PreGait: Patient performed pregait activities of stepping strategies in // bars.
Pre-Gait Trg: Patient performed pre-gait tasks to improve unsupported standing, weight shift during mobility and pre-gait activities in parallel bars.
Gait: Patient performed GT with emphasis on increased stride length for safety, heel to toe walking, side stepping, and single leg activities for balance.
Gait Trg: Patient performed training in correct sequencing of gait with AD to increase safety, weight shift during mobility and training strategies in straight level surfaces.
Gait Trg: Patient performed training in correct sequencing of gait with AD to increase safety, weight shift during mobility and training strategies to safely maneuver around obstacles.
Patient coached through proper gait pattern and safety, while ambulating ---- ft. with ----- at ------ . Patient required verbal ----- and tactile cues with gait training to ensure proper technique and safety.
The patient made strong progress this week as the patient ambulated ___ft with a_____ at ___A with out rest breaks. The noted complexity to the patient gait deviation was with the patient at times having a decrease BOS causing the patient to lose balance.
The patient made strong progress this week as the patient ambulated 75ft with a RW at Mod Ax1 with out rest breaks. The focus was with lateral weight shifting to promote increased BLE swing through for improved gait pattern.
Patient has made pronounced progress this week in gait with noted gains in ambulation distance of 100ft with a RW at Mod Ax1 with no rest breaks. The focus was with lateral weight shifting to promote increased BLE swing through for improved gait pattern.
The patient has demonstrated marked progress with gait as the patient is able to ambulate up to 30 feet with the use of a RW at mod A on straight level surfaces, mod A for negotiating turns, and mod A for negotiating obstacles with 15% verbal cueing for safety and to cue patient to advance LEs with adequate heel-to-toe gait pattern and to increase stride length in order for her to perform all ambulatory activities efficiently with reduced risk of falls/LOB.
Noted gains in gait were noted this week as the patient ambulated 75-85 ft with a RW at Min Ax1 with maximal verbal cues to increase the BOS and stride length for safer ambulation.
Noted gains in ambulation were noted this week as the patient traversed 150 ft with a RW at SBA with 10% verbal cues to increase the BOS and stride length for safer ambulation while negotiating around obstacles and varying surfaces.
Noted gains in ambulation were noted this week as the patient traversed 275 ft with a single point cane in straight surfaces at MI, unlevel and varying surfaces at Set up Assistance with improved balance reactions, and negotiating corners and obstacles at Set Up Ax1 with 5% verbal cues to increase the BOS and stride length for safer ambulation.
GENERAL: Notably patient demonstrates muscular imbalances at the ankle, knee and hip that impair balance and coordination leading to unsteady gait with decrease base of support and poor cadence. Patient has difficulty with proper weight shifting and hip rotation decreasing accuracy with navigating doorways, turning and avoiding obstacles.
SHUFFLING: Patient has uneven ----- shortened stride length demonstrating decrease step through pattern on ---- side. Gait deviations include decreased toe off, decreased heel strike, -------- gait pattern and decreased step length.
TECHNICAL: Patient is observed to have difficulty with ----- LE during ---- phase ---- , due to pain, limited ---- excessive ROM of ---- and lack of strength, lack of coordination
Patient was lead through gait exercise x 90 feet with use of R/w for stability in order increase tolerance to activity and improve functional mobility. Patient required CGA and verbal cueing in order to perform turning with proper timing. Patient tolerated ambulation well as evidenced by VS within normal values upon completion of exercise with BP=106/64 mmHg and HR=74 bpm.
Patient was coached through gait training with use of RW via marching in place, side-stepping, and ambulation x 90 feet with intermittent rest breaks for improved BLE strength, dynamic balance, swing phase of gait cycle, and tolerance to ambulation for improved functional mobility. Patient required moderate verbal cueing and maximal visual cueing for safe and correct performance of activities. Patient is demonstrating increased tolerance to activities as evidenced by less need for rest breaks and performance of tasks at a quicker pace.
In order to improve functional mobility, patient was coached through gait training exercise using RW with emphasis on improving sequencing of gait cycle without interruptions, dynamic postural control, and handling of AD. Patient required CGA, verbal and visual cueing in order to manage turns with RW, and tactile cueing to upper trunk for improved upright posture. Patient is demonstrating improvement in ambulation as indicated by increased cadence and minimal LOB during ambulation.
Patient was coached through gait training exercise with RW x 120 feet with min A for improved functional mobility. Patient required maximal verbal cueing for improved safety awareness and correct handling of RW.
In order to improve functional mobility, patient was coached through ambulation while maneuvering around object and others with emphasis on decreasing need for steadying on wall and improving gait cycle and stance phase to RLE. Patient required SBA and moderate verbal cueing for safety and postural awareness.
In order to improve functional mobility, patient was coached through gait training as follows: ambulation on level surface using RW with SBA, side stepping to R/L on parallel bars, alternating stepping with R/L onto 2-inch step, and sit-to-stands. Goals of tx were to increase dynamic balance, coordination, BLE extensor strength, functional activity tolerance, awareness to environmental hazards, and anticipatory reactions. Patient required monitoring of exertion and pain levels, frequent rest breaks, and demonstration of tasks in order to improve safety awareness and functional activity tolerance.
In order to improve participation in activities within facility, patient was coached through ambulation on level surface with use of RW. Goals of tx were to increase dynamic balance, coordination, BLE extensor strength, functional activity tolerance, awareness to environmental hazards, and anticipatory reactions. Patient required SBA and close monitoring for LOB and exertion and minimal verbal/visual cueing for improved coordination in maneuvering around objects, managing RW over carpeted mats and postural awareness. Patient was able to tolerate ambulation for 17 minutes today with intermittent halting in standing.
In order improve participation to activities, patient was facilitated through gait training via ambulation without use of AD. Patient required intermittent steadying on the walls and minimal verbal/visual cueing during ambulation; however, maximal monitoring for LOB and exertion levels. Patient was able to tolerate gait training for 11 continuous minutes and ambulated a distance of 537 feet.
In order to improve functional mobility and increase participation of daily activities, patient was coached through pre-gait training on parallel bars via side-stepping, f/b stepping, and alternating R/L f/b high stepping onto 4-in step. Patient required maximal visual cueing for correct and safe performance of activities and maximal verbal cueing to maintain correct upright posture and increase step-length. Patient was lead through sit-to-stands with use of BUE support for increased strength to BLE in order to improve tolerance to anti-gravity positions during functional mobility.
Patient was lead through ascending/descending 4-in step x 5 with BUE on parallel bars in order to improve BLE strength, dynamic balance, foot clearance with stairs, and kinesthetic awareness in preparation for gait and managing stairs. Patient required moderate verbal and visual cueing in order to increase safety awareness with proper positioning of upper and lower extremities.
In order to improve functional mobility, patient was coached through standing exercises with RW via standing and reaching activity using single UE support and ambulation x 70 feet for improved tolerance to standing, proprioceptive and kinesthetic awareness, dynamic postural control, and coordination. Patient required moderate visual, tactile, and verbal cueing for improved sequencing, posture, and safety awareness. Patient is demonstrating progress with improved maneuvering of RW and increased cadence.
Patient was lead through gait training x 5 feet for improved BLE strength to anti-gravity musculature, dynamic postural control, endurance and step length. Patient required min A and maximal tactile facilitation to L LE in order to promote step-through. Patient required 2 rest breaks intermittently and would benefit from continued PT for improved tolerance to ambulation.
Patient was coached through gait training using RW via marching in place, side-to-side stepping, knee bends, and ambulation x 150 feet in order to strengthen BLEs, improve dynamic postural control, improve coordination, and increase tolerance to activity for improved functional mobility. Patient required maximal visual and verbal cueing for improved safety awareness and coordination.
In order to improve functional mobility, patient was coached through gait training on parallel bars with BUE support x 5 feet x 2 trials with min A and tactile facilitation to L hamstrings in order to increase knee flexion and step-length during swing phase of gait. Patient tolerated treatment well and is demonstrating improvement via increased cadence and confidence during gait.
In order to improve functional mobility, patient was coached through gait training for improved tolerance to activity, BLE strength, and dynamic balance. Patient required moderate verbal cueing for improved reciprocal arm swing and step-through gait pattern.
Patient was lead through gait training x 65 feet with RW and CGA in order to improve functional mobility. Tx emphasized on improving dynamic balance, postural awareness, managing of RW, kinesthetic awareness, gait cycle, and BLE strength. Patient required maximal tactile facilitation to accurately make turns with RW and maximal verbal cueing for increased attention to task and safe ambulation.
In order to improve functional mobility, patient was coached through CGA ambulation x 470 feet for improved dynamic balance, tolerance to activity, BLE strength, kinesthetic sense, stance/swing phase, and upright postural awareness. Patient required maximal verbal/visual cueing for increased safety awareness and appropriate maneuvering around objects. Patient was able to tolerate standing position for 11 minutes.