Using Mechanical Aids For Walkin
Uploaded by
shannon c. lewisUsing Mechanical Aids For Walkin
Uploaded by
shannon c. lewisUSING MECHANICAL AIDS
FOR WALKING
Purpose
• To assist client to ambulate.
Preparation
• Review ambulation orders
• Determine how much assistance is needed by
assessing the client’s:
– History of ambulation activity
– Weight
– Strength
– Mobility
– Endurance
– Presence of physiological challenge (i.e., surgery,
weight bearing restrictions, shortness of breath)
• Ability and willingness to follow instructions
• Assess for tubes and equipment that need to
accompany client during ambulation
• Position all equipment and tubes safely
• Assess client’s level of pain and history of
pain upon movement; implement pain relief
intervention as needed
• Explain the purpose and describe the details
of ambulating with assistive device to client
and significant others as appropriate
• Prepare the environment:
• Make sure there is a path free of obstacles
and hazards for client and
assistants/equipment
Equipment
• Non-slip covering for feet
• Safety belt (ambulation belt/gait belt/transfer
belt) if client’s gait is unsteady
• Clothing to provide client privacy
Types of Canes
Quad cane
Standard straight-legged cane
Tripod or crab cane
Walkers
Standard walker
Four-wheeled walker
Two-wheeled walker
Crutches
Platform
Axillary
Loftstrand
Crutch Attachments
Two methods of Measuring
Clients for Crutches
1. The client lies in a supine position and the
nurse measures from the anterior fold of the
axilla to the heel of the foot and adds 2.5 cm
(1 in.).
2. The client stands erect and the nurse make
sure the shoulder rest of the crutch is at least
three fingerwidths, that is, 2.5 to 5 cm (1 to 2
in.), below the axilla.
To determine the correct placement of
the hand bar:
1. The client stands upright and supports
the body weight by the hand grips of
the crutches.
2. The nurse measures the angle of the
elbow flexion. It should be about 30
degrees. A goniometer may be used to
verify the correct angle.
Procedure
Crutch Stance (Tripod position)
Four-Point Alternate Gait
• The most elementary and safest gait,
providing at least three points of support at all
times, but requires coordination.
• To use this gait, the client needs to be able to
bear weight on both legs.
The nurse asks the clients to:
1. Move the right crutch ahead a suitable
distance, such as 10 to 15 cm (4 to 6 in.).
2. Move the left front foot forward, preferably
to the level of the left crutch.
3. Move the left crutch forward.
4. Move the right foot forward.
Three-point Gait
• To use this gait, the client must be able to bear
the entire body weight on the unaffected leg.
The two crutches and the unaffected leg bear
weight alternately.
The nurse asks the clients to:
1. Move both crutches and the weaker leg
forward.
2. Move the stronger leg forward.
Two-point Alternate Gait
• Faster than the four-point gait.
• Requires more balance because only two
points support the body at one time; it also
requires at least partial weight bearing on
each foot.
• Arm movements with the crutches are similar
to the arm movements during normal walking.
The nurse asks the clients to:
1. Move both crutches ahead together.
2. Lift body weight by the arms and swing to
the crutches.
Swing- To Gait
• Used by the clients with paralysis of the legs
and hips.
• Prolonged use of these gaits results in atrophy
of the unused muscles.
Swing- To Gait
The nurse asks the
clients to:
1. Move both crutches
ahead together.
2. Lift body weight by
the arms and swing
to the crutches.
Swing- Through Gait
The nurse asks the
clients to:
1. Move both
crutches forward
together.
2. Lift body weight
by arms and
swing through
and beyond the
crutch.
Going Up stairs
The nurse asks the clients to:
• Assume the tripod position at
the bottom of the stairs.
• Transfer the body weight to the
crutched and move the
unaffected leg onto the step.
• Transfer the body weight to the
unaffected leg on the step and
move the crutches and affected
leg up to the step. The affected
leg is always supported by the
crutches.
• Repeat steps 2 and 3 until the
client reaches the top of the
stairs.
Going Down Stairs
• The nurse asks the clients to:
• Assume the tripod position at
the top of the stairs.
• Shift the body weight to the
unaffected leg, and move the
crutches and affected leg
down onto the next step.
• Transfer the body weight to
the crutches, and move the
unaffected leg to that step.
The affected leg is always
supported by the crutches.
• Repeat steps 2 and 3 until
client reaches the bottom of
the stairs.
