Gait

Question 1

what do you need to have in order to have capacity for mobility

Answer 1

rom, muscles innervated

Question 2

how can you determine a patient’s stability/static control?

Answer 2

can pt. sit on edge of bed?

Question 3

controlled mobility using crutches

Answer 3

can you go crutches, right, left, crutches, right, left

Question 4

choose the

Answer 4

least restrictive device

Question 5

pre-gait activities

Answer 5

sitting balance; just start walking

Question 6

what is functional walking?

Answer 6

smooth progression of CoG over BoS; adaptable to be funtional

Question 7

Rancho Phases of Stance

Answer 7

initial contact
loading response
mid-stance
terminal stance
pre-swing

Question 8

Traditional Phases of Stance

Answer 8

heel strike
foot flat
mid-stance
heel off
toe-off

Question 9

Rancho Phases of Swing

Answer 9

initial swing
mid-swing
terminal swing

Question 10

Traditional Phases of Swing

Answer 10

acceleration
mid-swing
deceleration

Question 11

parameters of gait

Answer 11

step/stride length
stride width (base of support)
walking velocity
step/stride time
single limb support
single/double limb support time
cadence
line of progression
coordination

Question 12

step length

Answer 12

one foot to other foot

Question 13

stride length

Answer 13

same foot to same foot

Question 14

non-weight bearing

Answer 14

no weight on that limb; that foot should not touch the floor

Question 15

toe-touch or touch-down WB

Answer 15

touching with toes for balance
5% BW
hop with walker

Question 16

why would you instruct someone to hop with the walker when practicing/performing toe-touch or touch-down WB?

Answer 16

old motor learning pattern; do not have toe touch pattern

Question 17

partial weight bearing

Answer 17

provide external target
percentage is a generalization
check with physician

Question 18

weight bearing as tolerated is limited by

Answer 18

pain

Question 19

what mobility devise requires the most energy consumption?

Answer 19

standard walker

Question 20

what should you consider when choosing the least restrictive mobility device?

Answer 20

1. be safe

2. least restrictive vs. stability

Question 21

stability vs mobility trade offs

Answer 21

reduced LE weight bearing
LE weakness
impaired balance

Question 22

parallel bars are the _____ ________ and used in _____ ____

Answer 22

most restrictive; early gait

Question 23

what is a negative factor of using a rollater?

Answer 23

creates an abnormal gait pattern; used by those with poor balance

Question 24

sit to stand transfer

Answer 24

patient slides to edge of chair
stronger foot posterior to weaker foot
keep affected leg extended
push down on armrests

Question 25

sit-to-stand after THA

Answer 25

cannot do traditional involved foot out front give a visual-->pregnant lady; lead with your hips

Question 26

parallel bars

Answer 26

most stable; lest mobile | great for training

Question 27

how high should parallel bars be?

Answer 27

handle of device to wrist/greater trochanter | hands in functional position with slight flexion

Question 28

where should you guard during gait?

Answer 28

guard on the side the patient is most likely to fall (weaker side)

Question 29

how do you quickly move a wheelchair?

Answer 29

pick it up and wheel it on the casters

Question 30

what is the least mobile type of walker?

Answer 30

standard walker

Question 31

requirements for a rollater

Answer 31

manage breaks | ability to stand/turn

Question 32

when might you use a platform walker?

Answer 32

help with posture cannot put weight through hand or loss of function can't grip walker

Question 33

advantages and disadvantages of a hemi walker

Answer 33

used with strength only on one side promote increased lateral sway and more weight bearing on strong side used with hemiparesis better ideas => platform walker

Question 34

how high should a cane be?

Answer 34

come to ular styloid process

Question 35

fitting walker, crutch, cane

Answer 35

elbow with 15-20˚ flexion elbow position determines forearm positition forearm position determines line of force

Question 36

guarding techniques

Answer 36

requires a gait belt unless nearing independence--not patient's pants gait belt should be snug and held with a supinated grip guard behind and slightly to the side to which the patient is most likely to fall (weak side) wide BoS--lateral and A-P

Question 37

tips for axillary crutches

Answer 37

stand upright look straight ahead do not hang on the axillary pads

Question 38

what side should a singular cane/crutch go on?

Answer 38

the contralateral side to off-load

Question 39

a 2-point gait pattern is

Answer 39

reciprocal gait, simultaneous

Question 40

3-point gait pattern

Answer 40

crutches, R, L | crutches w/ NWB

Question 41

4-point gait pattern

Answer 41

2 crutches, 2 legs, opposite leg, opposite crutch also known as a deliberate 2-point gait cannot do with one extremity

Question 42

step-to gait

Answer 42

step to crutches | more stable-->more time in double stance phase

Question 43

step-through gait

Answer 43

step through crutches uninvolved goes past during swing phase of gait

Question 44

swing-to/swing-through gait pattern

Answer 44

``` both legs move together cannot step tri-pod power of advancing legs comes from momentum of hips and trunk typically land on both feel =>foot-flat ```

Question 45

cutches and injured leg always go

Answer 45

together

Question 46

when using a walker to go up or down stairs, which leg goes first?

Answer 46

the walker always goes first

Question 47

to safely fall forward when using crutches

Answer 47

push crutches away to the side (ER) flex elbows slightly turn head

Question 48

falling backward with crutches

Answer 48

push crutches to the side tuck chin toward chest reach forward with both upper extremities (slow fall and move center of gravity forward)

Question 49

progressive gait training

Answer 49

``` ambulate on uneven surfaces ambulate on unsteady surfaces directional changes vary gait speed and incline increase environmental obstacles and distractions walk backwards side-stepping braiding (grapevine) tandem walk on toes/heels have patient practice opening and closing doors and ambulating over the threshold ```