HomeExam ArticlesCRUTCH WALKING ortho theory notes
ORTHODNB.COMApril 17, 2018Exam Articles,
CRUTCH WALKING
function to prevent weight bearing – eventally to walk unaided
muscles required for using crutches are
flexors of fingers and thumb to hold the hand grip firmly
dorsiflexion of wrist and stabilize the wrist in dorsiflexion
extensors of elbow to stabilize elbow in slight flexion – to take the body wt through upper limb
flexion of shoulder to move the walking aid forward
depression of shoulder girdle to support the body wt
ability to use crutches efficiently depends on
strength of the muscles required
See AlsoAnalysis of Crutch Position in the Horizontal Plane to Estimate the Stability of the Axillary Pad in the Axilla during Single-crutch WalkingAnalysis of crutch position in the horizontal plane to confirm the stability of the axillary pad for safe double-crutch walkingAssessment of Gait Patterns during Crutch Assisted Gait through Spatial and Temporal Analysisselection and adjustment of crutches
sense of balance
familiarity and manintance of crutches
crutch stance
knowledge of how to stand and balance on crutches before step
gait pattern
energy necessary for the gait pattern
Crutch stance for the axillary crutch
patient against wall – crutches placed under each arm
correct stance – head up – back straight – pelvis over feet – shoulder depressed – axillary pads of crutches gripped between the lateral wall of chest and medial aspect of arm , 2 inches below the anterior axillary fold – crutch tips 6 inches forward and 6 inches out from tip of toes – palms of hands on hand grips of crutches – elbows in 300flexion – body wt taken mainly on hands
Gait patterns
swinging crutch gait
swing to crutch gait
swing through crutch gait
four point crutch gait
two point crutch gait
three point crutch gait
selection of gait depends on
ability of the patient to step forward with either one or two feet
ability to bear weight and keep balance on one or both feet
ability to push body forward by presssing down both crutches
ability to maintain body errect
ability to control the crutches
all assisted gaits need more energy
2 and 3 point partial weight bearing gaits need 33% more energy than normal gait
3 point non weight bearing and swing through gait need 78% more energy
Swinging Crutch gait
body wt can be taken through both lower limbs together
but uncapable of moving his lower limbs due to paralysis
calipers are used to stabilize the limbs – limbs are moved by the muscles acting on pelvis
stable position is of tripod – triangular base – apex on shoulder
crutches form two anterior legs
trunk and lower limbs form the posterior leg
paralytic is stable in this position – except no FFD of hip, knee, ankle
knees braced in extension – centre of gravity falls in front of the hip joint
swinging to crutch – advances the crutch – swings the body to crutches
swinging through crutch – body swings through beyond the crutches
Four point crutch gait
when all/ part of body wt can be taken on each foot – but patient is unsteady and needs wide based gait
as condition improves – moves to two point gait
right crutch – left foot (body wt on right hand) – left crutch – right foot ( body wt on left hand)
Two point crutch gait
to reduce the amount of body wt taken on both foot – some body wt can be taken by both l/l – good balance – both lowerlimbs painful/ weak
right crutch and left foot simoultanously ( taking part of body wt on left foot) - left crutch and right foot simultanously (taking part of body wt on right foot)
Three point crutch gait
when one limb can support the whole body wt and other cant
both crutches support the weak limb – stronger limb takes the whole body wt without support of crutches
both crutches and weak limb together – stronger lower limb
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