Gait Aids.

งานนำเสนอเรื่อง: "Gait Aids."— ใบสำเนางานนำเสนอ:

1 Gait Aids

2 Gait aids

3 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

4 Canes Body weight transmission is %

5 OA hip OA knee Impaired balance etc

6 การปรับระดับความสูง วางส่วนปลายของไม้เท้าชิดนิ้วเท้าด้านนอก ให้ระดับ hand grib อยู่ตรงระดับปุ่มกระกูกข้างสะโพก greater trochanter ถ้าไม่สามารถคลำปุ่มกระดูกได้ ให้ปรับระดับความสูงโดยห้อยแขนข้างลำตัวและให้ระดับของมือจับอยู่ตรงกับปุ่มกระดูก ulnar styloid เมท่อได้ระดับแล้วข้อศอกจะงอประมาณ องศาเมื่อจับไม้เท้า

7 Cane gait

8 Crutches Body weight transmission
bilateral axillary crutches = 80% of BW nonaxillary crutches = % of BW

9 Axillary crutches Crutch length :
Supine: measure anterior axillary fold to point 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 degree , 2-3 FB from apex of axilla Crutch palsy = Compressive radial neuropathies

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

11 Lofstrand/forearm crutches
Hand grip : at ulnar styloid level, elbow flexed FB from elbow Forarm cuff: below olecranon 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

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

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

14 Walker Hand grip : at ulnar styloid level, elbow flexed degree

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

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

17

18 Four-point gait Ataxia or incoordination Slowest, difficulty

19 Three-point gait for lower limb fracture or amputation

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

21 Cane gait

22 Swing-through gait

23 Swing-to gait

24 Drag to gait

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

26 Wheelchair

27 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

28 COMPONENT

29 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

30 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

31 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

32 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

33 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

34

35 Standard Wheelchair

36 Standard hemi Wheelchair (One arm drive Wheelchair)

37 Sport Wheelchair

38 Reclining Wheelchair

39 Standing Wheelchair

40

41 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

42 Geared and Power-Assisted Wheelchairs

43 Thank You