedure of lateral transfer

Answer 18

lift shift and lower

Question 19

Seated transfers

Answer 19

dependent lateral lift
lateral seated transfer w/ & w/o sliding board
A-P transfer w/ & w/o sliding board

Question 20

Pivot transfers

Answer 20

Squat and standing

Question 21

Patient conditions to consider during transfers

Answer 21

NWB, hemiplegia, SCI, post surgery

Question 22

When can a transfer be considered complete?

Answer 22

When patient is comfortable and secure and has a way to call for help

Question 23

Bed to Wheelchair
Independent sliding board transfer to left steps

Answer 23

angle right side of WC close to bed
lock chair
lean trunk to right, place one end of board under left hip and other end over wheelchair seat
place left hand out on board and press down with both hands
lift shit and lower hips
remove board

Question 24

clinical assistance in sliding board transfer
Guard position

Answer 24

front

Question 25

clinical assistance in sliding board transfer CCDD

Answer 25

control centrally, direct distally to assist with hip movement

Question 26

Assisted pivot transfer Guidelines to set up environment

Answer 26

footwear remove leg rest and arm rest equalize surface heights secure surfaces use gait belt for dependent transfers

Question 27

Ready position for assisted pivot transfer

Answer 27

Scooting hips forward in chair

Question 28

Assisted pivot transfer ready position

Answer 28

feet back, inner foot slightly inward trunk flexed hands placed on armrests

Question 29

Assisted pivot transfer clinician position

Answer 29

in front of patient hips and knees flexed, wide staggered stance inner foot slightly posterior supinated grip on gait belt

Question 30

Purpose of blocking knees

Answer 30

creates extension moment to counteract flexion moment at hips and knees

Question 31

Area of contact for knee blocking

Answer 31

pts proximal tibia

Question 32

Rise of assisted pivot transfer

Answer 32

count of 3 rocking momentum clinician leans posteriorly

Question 33

differences between squat and standing pivot transfers

Answer 33

uprightness hand placements pause when upright in stand -pivot

Question 34

How to assess ability to stand

Answer 34

is there a mobility or balance defecit? determine level of assistance/guarding

Question 35

How to assess ability to walk

Answer 35

is an AD needed? what type of AD is best for this person? determine level of assistance/guarding

Question 36

What assistive device is used first with gait training?

Answer 36

parallel bars are used prior to training w/ other devices

Question 37

types of walkers

Answer 37

standard rolling hemi

Question 38

types of crutches

Answer 38

axillary forearm

Question 39

types of canes

Answer 39

quad single-point

Question 40

When is it appropriate to progress from parallel bars?

Answer 40

when pt is able to walk the length of the bars with good form

Question 41

Guarding position

Answer 41

slightly behind pt and on involved side with limited weight bearing

Question 42

comparison of walkers

Answer 42

standard walkers require more energy than rolling rolling is faster but less stable

Question 43

Proper walker position

Answer 43

walker should come to greater trochanter allow for 20-30° of elbow flexion

Question 44

Ascending curb with walker

Answer 44

advance walker first, followed by stronger LE pt must lean forward for effective push through UE before lifting weaker LE

Question 45

forward gait w/ axillary crutches

Answer 45

crutch, involved LE, then uninvolved LE progress from step to, to step through

Question 46

stairs with axillary crutches

Answer 46

up w/ the good, down w/ the bad keep crutches on same step as involved LE

Question 47

adjusting axillary crutches

Answer 47

overall height before grip height height minus 16 inches 77% of heigh ATNR pose some crutches have height markings

Question 48

confirming axillary crutch height

Answer 48

two fingers between axilla and pad elbows in 20-30° of flexion wrists neutral

Question 49

best method of sit to stand with axillary crutches

Answer 49

both crutches to one side, push down on chair and crutch grips, stand, balance, and transfer crutch under each arm

Question 50

forearm crutches

Answer 50

less stability but more mobility than axillary

Question 51

types of gait w/ forearm crutches

Answer 51

two point three point four point

Question 52

what are forearm crutches often used with

Answer 52

bilateral KAFOs that require swing to or swing through gait

Question 53

Knee walker/scooter

Answer 53

more stable than crutches less upper body EE not for limited WB at or above knee or stairs

Question 54

What is a hemi walker

Answer 54

provides one sided support w/ more stability than a cane

Question 55

hemi walker can be used for which WB

Answer 55

FWB PWB WBAT

Question 56

When would a pt progress from a hemi walker

Answer 56

when pt's stability increases or when gait speed causes pt to "rock" hemi walker

Question 57

How are canes used

Answer 57

used singly on opposite side of bad leg or bilaterally

Question 58

Cane progresion

Answer 58

progress from wide based and small based quad cane to single point cane

Question 59

Sit to sand with cane

Answer 59

move into ready position lay cane to side and hold handle in same hand w/ armrest push to standing an place cane upright

Question 60

Stairs w/ cane

Answer 60

up/ the good leg, down w/ the bad leg keep cane on same step as bad leg