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