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Flashcards in GRFC - functional training Deck (51)
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1

Ambulation aids from most coordination needed to least coordination needed

-Non-axillary crutches
-Axillary crutches
-Cane
-Walker
-Parallel bars

2

Parallel bars measurement

Height: level of greater trochanter, 20 degrees to 30 degrees of elbow flexion

Width: +1 inch from each greater trochanter (+2 total)

3

Ambulation aids from least stable to most stable

Cane
Non-axillary crutches
Axillary crutches
Walker
Parallel bars

4

Assistive device weight transmission

Cane: 20% to 25% (up to 30%, NPTE)
Non-axillary crutches: 40% to 50%
Axillary crutches: 80% to 90%
Walker: 85%

5

Walker dimension measurement

Height: 20 degrees to 30 degrees elbow flexion, height of greater trochanter

Distance: 10" to 12" anteriorly (12" ideally)

Rubber tip height: 2" to 3"

Rubber tip diameter: 1" to 1.5"

6

Different types of walker (with indications and features)

Standard (collapsible) walker: For easy storage, for those who travel frequently, for those with PD with stereotypic (festinating) gait

Hemi-walker: For persons with CVA, 1 UE and 1 LE amputation; has centrally located handgrip; contraindicated for those with (R) CVA with (left) unilateral neglect

Stair-climbing walker: Has additional 2 posterior uprights

Reciprocal (reciprocating) walker: For those with RGO using reciprocal gait pattern, for those with SCI and spina bifida (at T12 - L1)

Rollating walker (rollator): with wheels, for those with PD with akinesia

7

Anterior rollating walker

For those with stooped posture, PD, CP, osteoporosis, for the elderly; anterior tips replaced with wheels

8

Posterior rollating walker

For those with CP and increased flexor tone; posterior rubber tips are replaced with wheels

NOTE: For energy efficiency and increased velocity, use posterior rollating walker with 4 wheels

9

Types of crutches

Axillary
Non-axillary

10

Axillary crutch dimension measurement (standing)

Axillary pad: 2" (2 to 3 finger) below axilla

Handgrip: 20 degrees to 30 degrees elbow flexion, level of greater trochanter

Rubber tips: 6" anterior, 2" lateral from 5th toe

NOTE: Can also be measured using patient's height -16"

11

Axillary crutch dimension measurement (sitting)

(R) shoulder abducted with elbow flexed
(L) shoulder abducted with elbow extended
Axillary pad on tip of olecranon process
Rubber tip on tip of 3rd digit (2nd finger or middle finger)

12

Axillary crutch dimension measurement (supine)

Axillary pad over anterior axillary fold
Rubber tip 6" to 8" from lateral heel OR at side of lateral heel +2" without shoes

13

Non-axillary crutch dimension measurement

Forearm cuff orientation: Facing medially and anteriorly

Forearm cuff location: Proximal 1/3 of forearm (1" to 1.5" below elbow)

Handgrip: 20 degrees to 30 degrees elbow flexion, level of greater trochanter

Rubber tip: 6" anterior, 2" lateral to 5th toe

14

Platform attachment details

For those with arthritic hand, elbow flexion contracture, distal forearm and wrist fracture

NOTE:
Platform crutch - if attached to crutch
Platform walker - if attached to walker

15

Triceps (Canadian) crutch details

For those with triceps weakness

Has two cuffs:
Triceps cuff (locks elbow in extension)
Forearm cuff

16

Types of gait patterns

Point gait:
Four-point (most difficult to teach/ instruct)
Three-point
Two-point

Swing gait:
Swing-to
Swing-through (most advanced, most difficult to learn)

Drag gait:
Drag-to (for those with severe spasticity)
Drag-through

Simultaneous gait (for those with coordination problems)

NOTE: Always teach 2 gait patterns (1 for stability, 1 for speed)

17

Therapist position/ assistance

Level surface: Posterolateral, near weaker/more affected/ affected side

Stair ascent: Posterolateral, near weaker/ more affected/ affected side

Stair descent: Anterolateral, near weaker/ more affected/ affected side

NOTE:
If with handrail, use handrail (place (B) crutches, canes on one side)

18

Scapular depressors (crutch walking muscles)

Latissimus dorsi
Lower trapezius
Pectoralis minor

19

Shoulder adductors (crutch walking muscles)

Latissimus dorsi
Pectoralis major

20

Shoulder flexors, extensors, abductors (crutch walking muscles)

Deltoids

21

Elbow extensors (crutch walking muscles)

Triceps brachii
Anconeus

22

Wrist extensors (crutch walking muscles)

Extensor carpi radialis longus
Extensor carpi radialis brevis
Extensor carpi ulnaris

23

Finger flexors (crutch walking muscles)

Flexor digitorum superficialis
Flexor digitorum profundus

24

Thumb flexors (crutch walking muscles)

Flexor pollicis longus
Flexor pollicis brevis

25

Cane dimension measurement and indication

Handgrip: Beside straight leg, at level of ulnar styloid

Rubber tip: 6" lateral to tip of 5th toe

26

Different types of canes

Standard aluminum adjustable cane

Standard aluminum offset cane - point of support is directly beneath hand

Quad cane (large-base: more stable, small-base: intended for stair ambulation) - best for antalgic gait

27

Wheelchair back rest height measurement

From seat to base of axilla -4"
From seat to inferior angle of scapula -2"

NOTE:
For those with high level SCI: high back rest
For those wit paraplegia: low back rest

28

Wheelchair back rest width measurement

Normal: 16" to 18"

29

Wheelchair seat depth measurement

Normal: 16"

From back of seat to popliteal fossa -2"

NOTE:
If too long: Sacral sitting
If too short: Decreased stability, uneven weight bearing on buttocks and thighs

30

Wheelchair seat width measurement

Normal: 18"

Widest portion of buttocks +1" each side (each greater trochanter) (total of +2")

NOTE:
Too wide: Difficulty with propulsion
Too narrow: Pressure on greater trochanter