Gait Training Scenarios – Flashcards
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17 y.o. pt. with R tibia fx. NWB on the R LE. B UEs and L LE are strong. She is ready to be up and ambulating. Gait pattern? Assistive device? Consider if pt. is fearful/ anxious
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GP: 3 point gait AD: Cx 3 point gait with walker
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72 y.o. pt. s/p L THA 2 days ago. TTWB on L LE. B UEs and R LE have good strength. Pt has mild confusion secondary to anesthesia Gait pattern? Assistive device?
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GP: mod. 3 point AD: standard walker
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35 y.o. pt. with Guillian Barre Syndrome. Mild weakness of B UEs and B L Es. Gait pattern? Assistive device? What if pt had moderate weakness throughout or decreased balance?
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GP: 4 point gait AD: fore-arm cx 4 point gait with recip. walker
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54 y.o. pt. with B BKA and B LE prostheses. Has been ambulating with a reciprocal walker and a 2 point gait pattern, but has improved with balance and is ready to progress. Gait pattern? Assistive device? What would be the next progression?
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GP: 2 point gait AD: Cx 2 point mod. gait with cx
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49 y.o pt. with severe RA. Pt has moderate weakness of B UEs with deformities of B wrists/ hands. Pt also has mild weakness of B L Es. Gait pattern? Assistive device?
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GP: 4 point gait AD: FWW with platform
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72 y.o. female who had a fall at home when getting up in the middle of the night to use the bathroom. She is in the acute care hospital 2 days s/p R THR. Her doctor has ordered PWB (40lbs) on right. B UE and LLE strength is WNL. Instruct in gait training with appropriate assistive device and appropriate gait pattern.
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GP: 3 point mod. gait AD: rolling walker walker
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You are seeing a 43 y.o. patient with Multiple Sclerosis. Patient currently has weakness of LE>UE, (legs are weaker) balance is fair (a little wobbly). Patient has come down to the therapy department by wheelchair. You are to assist the patient by instructing in use of appropriate assistive device and gait pattern.
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GP: 4 point gait AD: recip. walker
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Your patient is a 67 y.o. s/p left hip fx with THR three days ago. Patient is TTWB L. You are seeing the patient bedside. Upper extremity and right lower extremity strength are WNL. Begin gait training with appropriate assistive device and gait pattern.
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GP: 3 point mod. gait AD: stand. walker
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You are seeing a 65 y.o. patient who is one week s/p CVA with left hemiplegia. The patient can ambulate in the parallel bars. Balance is fair. Patient comes to therapy department in wheelchair. Strength of the right extremities is WNL. Begin gait training with appropriate assistive device and gait pattern.
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GP: 4 point mod. gait AD: hemiwalker
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You are going to see a 32 y.o. factory worker with a femur fx following a MVA. Patient is NWB right and has had a long leg cast applied Upper extremity and left lower extremity strength is WNL. He is being discharged after you instruct in gait training with appropriate device and appropriate gait pattern.
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GP: 3 point gait AD: axillary Cx
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You are seeing a 28 y.o. pt. with a Fx right ankle with a short leg cast and cast boot. MD has stated patient is PWB. Upper extremity and left lower extremity strength is WNL. Perform gait training with appropriate assistive device and gait pattern for d/c.
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GP: 3 point mod. gait AD: Cx
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You are seeing 66 y.o. patient with a right above-knee amputation. Patient has been ambulating with a walker and a prosthesis. Patient cannot afford Lofstrand crutches and prefers to use axillary crutches. Patient comes to PT department in wheelchair and is ready to progress gait training. Upper extremity and left lower extremity is WNL. Perform gait training with appropriate assistive device and appropriate gait pattern.
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GP: 4 point gait AD: axillary Cx
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This 45 y.o. female with Guillian Barre (neuromuscular disease) has been ambulating with a reciprocal walker, but is ready to progress to the next level. Upper extremity strength is Good. Lower extremity strength is moderately decreased. Gait train with the appropriate assistive device and appropriate gait pattern.
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GP: 4 point gait AD: loft-strand/forearm cx
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This 72 y.o. female fractured the radial head on the right and is in a cast up to the mid humerus (Elbow flexed to 70 degrees.) She also fractured the left medial malleolus us and has a short leg cast on the left (PWB). She is unable to raise the right arm above 30 degrees due to the weight of the cast. Left upper and right lower extremity strength are WNL. Gait train with an appropriate assistive device and appropriate gait pattern.
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GP: 3 point mod. gait AD: FWW with right plaform
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You are seeing a sixty-seven y.o. patient with Parkinson's Disease (which has caused marked rigidity and decreased coordination especially to his upper extremities). All muscle tests are WNL. Gait train the patient with an appropriate assistive device and appropriate gait pattern.
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GP: 4 point gait AD: reciprocating walker with B platform
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Thirteen y.o. female with compound Fx of the L femur due to MVA. She has a long leg cast and is NWB L. B UE's and R LE strength WNL. Gait train with appropriate assistive device and appropriate gait pattern.
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GP: 3 point gait AD: axillary cx
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Fifty-five y.o. female with OA, had a THR on the R 2 days ago. Orders are for TTWB. BUE are weak and the L is strong. Gait train with appropriate assistive device and appropriate gait pattern.
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GP: 3 point mod. gait AD: rolling walker
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Forty y.o. male R BKA following farming accident. Patient is pre-prosthetic. UE's and L LE are strong. Gait train with appropriate device and appropriate gait pattern.
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GP: 3 point gait AD: axillary Cx
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Sixty-five y.o. female with RA and an elbow flexion contracture on right of 70 degrees. Painful wrists and hands with mild flexion contractures B. Generally weak in all extremities, needs assistive device for moderate support and balance. Gait train with appropriate assistive device and appropriate gait pattern.
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GP: 4 point gait AD: rolling walker with B platform
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Eighteen y.o. basketball player with a right fibula Fx. The pt has a long leg cast but is PWB. B UE's and L LE are strong. Gait train with appropriate gait assistive device and appropriate gait pattern.
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GP: 4 point mod. gait AD: Axillary cx
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Nineteen y.o. female with a left ankle fx and short leg cast and a right wrist Fx with a forearm cast. PWB status. L UE and R LE are strong. Gait train with appropriate assistive device and appropriate gait pattern.
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GP: 4 point mod. gait AD: Axillary Cx
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Forty-five y.o. female with MS with resultant decrease in strength of B UE's and B LE's [UE stronger than LE]. Pt has poor balance and decreased proprioception. Gait train with appropriate assistive device and appropriate gait pattern.
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GP: 4 point gait AD: recip. walker
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Sixty y.o. male with bilateral BKA and prostheses. He is diabetic but active. B UE's strong. Gait train with appropriate assistive device and appropriate gait pattern.
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GP: 4 point gait AD: forearm Cx
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Seventy-five y.o. female with diagnosis of left hip fracture. She is five days post pinning of left hip and is slightly confused. Her orders are for gait training with toe touch weight bearing left. Gait train with appropriate assistive device and appropriate gait pattern.
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GP: 3 point mod. gait AD: rolling walker
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Twenty-eight y.o. highly motivated male with diagnosis of bilateral femur fractures secondary to MVA 10 weeks ago. Fractures have healed. Orders are for gait training with PWB bilaterally. Gait train with appropriate assistive device and appropriate gait pattern.
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GP: 2 point gait AD: Cx
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Thirty-nine y.o. male with diagnosis of tetraparesis (weakness in all four extremities ; trunk) secondary to a motorcycle accident. He is three months post-accident and his condition is very stable. His LEs are weaker than his UEs. Orders are for gait training with appropriate assistive device and appropriate gait pattern.
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GP: 4 point gait AD: Cx
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Fifty-five y.o. female with left ankle fracture secondary to fall one day ago. She has a left short leg cast and is very pleasant but extremely apprehensive about ambulation. Orders are for gait training with left LE NWB status. Gait train with appropriate assistive device and appropriate gait pattern
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GP: AD:
