Ambulatory with Support Required
Lower limb weakness at this mode is it's "own entity" for physical therapy, as a challenge for gait training using assistive devices. The person cannot combine upper and lower body actions at the same time for the effective use of a rolling walker. Hands-free pelvis supported walkers are not easy to access for adults and constant supervision is still required. Schedule assisted walking with a caregiver using a support belt or a forearm support frame for them to hold onto.
Ambulating Individuals
The person is able to reposition their body weight independently and can sit on most surfaces.
Provide flat floors / walkways for walking; monitor for the avoidance of barriers above knee height and remove objects below knee height.
Provide options to walk, sit or lie down. For group activities and exercises, you can begin by going on guided "walkabouts." Although capable of "walking," they may tend to just shuffle along due to not being able to fully perceive (and control) the relationship between their feet and the external surface below their knees, such as steps and uneven ground.
Within ACL 3.4, cue to alter pace or redirect their attention if the person becomes distracted.
Wheelchair Walking Individuals
The person may only be strong enough to effectively "walk" on less resistive floor surfaces. Contact with the floor is comforting ("grounding") and can be facilitated with seated rocking mechanisms that allow them to "push" both feet on the floor. They are able to create their own rhythmical rocking effect as they wish, and can also build some strength and endurance in the process. Unsupported seating may be used. Footplates may be removed to allow "walking in chair for brief periods.
Use a wheelchair with an anti-tip bar / wheel to prevent the chair from tipping backwards.
Wheelchair Bound Individuals
If they are unable to propel themselves, it is important to take the person outside and move them around on a regular basis as part of their sensory stimulation program.