4.5 Instruction on the use of parallel bar

Prior to ambulation using the parallel bar, the following safety and precautions should be checked.


Also, the following instructions should be given to the users before they are positioned between the parallel bars:


Users of parallel bars first need to learn how to stand using the parallel bar. The user uses one of the upper limbs to hold one bars of the parallel bar (for stability and balance) and the other upper limb to assist in standing by pushing up on the seat (Figure 6A). Clinicians can assist the user into standing position from sitting by assisting the user from the axilla region. Immediately the user is almost standing user change the position of the upper limb that was on the seat to the other bar of the parallel bars (Figure 6B). User stands upright within the walker, adjusting the upper limb and lower limb till the user is balance.

When siting from standing using the parallel bar, the user follow the reverse pattern of standing. From upright standing within the parallel bar, the user place

4.9 Partial weight bearing (PWB)

Ambulatory Devices: Assessment and Prescription DOI: http://dx.doi.org/10.5772/intechopen.89886

to continue to move forward.

4.10 Weight bearing as tolerated (WBT)

ahead of the other during ambulation.

the FWB lower limb). Then cycle is then repeated.

4.11 Full weight bearing (FWB)

5.1 Description and components

5. Walker

Figure 7.

67

two wheel rollers in front.

The user slides the upper limbs on the horizontal bars forward to an arm's length distance. Then the user puts weight on the parallel bar using the upper limbs and moves the affected/involved lower limb forward (bearing less than 50% of body weight on the affected/involved lower limb). And the other 50% body weight is shared between unaffected lower limb and the horizontal bars. The user finally moves forward to complete the cycle. The user is made to repeat this cycle in order

While standing and sharing the body weight on the unaffected lower limb and the horizontal bars, the user slides the upper limbs on the horizontal bars forward to an arm's length distance. Then the user moves forward by taking the affected/ involved lower limb forward, bearing body weight that the lower limb can tolerate on the affected/involved lower limb, and finally moves the weight bearing lower limb. This cycle is then repeated. User can learn normal walking by putting one leg

The user slides the upper limbs on the horizontal bars forward to an arm's length distance. Then the user hold the parallel bar using the upper limbs and moves the affected/involved lower limb forward (bearing full body weight on the lower limb) and finally moves the weight bearing lower limb forward (same or different level as

Walker is also known as walking frame or called zimmer frame. It is a modified and mobile version of the parallel bar (Figure 7). It is a medical ambulatory device

Two types of walkers (walking frame); (a) with four rubber ferrules and (b) two rubber ferrules behind and

#### Figure 6.

Positioning for learning how to use the parallel bars: (a) learning how to stand when using the parallel bar, (b) moving the hand on the seat to the horizontal pole of the parallel bar to maintain stability.

one hand (i.e., upper limb) on the seat to control the speed and bear weight of sitting. Then the user sits gradually, using the other upper limb on the bar to control the movement back to seating.

#### 4.6 Weight bearing status possible with parallel bar

The following weight bearing status can be used with parallel bar: non-weight bearing (NWB), touch down weight bearing (TDWB), partial weight bearing (PWB), weight bearing as tolerated (WBT), full weight bearing (FWB).

### 4.7 Non-weight bearing (NWB)

The user slides the upper limbs on the horizontal bars forward to an arm's length (weight of the body is on unaffected lower limb and the affected lower limb is not touching the ground). The user shared his/her body weight between the unaffected lower limb and parallel bar by putting body weight on the parallel bar using the upper limbs. The user then moves the affects/involved lower limb (freely without bearing weight, i.e., NWB) forward and finally moves his/her body (weight), by propelling himself/herself forward (hopping) using the upper limbs to complete the cycle. The user is made to repeat this cycle in order to continue to move forward.

#### 4.8 Touch-down weight bearing (TDWB)

The user slides the upper limbs on the horizontal bars forward to an arm's length distance, with the body weight borne on unaffected lower limb while allowing the foot or toes of the affected lower limb to touch the ground without bearing any weight. Then the user put body weight on the parallel bar using the upper limbs and moves himself/herself forward, completing the cycle. This way the user finally moves forward. The user is made to repeat this cycle in order to continue to move forward.
