Lecture 5 - Functional Tasks and Transfers w/ an Assistive Device Flashcards
How do we instruct a patient to do a sit to stand with a walker?
- Hips forward in seat
- Unaffected LE slightly posterior to
affected - Both hands on armrest of chair or
one hand on walker one on
chair/bed - Trunk leans forward “nose over
toes” w/ simultaneous push
through UEs and the strongest LE
How do we instruct a patient to do a stand to sit with a walker?
- Pt approaches the chair and
pivots on the stronger LE until
back is to the chair - Steps back until the strongest LE
is in contact with the chair - Reaches with one hand at a time
for the arm rest and uses UEs to
control descent
How do we do a sit to stand with axillary crutches with NWB LE or forearm crutches with WBAT?
- Hips moved forward in chair
- Instruct pt to place NWB or weaker LE anterior to stronger LE or PT can support
NWB LE during task - Hand pieces of both crutches are grasped in hand (initially on weaker side)
slightly in front of the chair - Strong side hand is on arm rest or supporting surface
- To stand, “nose over toes” pushing through BUEs and stronger LE
- Switch one crutch to other hand once stable
How do we do a sit to stand with axillary crutches WBAT? (ALT METHOD/LESS SAFE)
LESS SAFE! SHOULD NOT BE USED IF POSSIBLE!
* Pt should have normal if not greater strength in BUEs
* Stronger LE is more underneath pt
* Hand pieces of crutches are grasped in each hand (slightly
in front of the chair
* To stand, “nose over toes” pushing through BUEs and stronger LE
How do we do a stand to sit with alternative method with axillary crutches WBAT?
Same as w/ NWB
* Need to control descent w/ hand on
the destination surface
How do we do a sit to stand with a cane?
Hips moved forward in chair
* Cane is placed either side next to the armrest
* To stand, “nose over toes” pushing through BUEs and LEs
* If chair does not have armrests, pt can use cane in hand opposite weaker LE
How can we transfer from crutches to floor?
Shift both crutches to side of weaker LE
* Pt reaches to floor with stronger side UE
using crutches for balance
How can we transfer from floor to crutches?
Pt side sits and grasps both crutches on
side of weaker LE
* Pt pushes to stand using stronger LE and
both hands
Where do we guard during descent of stairs or ramps?
in front of patient
Where do we guard during ascent of stairs or ramps?
Behind patient
What is recommended if not handrail is present?
2 people guard patient
Where do some PTs place their feet when guarding a pt on stairs?
place one foot on step pt is standing on and one 2 steps down
How can we ascend stairs or curbs with HRs with a standard walker?
- If pt uses walker for balance only and is
relatively strong - If significant strength deficits are present:
- Can use walker opened for greater stability
- Up w/ good, down w/ bad
How do we ascend stairs or curbs with HRs?
“Up with the good, down with
the bad”
How do we ascend stairs with HRs with bilateral canes or SPC?
- Hold both canes in one hand w/ other
on HR OR hold one cane in hand
holding onto HR parallel and other cane
in other hand - Up with stronger LE, weaker LE and
cane(s) follow
How can we ascend stairs with bilateral axillary crutches? (NWB, WBAT, or PWB)
- Hold both crutches in one hand OR
in one hand in a “T” formation OR
one in one hand the other parallel
to the HR in the other hand - Up w/ strong LE
How do we descend stairs or curbs with HRs?
- Back two legs on the same step w/ pt; front two legs on the step below
- Down with the weaker LE
How do we descent stairs or curbs with HRs?
- “Up with the good, down with
the bad”
How do we descend stairs with HRs with bilateral canes or SPC?
- Hold both canes in one hand w/
other on HR OR hold one cane in hand holding onto HR parallel and other cane in
other hand - Down w/ weaker LE and
cane(s) while slightly flexing
stronger LE hip and knee
How do we descend stairs with HRs with bilateral crutches? (NWB, WBAT, or PWB)
- Hold both crutches in one hand OR in one hand in a “T” formation OR one in one hand the other parallel to the HR in the other hand
- Down w/ affected LE
How can we ascend stairs or curbs without HRs?
up with the good, down with the bad
How do we ascend curbs/stairs without handrails with bilateral canes or SPC?
- up with stronger LE, weaker LE and cane(s) follow
How do we ascend curbs/stairs with bilateral crutches? (WBAT or PWB)
- same as cane
How do we ascend curbs/stairs with bilateral crutches when NWB?
- NWB LE is held in hip extension and ER with either knee ext or flexed
- UP with strong LE
