walking and mobility aids

Question 2

what are the purposes of using a walking aid?

Answer 2

• pain relief
• relief of WB from the affected leg
• assist with balance
• provides support in case of weakness
• psychological support

Question 3

what does the type of walking aid depend on?

Answer 3

• age of patient
• disability?
• physical status

Question 4

describe the basic walking frame (with the 4 legs) -** how does patient use it** and what are the advantages?

Answer 4

• **large amount of support and very stable **
• patient** lifts frame forwards,** transfers weight onto frame, takes 2 steps up to the frame - bad leg first, good leg second
• all 4 points of the frame must be on the ground at the same time before taking a step

Question 5

what are examples of other type of walking frames, apart from the basic one?

Answer 5

• wheeled walking frame
• foldable frame
• forearm walker
• reciprocal walking aid
• walkers

Question 6

what are the important considerations for walking frames?

Answer 6

• adjustable height
• correct height
• weight of patient
• diameter of walking frame - is it suitable for home?
• weight bearing status - is the patient NWB or PWB?
• safety / balance

Question 7

how do you measure the correct height of the walking frame for a patient?

Answer 7

• measure from the ulnar styloid to the ground with the patient standing erect, shoulders relaxed with elbows flexed 15-20 degrees
• when standing, the patient elbows should be slightly bent

Question 8

what are the 3 types of crutches?

Answer 8

• axillary (underarm)
• elbow
• forearm bearing

Question 9

what weight bearing status are axillary crutches used for?

Answer 9

NWB gait

Question 10

how does a patient use axillary crutches?

Answer 10

• the crutches rest against the axillary wall

Question 11

what is the risk of using axillary crutches?

Answer 11

• there may be a risk of neurovascular damage - ie to the axillary nerve

Question 12

what weight bearing status are elbow crutches used for?

Answer 12

• both NWB and PWB

Question 13

under what circumstance are elbow crutches unsuitable?

Answer 13

• unsuitable for patient if they have restricted elbow and wrist ROM

Question 14

what are the advantages of elbow crutches?

Answer 14

• easily adapted
• lightweight
• handgrip variation
• height is adjustable

Question 15

in what situation would a patient use a forearm/gutter crutch?

Answer 15

• if the patient is unable to use a normal handgrip

Question 17

what are the advantages of a knee walker / scooter?

Answer 17

• dont have to carry around crutches etc
• provide patients with freedom of movement if they have problems with foot ankle etc

Question 18

what weight bearing status are walking sticks used for?

Answer 18

• PWB

Question 19

compare a** tripod vs a quadripod** walking aid

Answer 19

• tripod - 3 point base, good stability, good base of support
• quadripod- 4 point base, good stability and base of support

Question 20

which gait pattern is good to start with for a patient?

Answer 20

3 point - if they are able - then can adjust gait pattern

Question 20

what are the different** gait patterns**?

Answer 20

• two point - contralateral or ipsilateral
• three point
• four point
• reciprocal two point

Question 21

what is a contralateral two point gait with 1 stick/crutch?

example - left leg is bad leg

Answer 21

• stick / crutch is in right hand and bad leg is left leg
• left leg and stick in right hand move at the same time
• then good leg is moved

Question 22

what is an **ipsilateral 2 point gait **with one stick?

example - bad leg is left leg

Answer 22

• crutch or stick in left hand and bad leg is left leg
• bad leg and crutch/stick move at the same time - both on same side
• then move good leg

Question 23

what does a 3 point gait involve?

NB - 2 cructhes for this pattern

Answer 23

• 2 crutches
• crutches first, then bad leg, then good leg
• good to start with this pattern - eg first day after op

Question 24

what is the 4 point gait pattern?

Answer 24

* right crutch forward followed by left leg * left crutch forward followed by right leg * slower speed * normal gait pattern * pre FWB stage

Question 25

what is the** reciprocal 2 point gait**?

Answer 25

* 2 crutches * right leg and left crutch stick together * followed by left leg and right stick together

Question 26

what is 'swing to gait'?

Answer 26

* both crutches are put down first * then weight is transfered to crutches * limbs lifted and swung forward to the crutches

Question 27

what is the '**swing through gait**'?

Answer 27

* crutches are put forward * lower limb lifted * limbs swing forward** past the crutches **

Question 28

how do you go up the stairs with crutches?

Answer 28

* unaffected leg first * affected leg * crutches * NB - 1 crutch and hold hand rail

Question 29

how do you go down the stairs with crutches?

Answer 29

* crutch first * affected leg next * then unaffected leg

Question 29

what is an orthotic?

Answer 29

* a device that is applied directly and externally to the patients body * aims to support, correct or compensate for an anatomical deformity or weakness eg muscular dystrophy, polio * prevents the unwanted motion or replaces the action of weak or dysfunctional muscles

Question 30

what are examples of orthoses?

Answer 30

* foot orthoses * **AFO**- ankle foot orthoses - controlling mvt of ankle *** KAFO** - knee ankle foot orthoses- controlling mvt of ankle and knee

Question 31

what is a foot orthosis?

Answer 31

a functional foot orthosis is a device that is **contoured to the entire foot** and used to **reduce abnormal motion** or** abnormal position of the foot **

Question 32

what is an AFO - ankle foot orthosis?

Answer 32

* device used to **support the foot** in a** stable and neutral position ** * also** provides stability to the ankle** * used for neurological patients eg MS and spastic paralysis (damage to upper motor neurons) eg head injury or cerebrovascular accident (eg stroke)

Question 33

what is a KAFO - knee ankle foot orthosis?

Answer 33

* used to treat symptoms due to spina bifida, cerebral palsy, paraplegia, neuromuscular dystrophy * reduces stress on leg, stabilises knee and limits knee mvt

Question 34

what is a HKAFO used for? - hip, knee, ankle, foot orthosis?

Answer 34

commonly used to treat symptoms due to spina bifida, paraplegia, neuromuscular dystrophy etc

Question 35

what is a supportive knee orthosis used for?

Answer 35

* **relief of pain ** * **stability **in arthritis * **sports bracing** for ligamentous damage * **post operative **- limits movement and provides stability