Gait Aids

Gait aids

Purpose of gait aids Increase area of support, maintain center of gravity over support area Redistribute weight-bearing area อุปกรณ์ที่ใช้กับผู้มีปัญหาเดินลำบาก โดยมีวัตถุประสงค์เพื่อช่วยให้เดินสะดวกหรือเคลื่อนที่ได้สะดวกมากขึ้น เพิ่มฐานการรับน้ำหนัก ทำให้ทรงตัวดี ปลอดภัย และช่วยลดการลงน้ำหนักที่ขา

Canes Body weight transmission is 20- 25%

OA hip OA knee Impaired balance etc

การปรับระดับความสูง วางส่วนปลายของไม้เท้าชิดนิ้วเท้าด้านนอก ให้ระดับ hand grib อยู่ตรงระดับปุ่มกระกูกข้างสะโพก greater trochanter ถ้าไม่สามารถคลำปุ่มกระดูกได้ ให้ปรับระดับความสูงโดยห้อยแขนข้างลำตัวและให้ระดับของมือจับอยู่ตรงกับปุ่มกระดูก ulnar styloid เมท่อได้ระดับแล้วข้อศอกจะงอประมาณ 15-30 องศาเมื่อจับไม้เท้า

Cane gait

Crutches Body weight transmission bilateral axillary crutches = 80% of BW nonaxillary crutches = 40-50% of BW

Axillary crutches Crutch length : Supine: measure anterior axillary fold to point 10-15 centemeters from heel Hand grip: measure from elbow to tip of thumb Sit: tips of finger to other side of elbow Stand: measure anterior axillary fold to point 15 centemeters anterolaterally from toe plus 2-3 inches Hand grip : at ulnar styloid level, elbow flexed 15-30 degree , 2-3 FB from apex of axilla Crutch palsy = Compressive radial neuropathies

Axillary crutches Fracture lower limb Impaired balance Incomplete paraplegia Amputate patient etc

Lofstrand/forearm crutches Hand grip : at ulnar styloid level, elbow flexed 15-30 2-3 FB from elbow Forarm cuff: below olecranon 2.5-4 centimeters Single aluminum tubular adjustable shaft, handpiece, forearm piece 2 inches below elbow, forearm cuff anterior opening (hinge) - Requires great skill, good strength of UEs, trunk balance

Platform crutch Elbow flexion contracture Inability to weaght bearing at forarm, wrist, hand Weak hand grip

Walker stable base of support For patients requiring maximum assistance with balance, uncoordinated

Walker Hand grip : at ulnar styloid level, elbow flexed 15-30 degree

Walkerette/wheeled walker Add wheels to front legs for who lack coordination or power in upper limbs

Gait pattern Alternating (reciprocal gait pattern) Point gait (4,3,2) Cane gait Walker gait Swing (silmultaneous gait pattern)

Four-point gait Ataxia or incoordination Slowest, difficulty

Three-point gait for lower limb fracture or amputation

Two-point gait Faster than 4-point gait but less stability Decrease both lower limbs weight- bearing

Cane gait

Swing-through gait

Swing-to gait

Drag to gait

Weight bearing Non weight bearing Toe touch weight bearing Partial weight bearing weight bearing as tolerate Full weight bearing ไม่ลงน้ำหนักเลย ลงน้ำหนักไม่เกินร้อยละ 20 ของน้ำหนักตัว ลงน้ำหนักร้อยละ 20-50 ของน้ำหนักตัว ลงน้ำหนักร้อยละ 50-100 ของน้ำหนักตัว ลงน้ำหนักไม่เกินร้อยละ 100 ของน้ำหนักตัว

Wheelchair

Maximize functional independence with activities of daily living GOAL Maximize functional independence with activities of daily living Minimize the risk of secondary injuries Correct or accommodate skeletal deformities Assure comfort Promote positive and unobtrusive self image

COMPONENT

MEASUREMENT: seat width Seat width is determined by measuring across the widest point of the hips (with clothing and any braces or orthosis). Once this distance is obtained, add one inch (1") to this measurement

MEASUREMENT: seat depth Measuring from the dorsal buttocks to the popliteal fossa and subtracting 2–3" from this measurement. If the backrest is cushioned, the thickness of the cushion must be added If too shallow, ischial pressure is increased and stability of the chair is decreased

MEASUREMENT: seat height Measuring from the bottom of the heel to the posterior thigh, then adding 2" to compensate for leg rest clearance. Consider the cushion thickness and its relative additional height. Foam cushions compress to 1/2 their normal size Variations on seat height measurements occur in the foot drive, or hemiplegic chair, which is designed with the seat closer to the floor to allow the unaffected leg to propel the chai

MEASUREMENT: backrest The scapula should not hang over the chair. This is measured by the distance from the bottom of the buttocks to the level of the spine of the scapula. If too high -> interfere shoulder movement. If it is too low, not provide adequate trunk stability

Classification manual wheelchairs Power wheelchairs Indoor W/C standard W/C standard hemi W/C (One arm drive W/C) Sport W/C Reclining W/C Standing W/C Amputee W/C light weight W/C heavy duty W/C Power wheelchairs All time/ power assisted Drive selection scooter

Standard Wheelchair

Standard hemi Wheelchair (One arm drive Wheelchair)

Sport Wheelchair

Reclining Wheelchair

Standing Wheelchair

COMPONENT: safety equipment Seat belt Brakes or parking locks Antitipping device fixed or removable prevent the chair from falling backwards front-rigging to avoid forward tipping. mostly used in AKA, spinal cord injury Two types of parking brakes. A: toggle type. B: lever type. Variations of these two types of brakes are available

Geared and Power-Assisted Wheelchairs

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