Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PCM II - EXAM 2 > Lecture 4 - Assistive Devices and Guarding > Flashcards

Lecture 4 - Assistive Devices and Guarding Flashcards

1
Q

When is a tilt table used?

A

when patients need to acclimate to upright position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When are vital signs taken with a tilt table?

A

Before, during and after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a tilt table?

A

Table that is elevated gradually, starts supine and then goes to a “standing” upright positioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When are parallel bars used?

A

balance training, teaching specific gait patterns, support while measuring an AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How much elbow flexion do we need with parallel bars?

A

20-25 degrees elbow flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How much space horizontally does a patient need in the parallel bars?

A

2 inches wider than either greater trochanter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What should the top of a parallel bar be even to?

A

greater trochanter or wrist crease in standing with the UEs at sides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are ambulatory ADs?

A

devices that provide external support during gait training in an upright posture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are indications for usage of an AD?

A
  • structural deformity, amputation, injury, or disease resulting in inability to bear weight through the LEs
  • muscle weakness or paralysis in trunk or LEs
  • balance deficits
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What do ADs do?

A
  • increase BOS
  • provide a method for redistributing weight normally borne through LEs to UEs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Wha kind of force do ADs create?

A
  • additional force that keeps the pelvis level in the face of gravity’s tendency to adduct the hip during unilateral stance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is trendelenberg gait due to?

A

weakness or pain caused by large adductor moment due to the natural placement of the COM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to pts compensate with trendelenberg gait?

A
  • lean over the weaker side
  • decreases the adductor moment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is a cane useful for trendelenberg gait?

A
  • cane’s force substitutes for the hip abductors
  • transmits part of the body weight to the ground decreasing the muscular force required for balancing (decreased demand)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How can ADs help with pain?

A
  • decreased WB
  • distribution of force over larger surface area
  • improved joint stability (instability can cause pain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can ADs help with weakness?

A
  • increased BOS
  • redirection of the line of action of forces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can ADs help with limited PROM?

A
  • redirection of the line of forces
  • stabilization of uninvolved joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How can ADs help decreased endurance?

A
  • improved efficiency of movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How can ADs help with balance deficits?

A
  • increased BOS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can ADS help with impaired motor control?

A
  • increased BOS
  • increased WB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How can ADs help with fear of falling?

A
  • increased BOS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some examples of ADs?

A
  • walkers
  • axillary crutches
  • forearm crutches
  • canes (quad or single point)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do walkers provide?

A

a large degree of stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of patients would benefit from a walker?

A
  • generalized weakness
  • dehabilitating conditions
  • need to reduce WB on one or bothLEs
  • poor balance/coordination
  • inability to use crutches (need balance, coordination)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the types of walkers?

A
  • standard
  • wheeled (2 or 4)
  • stair climbing walkers
  • ring walkers (peds)
  • knee walkers
  • reverse walkers (peds)
  • hemiwalkers
  • reciprocal walkers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What kind of stability do axillary crutches provide?

A

Moderate stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Do axillary crutches require more or less coordination than walkers?

A

MORE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is a negative for axillary crutches?

A

Takes substantial amount of energy

29
Q

What kind of patient would benefit from axillary crutches?

A
  • weakness in one or both LEs
  • impaired balance
  • need for trunk support
  • permits 80-100% weight-bearing support
30
Q

What do forearm crutches provide in comparison to axillary crutches?

A
  • more ease of movement but less trunk support
31
Q

What is a pro of forearm crutches?

A

frees hands without having to drop the crutch

32
Q

What kind of patients are forearm crutches recommended for?

A
  • same patients that may require axillary crutches but do NOT require trunk stability
33
Q

Where should the cuff on forearm crutches fall?

A

2 inches below elbow (olecranon process)

34
Q

What kind of patient benefits from usage of a cane?

A
  • minimal LE weakness
  • require slight WB reduction
  • impaired balance
35
Q

What kind of patient benefits from usage of a quad cane?

A
  • limited or no use of one UE as with hemiparesis
  • similar impairments as patients who require SPCs but usually greater deficits
36
Q

What are some cons of quad canes?

A
  • slightly heavier
  • somewhat awkward with all 4 points on the ground
37
Q

What is non-weight bearing?

A
  • involved LE not to be WB or touching floor (NWB)
38
Q

What is toe touch weight bearing (TTWB)?

A
  • pt can rest toes on the floor for balance but cannot WB
39
Q

What is partial weight bearing? (PWB)

A
  • limited amount of WB tolerated
  • usually a percentage is given (i.e. 25% PWB)
40
Q

What is weight bearing as tolerated (WBAT)?

A
  • pt allowed to place as much or as little weight through the involved LE depending on tolerance
41
Q

What should we match when choosing an AD?

A
  • the needs and the abilities of the patient with the qualities of the device
42
Q

What are some common conditions warranting the usage of ADs?

A
  • pain
  • Limited PROM
  • decreased sensation
  • open wounds on WB surfaces
  • unstable structure (fractures)
  • decreased strength
  • decreased endurance
  • impaired motor control
  • balance deficits
  • fear of falling
43
Q

What AD is a good choice for increasing BOS?

A
  • parallel bars
  • walkers
44
Q

What AD is a good choice for PWB?

A
  • parallel bars
  • walkers
  • bilateral crutches
45
Q

What AD is a good choice for NWB and TTWB?

A
  • parallel bars
  • walkers
  • bilateral crutches
46
Q

What AD is a good choice for WBAT ?

A
  • Parallel bars, hemiwalkers, single point cane or crutch
47
Q

What can an improper fit or use of an AD lead to?

A
  • decreased stability
  • decreased function
  • decreased safety
  • increased energy expenditure
48
Q

How do we fit a walker?

A
  • with pt in standing or supine
  • shoes SHOULD be worn (when applicable)
  • hand grip at level of pt’s: wrist crease, ulnar styloid process and greater trochanter
49
Q

How do we fit axillary crutches if we know the pt’s height?

A
  • multiply by 77% or subtract 16 in from height
50
Q

How do we fit axillary crutches in supine?

A
  • use a tape measurer to measure the distance from axillary fold to the 6-8 inches lateral to the heel
51
Q

How can we fit axillary crutches in seated?

A
  • UE abducted at shoulder level
  • one elbow extended, one flexed to 90 degrees
  • measure distance between middle finger of extended elbow and olecranon process of flexed elbow
52
Q

How do we confirm the fit of axillary crutches in standing?

A
  • tips should be positioned 2 inches laterally and 4-6 inches anterior to toe of shoes
53
Q

How do we measure the hand piece height of axillary crutches in supine?

A
  • from greater trochanter, wrist crease, or ulnar styloid process to the heel of the shoe
  • use this number to measure from the rubber tip to the hand piece

OR

  • from anterior axillary fold to greater trochanter or ulnar styloid process
  • use this to measure form the axillary rest to the hand piece
54
Q

What should the patient elbows be doing with the crutches in tripod position?

A
  • pt should have approx 20-30 degrees elbow flexion with relaxed shoulders
55
Q

How much space should be present between the axillary rest and the bottom of the axilla with axillary crutches?

A
  • two findgerbreadths
56
Q

How do we fit a cane in standing?

A
  • place cane parallel to femur and tibia with foot of the cane on the floor or at the bottom of the heel of the shoe
  • hand piece should reach wrist crease, greater trochanter or ulnar styloid process
57
Q

How do we fit a cane in supine?

A
  • use a tape measure to measure from greater trochanter to heel with hip and knee straight
58
Q

How do we confirm the fit of a cane in standing?

A
  • tips should be positioned 2 inches laterally and 4-6 inches anterior to toe of shoes
59
Q

How do we measure the fit of the forearm cuff with forearm crutches?

A
  • top of the cuff should be 1-1.5 inches distal to the olecranon process when the pt grasps the hand piece with wrist in neutral
60
Q

How do we confirm the fit of forearm crutches in standing?

A
  • tips should be positioned 2 inches laterally and 4-6 inches anterior to toe of shoes
61
Q

Where should we guard with ADs?

A
  • should stand slightly to one side and behind the pt
  • on the weaker side usually
  • stride stance (outside foot behind the AD and the pt’s foot; other foot trails when you walk)
  • underhand grip with gait belt other hand on pt’s shoulder or chest
62
Q

How should we guard on level surfaces with ADs?

A
  • stand behind pt and slightly to the weaker side
  • one hand on gait belt with supinated grip
  • other hand lightly resting on pt’s shoulder (DONT impede motion)
  • PT’s stance staggered
  • advance front foot with AD, trailing foot moves when patient moves
63
Q

How do we guard during LOB?

A
  • not trying to stop the fall, just slow it down to give enough time for important structures to be protected
64
Q

Where do we guard if balance is lost forward?

A
  • pull back on gait belt
  • other hand pulls trunk upward and back
  • may need to push forward on pelvis as pull back on trunk
65
Q

Where do we guard if balance is lost backwards?

A
  • push forward on pelvis and trunk
66
Q

Where do we guard if balance is lost to one side (away from PT)?

A

pull gait belt toward you

67
Q

Where do we guard if balance is lost to one side (toward PT)?

A
  • turn body so that you face the pt’s side
  • widen BOS
  • use body to support pt
68
Q

What do we instruct the patient to do if LOB forward?

A
  • let go of AD and reach for the floor
  • cushion fall by bending their elbows and rolling to one side
  • turn head to one side to avoid injury to the face
69
Q

What does the PT do when balance is lost forward?

A
  • firmly but slowly pull back on gait belt avoiding excessive force
  • step forward with outside foot to help control descent

PCM II - EXAM 2 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions