A 70-year-old male status post right hip fracture is instructed to be non-weight bearing on the right leg for four weeks. What is the MOST appropriate gait training method?

• A. Ambulation with a quad cane and a three-point gait pattern
• B. Ambulation with bilateral crutches and a four-point gait pattern
• C. Ambulation with a walker and a three-point gait pattern
• D. Ambulation with a single point cane and a three-point gait pattern

Answer: (C)

When one leg must stay non-weight bearing, the goal is to protect the injured limb while providing the strongest, most stable base of support. A walker with a three-point gait does exactly that: the patient uses the walker to bear weight and advance the injured leg (which remains off the floor), then shifts weight to the uninjured leg. This pattern keeps the involved side unloaded and supported, reducing the risk of collapse or pain and helping maintain balance in daily walking.

Using a walker allows the trunk and arms to carry most of the effort, which is important for an older adult after a hip fracture. The three-point gait is specifically designed for situations with significant weakness or complete weight-bearing restrictions on one limb, making it the safest and most feasible option during a four-week non-weight-bearing period.

Other options either provide less stability (a single-point or quad cane) or require weight-bearing through the injured leg or a slower, more energy-demanding pattern (four-point gait with crutches). In the NWB scenario, the combination of a walker and a three-point gait best protects the healing limb while promoting safe ambulation.