ALAT BANTU AMBULASI

Andre S. Tjahja, dr. SpKFR

• Mobilisasi : tidak memperhitungkan jarak :– Duduk– Bridging– Transfer

• Ambulasi : memperhitungkan jarak– Independen

• Tanpa alat bantu• Dengan alat bantu

– Dependen : memerlukan bantuan orang lain

Alat Bantu Ambulasi

• Cane • Crutches• Walker • Wheelchair

Cane

Cane

• Handgrip & end tip halus dan tidak licin• Dapat mengurangi beban 25%• Semakin banyak titik sentuh >> lebih stabil• Dipakai di sisi sehat • Melangkah bersamaan dengan tungkai

sakit

Crutches

Crutches

• Dapat single atau bilateral• Cara memilih crutch :

– 6 inc lateral dig V pedis– Axllar pad menyentuh gentle pd anterior axillary

fold– Elbow fleksi 30⁰– Wrist ekstensi, hand dapat menggenggam erat

• Membutuhkan otot latissimus dorsi, triceps hand yang kuat

Jalan dengan Crutchesberdasarkan titik tumpu

2 point gait 3 point gait 4 point gait

Aid D + foot S → aid S + foot D

Unstable

Faster

EE higher (better strength & coordination)

Aid D&S + involved foot → uninvolved foot

Fairly stable

Fairly slow

EE lower (little strength)

NWB / Partial WB

Aid D → foot S → aid S → foot D

Most stable

Relatively slow

Lower

Ataxia

Jalan dengan Crutchesberdasarkan titik tumpu

Swing to Swing through Drag to

Aid D & S → arm push the handrim → foot lift & swing to the level of aid

Fairy stable

Slower than swing through

EE lower than swing through

Paraplegi

Aid D & S → arm push the handrim → foot lift & swing through the level of aidFairy stable

Faster

Higher (need more balance & strength

paraplegi

Aid D & S → arm push the handrim → foot lift & drag to the level of aidFairy stable

Slowest

Higher

Paraplegi

Walker

Walkers

• Advantage :– Maximum support

• Disadvantage :– Slow gait– Create bad posture & walking habits– Limited to indoor use– Cannot used safely to climb stairs

Walkers

• Indications :– Px confused or unsafe gait because of poor

balance (hemiplegi, ataxia)– Early gait training

• Measuring :– Place walker 12 inc in front of px → should

partially surround– Proper height : elbow flexed 20⁰

Wheelchair

• Indikasi :– Kelemahan AGB : paraplegi, amputasi AGB, hemiplegi– Tdk boleh WB– Gangguan CV– Tidak fungsional : cedera sumsum, amputasi bilateral, stroke,

CP

• Kontra insikasi :– Absolut : ulkus dekubitus, buta, poor judgement– Relatif : post-op pelvis/femur prox, fract vertebra, kelemahan

trunk, HNP

• Komplikasi :– Back pain– Deformitas– Pressure ulcer– Kontraktur – Edema AGB

Memilih wheelchair

• Seat width : lebar pinggul / paha terluar + 5 cm

• Seat height : dasar tumit s.d poplitea + 5 cm• Seat depth : ujung bokong s.d poplitea + 5

cm• Back height : permukaan atas seat s.d bwh

axilla – 10 cm• Armrest height : permukaan seat s.d bwh

siku + 2,5 cm• Leg length : menaikkan footrest 5 cm di atas

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