Question

Describe procedures for 5 crutch walking gaits, use of crutches on stairs and use of a cane. see Saunders NCLEX book as reference.

Answer 1

A. 5 crutch walking gaits :

1. 4-points gait : this is used when the patient can bear some weight on both lower extremities. Places the patient in the tripod position and instruct him to -

- move the right crutch forward.

- move the left foot forward.

- move the left crutch forward.

- move the right foot forward.

- repeat this sequence of crutch-foot-crutch-foot for desired ambulation.

2. 3-point gait : this is used when the patient. Should not bear any weight on the affected leg. Place the patient in the tripod position and instruct him to -

- move the affected leg and both crutches forward together.

- move the unaffected leg forward.

- repeat this sequence for desired ambulation.

3. 2-point gait : this is used when the patient can beer some weight on both lower extremities. Place the patient is tripod position and instruct him to -

- move the right leg and left crutch forward together.

- move the left leg and the right crutch forward together.

- repeat this sequence for desired ambulation.

4. Swing-through gait : this is used for patient with lower extremities that are paralysed and/or in braces. Place the patient in tripod position and instruct him to -

- move both crutches forward together about 6 inches.

- move both legs forward together about 6 inches.

- repeat the sequence in rhythm for desired ambulation.

5. Swing-to gait : this is used for patient with weakness of Both lower extremities. Place the patient in tripod position and instruct him to -

- advance both crutches forward.

- swing both legs forward at the same time to (not past) the crutches.

- repeat the sequence in rhythm for for desired ambulation.

Stairs: Do not attempt to climb stairs until you are confident using your crutches.

going upstairs -

- keep the walking crutches on the stair you are standing.

- support your weight between your crutches.

- bring your good leg up to the next step. Let the injured leg trail behind.

- straighten your good leg and bring the walking crutches and your injured leg up.

going down stairs -

- Put the crutches on the lower step while putting your injured foot forward.

- support your weight between your crutches.

- move your good foot to the lower step.

Cane: Generally used as mobilisation aids for patients can bear weight on the affected leg, but require some support.

using cane: the patient should the cane on the unaffected side with his elbow slightly flexed and the cane tip about 6 inches in front of and 6 inches to the side of his foot. Instruct the patient to ambulated using the following sequence -

- move the affected leg forward, parallel to the cane .

- move the unaffected leg forward so that the heel is just beyond the cane.

- move the affected leg forward so that it is even with the unaffected leg.

- move the cane forward 6 inches to the front and 6 inches to the side of the patient.