Teaching up stairs and down stairs ambulation with crutches procedure

Equipment
- Properly fitted crutches
- Regular, hard soled streed shoes
- Safety belt, if needed

Procedure
1. Explain the rational of the procedure to the client.
2. Apply safety belt if client is unsteady or requires support.
3. Demonstrate the procedure using a three-point gait.

Going Down Stairs
a. Start with weight on uninjured leg and crutches on the same level.
b. Put crutches on the first step
c. Put weight on the crutch handles and transfers unaffected extremity to the step where crutches are placed.
d. Repeat until the client understands the procedure

Going Upstairs
a. Start with the crutches and unaffected extremity on the same level.
b. Put weight on the crutch handles and lift the unaffected extremity on the first step of the stairs.
c. Put weight on the unaffected extremity and lift other extremity and the crutches to the step.
d. Repeat until client understands the procedure.

4. Help the client practice
5. Make sure that the client has adequate balance. Be ready to assist if necessary.
6. Assess the client’s progress, and correct any mistakes as they occur.
7. Document the following points:
- Time and distance of ambulation on crutches
- Balance
- Problems noted with technique
- Remedial teaching
- Client’s perception on the procedure