Gait training is an important part of patient management for various types of musculoskeletal, neuromuscular or cardiopulmonary disabilities. The purpose of gait training activities is to make the patient functionally independent and safe with least expenditure of body energy.
The therapist or the concerned person coming for home visit should always take information regarding the types of stairs, the number of stairs and its location to know about the convenience of the patient and other requirements. The information obtained should also include the height if the stairs apart from the number.
The therapist or the concerned person should also ask the family members regarding condition of the floor, stability of the railings (if any).
For the patient-
Patient should always be provided proper instructions and guidelines before stair climbing.
If railings are availaible, it should always be used.
Patient should be informed always that “
STRONGER LOWER EXTREMITY ALWAYS GO UP FIRST AND WEAKER ONE ALWAYS LEADS COMING DOWN”
FOR THE THERAPIST
DURING CLIMBING THE STAIRS
A wide base of support should be mentioned with each foot on a different stair by the therapist.
The therapist is positioned backward and lateral on the affected side behind the patient.
One hand is placed on the back guarding the belt and other hand supporting shoulder of the weaker side.
FOR DESCENDING THE STAIRS
Therapist should stand in front of the patient towards the affected side.
Each foot should be on different stair with wide base of support by the therapist.
One hand should be placed for guarding the belt and other near the shoulder of the weaker side.
IF PATIENT LOOSES BALANCE DURING STAIR CLIMBING-
If the patient looses balance during the stair climbing, the first contact for support should be made with the hand guarding the shoulder.
The therapist should move towards the patient .Avoid patient to be pulled towards the therapist .
Patient can be made to sit down on the stairs for a while after informing.
These were the general instructions for stair climbing using axillary crutches
ACTIVITIES ON OUTDOOR SURFACES ARE THE FINAL COMPONENTS OF GAIT TRAINING IN PATIENTS.It has to be specifically assessed depending on the patient.Mainly gait training on outdoors include sidewalks and walk on grassy surfaces or training the patient for crossing the street.
Gait training is a vast topic for discussion and practical implementation as it involves various types of supportive devices, training with them according to the assessment and requirement of the patient plus taking the age and lifestyle of the patient into consideration.
In our next article we will study in detail about supportive devices and its use in gait training of patients.
AUTHOR-DR.INDIRA SHIVANI .G, M.P.T
Author is a physiotherapist with more than 9 years of experience.
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