Gait

Question 1

What is the best predictor for future risk of falling?

Answer 1

History of previous falls

Question 2

What can be used to prevent falls?

Answer 2

• Balance, Strength, Appropriate Device
• Gait Training and Fall Training
• Good lighting, removing obstacles, etc.

Question 3

Collapsing Fall, what to do?

Answer 3

Sit back onto you

PT:
* Move closer and lift slightly on the gait belt to help the patient regain support.
* After the fall take vitals, make sure they are okay, make them comfortable why they are there, why they think they fell.

Question 4

Angular Fall, what to do?

Answer 4

Pt. tips straight back or to the side

PT
* Move in close and attempt to bring Center of Mass (CoM) back over Base of Support (BoS)

Question 5

If a patient begins to fall, what to do?

Answer 5

If regaining position is not possible and a chair is not immediately available, deepen your stride and rest the patient on your forward thigh.

If resting on your thigh is not an option, carefully lower the patient to the floor.

Question 6

Falling with Crutches

Answer 6

Decrease risk of injury in a fall by:
* Dropping crutches behind and out to the side
* Slightly flexing elbows of extended arms
* Turning head to the side (High risk of injury of spinal cord if falling down)

Question 7

Getting Up After a Fall: If Unable to Crawl to a Nearby Chair

Without KAFOs

Answer 7

• Gather crutches.
• Move into kneeling with both crutches on one side.
• Move into half-kneeling (foot of stronger LE forward).
• Move into full standing and place a crutch on each side.

Question 8

Getting Up After a Fall: If Unable to Crawl to a Nearby Chair

With KAFOs

Answer 8

• Stand one crutch up and use it to push up from the floor, with balls of feet in contact with the floor.
• Quickly pick up the other crutch and stand it erect.
• Reposition crutches for ambulation.

Patients with Spina Bifida or SCI

Question 9

What to consider with patient fatigue

Answer 9

• W/c follow
• Pre-plan for rest breaks
• Consider using 4ww with seat

Question 10

Patients who are impulse, what to consider:

Answer 10

• Guard appropriately
• Provide calm verbal and tactile cues
• Cease unsafe activity / assist to seated position
  – Spend time on education about weight bearing status and proper gait
  – Consider demonstration
• May place foot ahead of walker to slow velocity

Patients with a TBI or younger population

Question 11

What to do when patients no longer maintain WB restrictions

Answer 11

• Take a rest break
• Re-educate
• Use Limb-Load Monitor

Question 12

What to do with patients develop nausea or increased pain

Answer 12

• Continue guarding
• Sit down and grab emesis bag / basin OR try to continue to bathroom
• Pre-plan (emesis bag in pocket)
• Inform nurse after session

Have a baseline of pain before a session and assess throughout activity. Are you okay with continuing with activity?

Question 13

What to do when pt’s incorrectly use the gait device

Answer 13

• Stop and re-educate
• Try another device
• Elicit feedback
• Demonstrate

Form first before preceding