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PTA Blog Talk

Not Assessed

Published August 26, 2009 10:32 PM by Jason Marketti
My scenario:

A patient was evaled and goals were established for transfers and strengthening exercises. So I see the patient this last week and have her stand up with a FWW.  She took a step.  This was followed by several more steps on her own initiation and she eventually walked across the room.  I have seen patients do a one time walk and not do it again for the whole time they are on therapy, but his patient walked everyday as soon as she stood up.  

Unfortunately the PT was on vacation last week and was not able to establish any goal for gait.  

My thought processing with this patient was that the standing, the transfers, and the walking would fit into the goals that were established.  Since I walked (no gait) with the patient this fits into strengthening, right? And/or functional mobility.

And before anyone says anything, I checked the H and P, POC, eval, nursing and MD notes and there was not anything in there that excluded walking or weight bearing through bilateral lower extremities. 

This is a dilemma for me that I have yet to resolve or solve for myself.  If a patient stands and decides that they want to walk and no PT is available do I walk with them and discuss it with the PT later, or lose the rhythm of treatment and have the patient sit back down and wait until I find a PT that can assess the patient if no goal is established?

Getting up, weight bearing through the legs and walking is a natural sequence of events that we learn as children and it stays with us through our lives unless if we can't or absolutely don't want to.  Should I have allowed a person to do a natural sequence of events that was learned before I was born even though a PT did not assess it and establish a goal for it?

posted by Jason Marketti


Sounds like the patient wants to be up and moving. Any PT worth their weight in salt should know it's absurd and counterproductive to make a patient stay in the WC as long as they are able to walk safely and there is no medical reason to avoid walking.  So what if there is no gait goal, and you can't work on gait/bill for gait? Why not have the patient walk to the bars and do some LE exercises in standing?  Walk to the mat to do more exercises, and then work on mat transfers. Walk to the bathroom for toilet transfers, walk to their room for bed transfers....walk to a chair.....walk to the recumbent bike...you get my drift.

Andi , PTA September 2, 2009 3:34 PM

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About this Blog

    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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