Assistive DevicesAmbulation Aids

Canes
y

Go to: Top When properly used canes will: 1. Increase base of support 2. Decrease loading and demand on the lower limbs 3. Provide additional sensor information 4. Assist acceleration/deceleration during locomotion Prescribed in various disabilities to: 1. Improve balance 2. Decrease pain 3. Reduce weight-bearing forces of injured structures 4. Compensate for weak muscles 5. Scan the immediate environment Components
y y y y y

Handle Adjusting knob for handle Shaft Adjusting mechanism for height Rubber tip

C-handle or crook top cane

Advantages: inexpensive Disadvantages: uncomfortable, difficult to grasp (i.e., RA patient), weight-bearing line falls behind the shaft of the cane reducing support, not adjustable

Adjustable metal cane

Advantages: inexpensive, adjustable

Disadvantages: same as above

Functional grip cane

Advantages: handle fits the grip, conforms to natural angle of hand. and is more centered over the shaft of the cane, provides more support Disadvantages: more expensive

Wide-based or quadruped cane

Advantages: more support Disadvantage: heavy, awkward appearance, WBQC does not fit on stairs

Difference Between Crutch and a Cane?

y y

Cane has one point of contact with the body Crutch has 2 points of contact with the body

Cane Measurement/Prescription
20 elbow flexion or height of greater trochanter

Crutches
y

Go to: Top

Axillary Crutches
Components
y y y y y

Padded axillary piece (on top) Two upright shafts Handpiece (in middle) Extension piece Rubber tip

Advantages: inexpensive, adjustable, easier to use Disadvantages: need good strength and ROM in upper limbs, ties up hands. Increased cardiac/metabolic demand

Forearm Crutches/Lofstrand crutches

Components
y y y y y

Forearm cuff with narrow anterior opening Forearm piece bent posteriorly and adjustable (extends to 2 inches below elbow) Molded handpiece Single aluminum tubular shaft Rubber tip

Advantages: lightweight, easily adjustable, freedom for hand activities Disadvantages: needs more strength, requires more skill, and better trunk balance

Platform Crutches
Advantages: Do not need weight bearing through wrist and hand (i.e., fractures, arthritis of wrist or hand. or weakness triceps or grasp) Disadvantages: awkward, heavy

Walkers
y

Go to: Top

Indications
1. Bilateral weakness and/or incoordination of the lower limbs or whole body, whenever a firm, free standing aid is appropriate (i.e., multiple sclerosis or Parkinsonism) to balance 2. To relieve weight bearing either fully or partially on a lower extremity (allow the upper extremities to transfer body weight to the floor) 3. Unilateral weakness or amputation of the lower limb where general weakness makes the greater support offered by the frame necessary (i.e., osteoarthritis or fractured femur) 4. General support to aid mobility and confidence (i.e., after prolonged bedrest and sickness in the elderly)

Advantages
Provide a wider base of support

More stable base of support Provide a sense of security for patients fearful of ambulation

Disadvantages
More conspicuous in appearance Interfere with development of a smooth reciprocal gait pattern (e.g., step-to-gait pattern) step length with

Interfere with stair negotiation /difficult to maneuver through doorways or bathrooms

Types
y y y y y

Lightweight walking frame Folding walking frame Rolling walking frame Forearm resting walking frame Hemi-walking frame