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PTA Blog Talk

Dropping Gait Belts

Published June 2, 2010 4:16 PM by Jason Marketti

Gait belts are often a requirement during gait training, transfers and balance activity. However, there are some therapists who do not use gait belts. As long as the patients are safe during the activity, it becomes an individual choice. Several years ago I worked with a PT who instructed me to place a gait belt closer to the patient's center of gravity - approximately around the hips - rather than around the waist, "So you have greater control of the patient."

When a gait belt is placed around the waist of a patient and he is assisted to stand by pulling the gait belt from behind, the patient flexes the trunk and often the belt slips up out of position. This can also cause skin abrasions. Placing the belt lower will certainly give me more control of the patient's weight shifting ability; however, it does little if he has poor trunk control. So I am careful about which patients I drop the belt on.

Then there are patients I place a belt on but never use it. I end up facilitating standing by gently pulling forward and upward on their shoulder blades or assisting them to stand from behind by gently lifting their hips to initiate the motion to get up. Over the years I have gotten a sense of which patients respond better to the different types of transfers.

Policies of a facility usually dictate gait belt usage as well as the patient's safety and circumstances of injury. There are always patients who are unsafe and unaware of their own limitations. As far as which position is better for gait belt usage, it really depends on the patient, as well as the therapist's knowledge of how to effectively and safely transfer and facilitate mobility with the patient.

5 comments

Ruth,

Email me at ptablogtalk@gmail.com

Jason Marketti February 13, 2014 8:59 PM

Dear Jason My son who is mentally challenged with epilepsy attends a day program. His doctor does not feel he needs a gait belt or toilet straps. The facility's PT person put a gait belt on him I dont feel he needs these items I am a Regestered Nurse. Have you ever heard of these items being used as seizure precausion? My son ambulates and has no difficulth with transfer. He has normal balance.  I would like your feelings on this issue thank you

Ruth , Parent February 13, 2014 9:34 AM
Deer Park NY NY

Hey Jason,

Great BLOG first of all (after doing my 2 minute scan - which as a Gen Xer is my norm re: gleaning over an article, résumé etc).

I wanted to add that in one clinic, one PT was injured due to a client loss of balance and was not covered by worker compensation due to the fact that she did not use a gait belt.

For me as a PTA, if the PT assesses a fall risk and I am doing gait or balance training, I generally use a gait belt for my and my clients safetly (and to CMA in case anything does happen).

Best regards - Shalom,

Marc

Marc Duyck, Education, PT - PTA, Education, Providence Portland July 5, 2010 11:40 AM
Portland, Salem, Eugene OR

A common question a falls investigation report has is if a gait belt was used.  What harm will it cause if you applied  a gait belt to all your Pts? Don't leave yourself and facility open for possible litigation. It's easier to apply a gt belt than give a deposition on reasons why you did not

Tom June 7, 2010 10:14 PM

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June 2, 2010 12:20 PM

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