4.3.2 Ambulation

The definition of ambulation per the Medical Dictionary is “to walk or move about freely.” (“Ambulation” n.d.). In contrast, mobility is a term used for clients who may be unable to stand and walk, but are still able to move about freely. For example: a person is mobile in a wheelchair even though they can not stand to ambulate.

To assist with ambulation and mobility, you must understand and be capable of facilitating the general guidelines of assisting with movements that we discussed previously.

When assisting a client to ambulate, review the care plan to note the orders for ambulation, the equipment needed to ambulate, and the tolerance level and length of ambulation that is safe for the client. Complete a safety assessment to determine the strength of the client and the current status of the client today.

When you have found the client is capable of ambulation, assemble any equipment needed for the client. You are now ready to assist the client with ambulation.

If the client has a stable gait (manner or style of walking), they may only need to walk next to you (“Gait” n.d.). If the client has a stable gait but would like to hold onto your arm for reassurance, use the hand-under-hand hold. Practice the hand-under-hand technique with a volunteer until it becomes your natural practice during care.

This video provides a visual instruction on the hand-under-hand technique which works well to stabilize a client for walking. This technique works well for assisting with one or two hands during ambulation.

Click here for a video transcript in .docx format: Video Transcript

The steps to follow when assisting ambulation when no assistive devices are needed are as follows:

  1. Complete the general guidelines.
  2. Use a transfer belt if needed.
  3. Place footwear on client prior to assisting them to stand.
  4. Once client is standing, walk slightly behind and to the side of the client.
  5. Encourage a non-dragging shuffling gait; the client’s heel should connect with the surface first when walking.
  6. Do not rush the client, and only walk slightly farther than the last walk the client tolerated well, per the chart. Pay close attention to the client’s body language, looking for cues that they are tiring or struggling.

This video will demonstrate the process of assisting with ambulation without needing equipment.

Click here for a video transcript in .docx format: Video Transcript


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