Carter Physical Therapy Gait Training + Assistive Devices Presented by: Larry Carter P.T.

Purpose NWB (non weight bearing) PWB (partial weight bearing) Become familiar/competent in measuring assistive devices: cane, crutches, walkers for patients. Become familiar/competent instructing patients using devices for gait in: NWB (non weight bearing) PWB (partial weight bearing) WBAT (weight bearing as tolerated) Become familiar/competent in gait patterns: 2 point 3 point 4 point Step-to Step through Become familiar/competent in device use ( cane/crutch) for advanced gait patterns

How to Measure Cane Crutches Walker Measure from wrist band, 6” in front 6” to side of the unaffected side Crutches Measure from axilla 2” below axilla Handles: elbow 15-20° flexed position (triceps) Walker Measure height from handles to elbow flexion at 15-20° of flexion to use triceps/shoulder depressors.

Gait Cane 2 point gait 3 point gait Cane (wear on opposite side affected lower extremity) with affected lower extremity using step to or step through 3 point gait Cane (affected/weak lower extremity) the unaffected/stronger leg use step-to or step through

Gait Crutches 2 point: 2 crutches 3 point: 2 crutches R crutch with left lower L crutch with right lower 3 point: 2 crutches Both crutches affected leg Unaffected either step-to OR step through 4 point: 2 crutches Sequence- Example: affected left lower extremity R crutch -> L lower extremity -> L crutch -> R lower extremity

Gait Walker 2 point 3 point Usually NWB gait- walker, then strong leg Usually PWB > WVAT- walker, then affected leg or strong leg: Step-to OR step through

Rules for Gait Know the weight bearing status! Know the device the patient uses is safe for their ability Know their balance Know their endurance Know their environment needs