Week 5

Patient D was cleared for WB on monday this week after orthodpaedic reveiw, post fractured NOF. Prior to the orthopaedic review i have been doing alot of strengthening work, particulary on her quads. I have also had patient D in single leg standing, and doing small repetitions of single leg squats. Patient D usually ambulates with a 4 WZF however has been using a 2WZF to transfer whilst NWB on her L LL. During my treatment session today, patient D asked if she could return to using her 4 wzf. I decided to let her walk to the end of the corridor and back to her room wih her old 4wzf. Reflecting on this decision, i think i should not have tried her with the 4wzf. Patient D was very unsteady on her feet. I need to do alot more dynamic standing balance work before i progress her aid. I also noted that this was not an apprpopriate aid as she is ambulating with a very NBOS. Although i have attempted to correct this and continue to remind my patient to walk with a wider BOS, she has early onset dementia and needs constant prompting. I think that enabling my patient to try ambulating with the 4 wheeled walker affected her confidence, as she did not feel stable on her feet, and seems to have a more apparent fear of falling now. In future i need to think about, dynamic balance, BOS and general gait pattern more carefully before i progress a walking aid.