F- CLINICAL ASPECTS OF SPINAL CORD INJURIES
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FIG. 242.
arms and crutches. This posture guarantees a firm triangular base and prevents over
balancing in forward direction.
Swing-through gait.
This type is especially used in cord lesions at the level of T9 and
below and represents the quickest form of locomotion. The arms and crutches are moved
forward, and the body is then swung through in front of the arms and crutches, the hips
and spine being held in hyperextension (Fig. 244). Then the arms and upper trunk are
swung forward simultaneously, so that a firm traingular base is established, and then the
legs and body are swung forward again. However, in higher lesions, especially those
with spasticity of the abdominal muscles, the swing-through gait may entail the risk of
throwing the patient off balance by sudden abdominal spasms resulting in a * jack-knife'
forwards movement.
Walking sideways, backwards and up and down stairs.
Once the paraplegic has gained skill
and confidence in forward walking on an even surface, he is taught to walk over small
obstacles, such as sandbags or blocks, in order to be able to negotiate kerbs and, as a
preliminary, to walking up steps and stairs. Furthermore, he has also to learn to walk
sideways and backwards, as a preliminary to getting into and out of his wheelchair and
negotiating corridors, toilet, etc., unaided.
