Download MBBS Physical Medicine and Rehabilitation Presentations 2 Ambulatory Aids And Gait Training Lecture Notes

Download MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st Year, 2nd Year, 3rd Year and Final year Physical Medicine and Rehabilitation 2 Ambulatory Aids And Gait Training PPT-Powerpoint Presentations and lecture notes




AMBULATORY AIDS AND GAIT

TRAINING

Department of PMR

Ambulatory Aids

Assistive devices for mobility/ambulation.

Provide support and transmit body weight.


Types

Canes

Crutches

Walkers

Whom to be given?

who have dif iculty maintaining their center of gravity

within support area.

It increases the area of support.
How it works?

Improve balance

Redistribute and extend the weight-bearing area

Reduce lower limb pain

Provide small propulsive forces

Provide sensory feedback.

They should be considered an extension of the upper limb.

Pre-requisite for use

Adequate upper limb strength and coordination

Endurance

Stability

An exercise program for the upper limbs and a supervised

period of training program is recommended.


Which type of aid needed ?

Depends on how much balance and weight-bearing assistance is

required.

The body weight transmission -

Unilateral cane - 20% to 25%

Forearm or Arm cane - 40% to 50%

Bilateral crutches - up to 80%.

Canes

Length Measurement ?

Tip of the cane at the level of the greater trochanter in an

upright position.

Elbow flexed approximately 20 degrees

Cane with height adjustable notches - "one cane fits all"


Canes

Parts - handle, shaft, and base

Material ? woods, metal especially aluminum, plastics, and

carbon fibre.

Types - C cane (crook top cane or J cane), Functional grip

Cane, Quad cane

Canes

The cane usually is held on the side opposite the affected

leg.

The patient advances the cane and the affected foot,

then moves the unaffected foot.


Crutches

Types -

Underarm (Axil ary)

Forearm (Lofstrand)

Canadian (Triceps crutch)

Forearm support (Platform crutch)

Axil ary crutch

Length: anterior axil ary fold to a point 6 inches

lateral to the fifth toe with the shoulders relaxed.

Crutch handle : elbow flexed 30 degrees, the wrist

in maximal extension, and the fingers forming a

fist, crutch 3 inches lateral to the foot.


Forearm (Lofstrand)

Length: standing upright with elbow in 20 degrees of

flexion.

Less supportive than axil ary crutches for ambulation.

Platform Forearm Crutch

Length: The distance from the ground to the

forearm rest with the shoulders relaxed and the

elbows flexed 90 degrees

Indications - painful wrist & hand conditions,

elbow contractures.


Commonly used crutches and canes

Walker

Length: patient stand upright and the elbows flexed 20

degrees. Front of the walker 12 inches in front of the patient.

Provides maximum support but a slow gait.

Front wheels facilitate movement of the walker for those who

lack upper limb coordination.

Useful for hemiplegia and ataxia.




Walker types

Standard walker

Platform walker

Reverse walker

Wheel walker

Gait Patterns
Foot sequence of an individual using

assistive devices.

Gait pattern depends upon ability to-
Move the feet reciprocally

Tolerate ful load on each leg

Lift the body off the floor

Maintain the balance


Gait Patterns

q Alternating (reciprocal) gait pattern

Four-point gait

Two-point gait

Three-point gait

q Swinging (simultaneous) gait pattern

Swing-to gait

Swing-through gait

Four-point Gait


Three-point Gait

Two-point Gait


Swinging (Simultaneous) Gait Pattern

Swing-to gait

Swing-through gait

AMPUTATION - GAIT TRAINING


Amputation - Gait Training

Steps:

a) Weight-bearing and balance training

b) Basic Gait training

c) Advance gait training

d) Functional training

Weight Bearing and Balance

1. Partial weight bearing (with & without support)

2. Partial weight shift (with & without support)

3. Pelvic rotation training

4. Sideward walking (two-hand support)

5. Full weight shift (with & without support)

6. Heel strike (with or without support)

7. Handball (with or without support)




Partial Weight Bearing

Partial Weight Shift




Pelvic Rotation Training & Sideward

Walking

Full Weight Shift


Heel Strike

Handball




Basic Gait Training

1. Sound-leg step forward & backward (two-hand

support)

2. Sound-leg step through (with & without support)
3. Prosthetic-leg step forward & backward (two-hand

support)

4. Prosthetic-leg step through (two-hand support)
5. Prosthetic-leg step forward (one-hand support)
6. Prosthetic-leg step through (without support)
7. Walking between the parallel bars (with & without

support)

Sound-leg Steps




Sound-leg step through

Sound-leg step through

Walking between the parallel bars


Thank You

This post was last modified on 08 April 2022