06 - Walking and tone

Summary

In the script, Allan is assessed for walking aids, starting with a tripod cane which he leans on heavily with his left hand, causing asymmetrical weight distribution. The therapist then raises the cane's height to encourage Allan's right leg to bear more weight, leading to improved symmetry. They also try a single point cane, which further enhances Allan's gait symmetry. Finally, Allan practices walking without a cane but with an Ankle Foot Orthosis and a rest splint, which significantly improves his balance and muscle tone control, resulting in a more natural and unrestricted walking style.

Takeaways

• 🚶‍♂️ Allan is being assessed for walking aids and is initially using a tripod cane.
• 🔄 The tripod cane provides Allan with support, but he leans heavily on his left hand, affecting his right leg's weight distribution.
• 📏 The therapist adjusts the height of the tripod cane to encourage Allan's right leg to bear more weight and reduce reliance on his left arm.
• 👍 After raising the cane's height, Allan shows improved weight distribution, becoming more symmetrical in his walking.
• 🛑 The therapist determines Allan may not need a cane as supportive as the tripod and suggests trying a different type of walking aid.
• 🤔 Allan tries a single point cane, which is intentionally left high to reduce the ease of pushing down, leading to better symmetrical walking.
• 🦿 Allan is also using an Ankle Foot Orthosis (AFO) and a rest splint for his hand and wrist to help control their position.
• 🧍‍♂️ The therapist instructs Allan to try standing and walking without the cane but with the splint, using a specific technique to control muscle tone.
• 🌟 Without the need to use his left arm and with his right foot and ankle well controlled, Allan's walking becomes more relaxed and symmetrical.
• 👍 The therapist concludes that walking without a stick but with the AFO and splint is a better approach for Allan, as it is less restrictive and allows for better use of his left hand.
• 🤝 The session ends with Allan expressing gratitude for the assistance, and the therapist acknowledges the progress made in finding a suitable walking method.

Q & A

What is the initial walking aid Allan is using at home?

Allan is initially using a tripod cane, which has three feet for added support.

What observation does the speaker make about Allan's weight distribution while using the tripod cane?

The speaker observes that Allan is taking a lot of weight through his left hand, reducing the weight on his right leg, and this increases activity in his right arm.

What adjustment does the speaker make to the tripod cane, and why?

The speaker raises the height of the tripod cane to reduce the weight Allan can place on his left arm, encouraging more weight on his right leg and promoting more symmetrical walking.

What is the result of raising the height of the tripod cane for Allan?

Raising the height of the tripod cane results in Allan placing more weight on his right leg and less on his left arm, leading to more symmetrical walking.

What type of walking aid is introduced after the tripod cane, and what is its intended effect?

A single point cane is introduced, left deliberately high to make it harder for Allan to push down on, aiming to further improve his weight distribution and walking symmetry.

How does Allan's walking change with the single point cane?

Allan's walking becomes much more symmetrical, with more weight on his right leg, indicating an improvement.

What additional support devices is Allan using when trying to walk without the cane?

Allan is using an Ankle Foot Orthosis (AFO) and a rest splint on his hand and wrist to control the position of his foot and hand.

What technique is suggested for Allan to use when standing up before walking without the stick?

Allan is advised to bring his weight forward from the hips, take his hands towards the floor, and then stand up on both legs.

How does Allan's arm and overall walking symmetry change when not using the stick but wearing the AFO and rest splint?

Allan's arm is much more relaxed, and his walking becomes more symmetrical without the stick, suggesting better control and less restriction.

What conclusion does the speaker reach about Allan's walking aid needs?

The speaker concludes that Allan walks better and more symmetrically without a cane, provided he uses the AFO and rest splint, which help control the muscle tone in his right side.