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What Destroys Joy
Published in Eve Shapiro, Joy in Medicine?, 2020
They’re talking about making things more challenging than they are now—double-booking patients—seeing two patients at the same time, trying to be more accommodating. In certain ways they want us to do even more. And I don’t know how that would play out. For example, they might say, “You’re going to see two patients at the same time.” And I’m thinking, how would I treat two people together? And go back and forth to see them both? I have concerns about safety. I have patients who have a high fall risk, they walk with walkers, I can’t do both and say that I’m being cautious at the same time. Things like that make me think I can’t compromise the patient. I can’t compromise my life.
Familial Dysautonomia
Published in David Robertson, Italo Biaggioni, Disorders of the Autonomic Nervous System, 2019
Varying degrees of hypotonia will be noted in the infant and young child contributing to delay in motor milestones. In the ambulatory individual, the gait is often broad based and mildly ataxic with special difficulties in performing rapid movements or turning. Many patients walk listing forward with a compensatory increased stiffness in shoulders and neck leading to protracted shoulders. Physical therapy is useful in avoiding pathological movements, decreasing contracture, and promoting more normal alignment. It will not prevent spinal curvature but it is a useful adjunct to brace therapy. Deterioration of gait with progressive ataxia is a common complaint of adult patients. Many have had to resort to use of walkers or wheelchairs when outside the home.
The synergetic, probabilistic pathways of typical motor development
Published in Anna L. Barnett, Elisabeth L. Hill, Understanding Motor Behaviour in Developmental Coordination Disorder, 2019
Kathleen M. Haywood, Nancy Getchell
Walking. Most typically developing infants begin walking anywhere from ten to eighteen months of age, when they can maintain an upright posture while alternating actions of their legs and feet (Haywood & Getchell, 2014). Unlike running and other more advanced forms of locomotion, walking does not contain a moment of flight where both feet leave the ground making it a highly stable form of locomotion. One foot will support the body as the alternate leg swings forward, then the body is supported by both feet and then the original support leg swings forward while the opposite foot supports; this pattern of single-double-single support (termed a step cycle) is repeated. Because no flight exists, walking requires a relatively small amount of leg strength to move the body’s center of gravity forward. Since it lacks a moment of flight, walking is also the most stable of the foot locomotor patterns. By having two feet on the ground between leg swings, it is easier for the walker to maintain balance.
Immediate effect of weight load on lower limb muscle activity and gait ability in patients with incomplete spinal cord injury during walker gait training
Published in The Journal of Spinal Cord Medicine, 2023
Gku Bin Oh, Chang Sune Park, Ki Hun Cho
This study has several limitations. First, this study was a preliminary assessment of the changes in lower limb muscle activity and gait ability of ISCI patients according to walker dependence. Although sample size was determined by sample size calculation, results of this study cannot be generalized to all ISCI patients because of its small sample size of 14 participants. Additional studies with larger numbers of participants are necessary. Second, although various factors, such as spasticity, rehabilitation period, and coordination,34,35 could affect the walking level of ISCI patients, this study investigated only the changes in lower limb muscle activity and gait ability according to walker dependence. These other factors must be considered in future studies. Finally, the DFW used in this study was developed based on a front-wheeled walker. However, standard walkers and four-wheeled walkers are also used in clinical settings.17 Therefore, additional studies are required to investigate the relationship between walker dependence and lower limb muscle activity and gait ability using various types of walkers.
The effects of a positional feedback device on rollator walker use: a validation study
Published in Assistive Technology, 2021
Courtney Golembiewski, John Schultz, Timothy Reissman, Harold Merriman, Julie Walsh-Messinger, Kurt Jackson, Kimberly Edginton Bigelow
Mobility aid use has increased significantly over the last few decades, with an estimated 24% of older adults in the United States now using some form of a mobility aid (Gell, Wallace, Lacroix, Mroz, & Patel, 2015). Over 4 million of these individuals use walkers (Gell et al., 2015). In addition to improving mobility and helping to maintain balance, the use of a walker has other documented clinical benefits including compensation for lower-extremity weakness; increased confidence and feelings of safety; physiological benefits; and increased levels of activity and independence (Bateni & Maki, 2005). However, adverse effects and potential disadvantages associated with walker use are also commonly highlighted in the literature including: increased attentional and neuromotor demands; destabilizing biomechanical effects during device advancement; and interference with reactive limb movements during balance recovery which could be influenced by walker fit and positioning (Bateni & Maki, 2005; Stevens, Thomas, Teh, & Greenspan, 2009).
Lost in Transition: Entering the Liminal Space of Rural Homelessness in a Small Prairie Town
Published in Journal of Social Distress and Homelessness, 2021
Many participants described rental properties that should be condemned. Substandard secondary suites in basements were also common. One participant described living in a basement suite with ceilings only 172 cm (5’8”) high. The local rental market was also constrained in its ability to meet the needs of people who required the use of mobility devices: I pay $850 here. I have to pull my walker up the stairs so I can get to the bathroom. There are two bedrooms upstairs. I needed somewhere without stairs, because of all the pending surgeries. So even though I don’t use a third of the house, I still have to pay for it …Several participants spoke of unsafe kitchen appliances that limited their ability to prepare or store food. Others complained of black water flowing from faucets and signs of combustion around the furnace.