Documenting Ambulation or Functional Mobility For Extended Periods of Time
Ambulation for Extended Periods of Time
A goal I have with almost every patient I treat is ambulation.
But this is not a quick and easy goal to accomplish with most of my patients.
Most have a lot of gait deviations as well as a lot of hindrances such as fear of falling and/or cognitive decline.
How to Justify
So how do I justify ambulation training for an extended period of time?
I focus on different parts of the activity on different days. I provide different levels of assist. I document different cues and exactly what I had to cue the patient on that day.
So for my patient today she had decreased step height.
So we did gait with verbal cues to increase step height and tactile cues at hip flexors to further increase height. I documented how she has a fear of falling (which is her hindrance and a reason for continued treatment.) And then what I did to address her fear which was fall prevention tips.
I then did a few activities focusing on step height such as stepping over a cone. And yes she did hit the cone so I would document how many times she knocked over the cone in 20 repetitions which this can also show progress over time and is an easy thing to document.
After doing this for a few treatments she should show progression and if not this activity and the cues provided can be given to a caregiver so no longer skilled.
For Future Treatment Use a Different Gait Deviations
For future treatments I would then focus on her:
- Narrow base of support
- Posture
- Endurance
- Lateral lean
- Etc.
Just remember what you are doing needs to show skill! Cueing needs to change and document exactly what you are cueing the patient to do.
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