Thursday, July 30, 2009

Why Use a Gait Belt?

Gait belts prevent falls.

That's why we use them in health care settings, and they can really be of benefit when your elderly or debilitated loved one requires extra care in their (or your) home.

A gait belt isn't something you would necessarily know about unless you've worked in health care or have a loved one who has been in the health care setting. The classic gait belt is long, and made from thickly woven cotton with a non-slip buckle that uses alligator teeth to keep the belt from slipping when in place. (Subtle variations of the gait belt certainly exist.)

Gait belts are an assistive device which can and "should" be used to help safely transfer a person in a weakened state from bed to chair, from sitting to standing, and even when entering and exiting a vehicle. The belt provides a "handle," of sorts, that allows whomever is escorting to weakened individual to easily grasp the belt and stabilize the patient if they lose balance.

The gait belt encircles the patient's waist snugly, but not too tight; at least two fingers should fit between the belt and body. Typically gait belts are very long to accommodate all sizes and shapes of individuals. The dangling end is best tucked into the belt to prevent trips or tangling. It is possible to find gait belts that have been manufactured so that there are actually several fabric handles incorporated on the belt to make the transfer even easier (one or more person can grab a handle as needed.)

Appropriate with a walker or cane?

By all means--use a gait belt whenever it's indicated. If your loved one has a "weak" side, be sure that you walk on that side of their body if they are using crutches or a walker. You'll be positioned in a way that allows you to more effectively help them.

Fastening the Buckle is like fastening the buckle of a military belt. In case you've never had to do that, here are some step-by-step photos to demonstrate.

The end with the metal tip starts threading behind the buckle

Insert metal tip through the open end of the buckle

Thread the metal tip forward between the metal teeth and opposite side of the buckle

Pull the metal tip completely through the buckle to tighten. Pull slack through the buckle area as necessary.

Ensure belt is not too tight by inserting two fingers between belt and patient's waist.

In this quick Youtube video: A rehab specialist demonstrates the value of a gait belt or leather belt. Although this expert discusses the value of the gait belt in a rehab/gym setting, this video is the best I've come across to concisely drive home how the belt can prevent injury.

Why I keep a gait belt on hand. My dear friend gave me a brand-new extra gait belt that her mother no longer wanted. I was rather delighted to have it, since we have a nearby friend with balance issues who has required "neighbors to the rescue" for some close calls on more than one occasion.

Recommended links:

A Plus:  Smart People Use a Gait Belt--comprehensive gait belt advice from Marcian Oliver, an experienced physical therapist.  Check out Marcia's blog for a wealth of patient information regarding physical therapy and fitness issues.

Patient Education about gait-belt-use--this nice, concise explanation is provided by a medical supply company.

From ehow: Transfer using a gait belt

OSHA guidelines for nursing homes provides tips for moving patients safely: gait belts, slider boards, slippery sheets, and mechanical lifting devices are briefly addressed with several helpful illustrations.

Select this link for another OSHA page describing even more types of assistive equipment used to move patients and here for CDC's check list for home safety

Need more ideas on how to prevent falls?
  • Install grab bars for the toilet, bathtub or shower
  • Keep walkways (including stairs) clear of books, papers, clothing, cords, etc.
  • Ensure stairway handrails are secure
  • Use light and plenty of it (ensure stairways are entirely lit--including at the top and bottom)
  • Get rid of small throw rugs
  • Place a glow-in-the-dark sticker or a bit of fluorescent paint on light switches
  • Have a bedside commode available--urgent trips to the bathroom result in too many falls!


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Carolyn Cooper, MPH, RN said...

Gait belts can cause injury if used improperly--remember they are meant to stabilize the patient for transfer or walking. Please take a look at a recent email and my response to the writer:

My mother is in assisted living, has a history of osteoporosis and has had kyphoplasty on T12. Is it safe to use a gait belt to transfer her from a chair or bed to a wheelchair?
Thank you for any information you can share.


Hi, Mary,

You ask a good question. Gait belts have been around "forever"--and are a standard assistance device that everyone in the medical industry can recognize and understand. That being said, they are not a perfect solution in every situation or for every patient. Actually, it is possible to do harm to a patient when a gait belt is improperly used.

Let me emphasize that gait belts are NOT meant to be lifting devices--instead they are to stablize the patient as they transfer (from bed to chair) or as they walk. The benefit in using a gait belt to assist your mother from bed to chair and vice versa is that it helps caregivers avoid grasping her in sensitive areas like her underarms--which could certainly cause an injury and wear and tear over time. However, using the gait belt as a lifting device can result in soft tissue injury to your mother's abdominal area--or if the belt slips up her chest and under her arms--if not correctly cinched around her waist--it is the same as lifting her by her underarms.

In your mother's situation, it seems that she is physically frail, and if it is not in her power at this time to rise independently. To avoid harming her delicate bones, the use of a medical device that is specifically designed to mechanically lift a patient is something for which you may choose to strongly advocate. A commone device that her assisted care facility will surely have is a Hoyer lift, a device that transfers patient by use of a mechanical sling.

There are other transfer aids available. I rather like the look of this transfer sling, but it's something I've never seen in a medical setting:

When correctly used to stabilize a patient, the gait belt is useful in preventing a fall that can injure the patient and/or the caregiver. Good training is always an important factor in preventing injury, even with the simplest medical device.