指导老年人使用拐杖行走训练

Instruct the Elderly to Walk with Crutches

张爷爷，69岁，中风后遗症半年，右侧偏瘫，经过康复治疗后站立稳定，近期康复师使用四角拐杖对张爷爷进行“三点步行”行走训练，现嘱咐健康照护师今天上午协助老年人使用四角拐杖复习“三点步行”行走训练，并且教“两点步行”和“上下楼梯”行走。

Mr. Zhang, 69 years old, has suffered from stroke sequelae for half a year, with right hemiplegia. After rehabilitation treatment, he could stand stably. Recently, the rehabilitation therapist trained Mr. Zhang to use a four-cornered crutch for Three-point Walking. The caregiver is now asked to assist the elderly in reviewing the Three-point Walking with a four-cornered crutch this morning, and then teach him Two-point Walking and walking up and down the stairs.

步骤1：工作准备

Step 1: Preparation

1、环境准备：地面整洁、平坦，无积水、无障碍物

1. Preparation of environment: The ground should be clean, flat, free of accumulated water and obstacles

2、照护人员准备：着装整洁，了解老人身体状况，与康复师沟通并制定了训练方案

2. Preparation of caregiver: The caregiver should dress neatly, understand the physical condition of the elderly, communicate with the rehabilitation therapist and formulate a training program

3、物品准备：四角拐杖、安全腰带、毛巾、笔、记录单。

3. Preparation of articles: a four-cornered crutch, safety belts, towels, pens and record sheets.

4、老人准备：着装合适；穿好防滑鞋；已到达训练室、坐在椅子上

4. Preparation of the elderly: The elderly should dress properly, wear non-slip shoes, arrive at the training room and sit on the chair

步骤2：评估与沟通

Step 2: Assessment and Communication

5、照护人员向老人解释训练目标、内容、时间，以取得老人的配合。

5. The caregiver should explain the training objectives, contents and time to the elderly to ensure good cooperation.

6、评估老人的身体状况，确认可否进行训练。

6. Assess the physical condition of the elderly and confirm whether training can be carried out.

7、检查拐杖是否完好。

7. Check whether the crutch is in good condition.

步骤3：行走训练

Step 3: Walking Training

8、照护人员讲解、示范：健手持杖，拐杖—患肢—健肢或拐杖和患肢—健肢。并告知注意事项。

8. Explanation and demonstration by the caregiver: Hold the crutch in the unaffected hand and move following the sequence of the crutch - the affected limb - the unaffected limb (or the crutch and the affected limb - the unaffected limb). Inform the precautions as well.

9、训练前准备：照护人员为老人系上腰带，教老人正确握拐杖

9. Preparation before training: The caregiver should tie the belt for the elderly and instruct the elderly to hold the crutch correctly

10、三点式训练：指导老人行走，先手杖，再患脚，再健脚，照护人员站在患侧保护

10. Three-point training: Instruct the elderly to walk, firstly moving the crutch, then moving the affected foot, and then moving the unaffected foot. The caregiver should stand on the affected side for protection.

11、二点式训练：指导老人行走，先手杖和患脚，再健脚，照护人员站在患侧保护

11. Two-point training: Instruct the elderly to walk, firstly moving the crutch and the affected foot and then moving the unaffected foot. The caregiver should stand on the affected side for protection.

12、上楼梯：指导老人持杖行走，先上健脚，再上拐杖，再上患脚行走。照护人员站在老人患侧后方，一手扶托患侧手臂，一手提拉腰带保护。

12. Walking up the stairs: Instruct the elderly to walk with a crutch. The elderly should climb with the unaffected foot first, then the crutch, and finally the affected foot. The caregiver should stand behind the affected side of the elderly, holding the affected arm with one hand and pulling the belt with the other hand for protection.

13、下楼梯：指导老人持杖行走，拐杖先下一阶梯；再下患脚；再下健脚，照护人员站在老人患侧前方，双手托扶患侧前臂保护

13. Walking down the stairs: Instruct the elderly to walk with a crutch. The crutch should go down the stairs first, then the affected foot, and finally the unaffected foot. The caregiver should stand in front of the affected side of the elderly, with both hands supporting the forearm of the affected side for protection.

14、训练过程中的要点：训练过程中、结束后，应注意观察、询问老人感受，如有不适，休息片刻；老人行走有进步时应给子鼓励

14. Key points in the training process: During and after the training, pay attention to observing and asking the elderly about his feelings, and take a break for a while in case of discomfort; Encourage the elderly when he makes progress in walking

步骤4：反馈记录

Step 4: Feedback Record

15、训练结束：了解老人在训练过程中的感受和存在的问题；照护人员协助指导解决，预约下次训练时间。

15. End of training: ask for the feelings and existing problems of the elderly in the training process; the caregiver should assist in solving these problems, and make an appointment for the next training.

16、七步洗手法洗净双手；记录训练起始时间、训练过程中老人感受

16. Wash hands with the seven-step hand washing method; record the starting time of the training and the feelings of the elderly during the training

注意事项

Precautions

1、使用手杖前，应告知老年人注意事项

1. Inform the elderly of the precautions before using the crutch

2、严格遵从医生或康复师对手杖的选择和步行的指导要求，指导老年人使用

2. Strictly follow the guidance of physicians or rehabilitation therapists on the selection of crutches and walking, and guide the elderly to use the crutch

3、平时手杖放在老人随手可及的固定位置

3. Always place the crutch in a fixed position within easy reach of the elderly

4、行走中避免拉、拽老年人胳膊，以免造成跌倒和骨折

4. Avoid pulling and dragging the elderly's arms during walking to avoid falling and fractures