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Gait Training: Gait belts with or without handles

Question

What is your position on the preferred use of gait belts with or without handles, and why?

Stan Brubaker
Liberty Mutual Group


Answer

Dear Stan:

As a reminder, a gait belt is a heavy canvas strap which is placed around the waist of an individual to be transferred so that the assisting person can have a safe hold without pulling on clothes or arms. Basically the belt is used to help support and guide a weak individual while they walk. Placing this belt around a patient's waist allows the caregiver(s) to firmly grip the belt rather than holding the patient's arms, thus the patient is prevented from falling and the chances of bruising the patient's arms are lessened. Because it enables a secure grip, the gait belt decreases the chance of a caregiver hurting her back while helping a patient transfer or walk. As you point out in your question, many newer model gait belts have added handles for convenience.


Generally, we believe the addition of handles is helpful. Handles allow the caregiver to use better body mechanics (bending your knees and keeping your back straight; lifting with your arm and leg muscles, not using your back muscles; and avoiding twisting your body while transferring a person.) However, as we pointed out in last month's Lift Doctor column, 'Caregivers risk injury if their hands get stuck in a handle of the belt, particularly if the patient is unstable or starts to fall. The caregiver should always be prepared to withdraw the supporting hand if the patient begins to fall and use it to control the fall in as gentle a manner as possible.'  In other words, while handles are an added improvement, they also represent a potential risk if they cause the caregiver to injure herself during an unanticipated movement such as a fall. The bottom line is that caregivers should be trained in use of gait belts just as they are trained in use of more complex pieces of equipment.


Finally, here are a few additional suggestions regarding use of gait belts:



  1. We believe it is important for readers to know that transferring with a gait belt is usually a task that requires 2 persons.


  2. Users should be advised of sanitary and infection control policies when using gait belts - for example, belts should be laundered if they come into extensive contact with an individual patient's skin, thus they should be applied over the patient's gown if possible.


  3. There are several assessment factors to consider when using a gait belt. Does the patient have weight bearing capabilities? Does the patient need any back or torso support? What is the mental status of the patient? Is the transfer realistic for use of a gait belt, or should a mechanical lift be used?

We hope this answers your question.


The Lift Doctor

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