Locomotion and Assistive Devices
As future OTs, we will be fitting our clients to assistive devices regularly. It is extremely important to fit these correctly to each patient. One reason why this is so important is that we need to give the client the right amount of stability needed. Another reason is that we need to make sure that it is comfortable for the client. They will most likely be using it every day, if not all day, so we need to make sure it correctly fits their body and needs.
A cane is the most unstable of assistive devices, however, it might be perfect for one of our clients and their needs. In order to fit a cane correctly, we need to make sure that the hand grips are at the same level as the ulnar styloid process, the wrist crease and/or the greater trochanter of the femur. Their elbows need to be relaxed here and flexed to about 20-30°. It is important to make sure that the clients shoulders are relaxed down and not elevated towards their ears.
To fit axillary crutches, you will use the same points here as you do with fitting a cane. In addition, the axillary rest needs to rest about 5cm (4 finger length) below the floor of the axilla. Make sure the clients shoulders are relaxed here and not elevated when you are fitting the axillary crutches. If the axillary rests are too high or too low, this could cause the client a lot discomfort.
Loftstrand crutches are attached to the forearm and are just slightly more stable than a cane. These crutches are mostly used for individuals with long-term disabilities. To correctly fit these crutches, you will follow the same points as previously stated when fitting a cane. Since these crutches attach to the forearm, we need to make sure that the arm cuffs are placed just 1-2 inched below the elbow.
Platform walkers look very similar to platform crutches. However, platform walkers have 4 points of contact to the ground and crutches just have two. Platform attachments are mostly used for individuals who cannot bear any weight on their hands and/or their wrists. In order to correctly fit platform walkers to your clients you need to first start with the client's forearms in neutral position and have them flex their elbows to 90°. You fit these the same way as you would a cane, and it is extremely important that the platforms are at the same height so that the client's weight is equally on both sides.
Lastly, to fit rolling wakers, you follow the same points as a cane. Making sure the hand grip is at the level of the ulnar styloid, the wrist crease and/or the greater trochanter. The clients elbows are relaxed and flexed to 20-30° and the shoulders are relaxed, not elevated. These walkers are essential for those with weakness in their upper extremity and will not be able to lift a walker up to move it. With this walker, the client will be able to just slide on the floor.
A cane is the most unstable of assistive devices, however, it might be perfect for one of our clients and their needs. In order to fit a cane correctly, we need to make sure that the hand grips are at the same level as the ulnar styloid process, the wrist crease and/or the greater trochanter of the femur. Their elbows need to be relaxed here and flexed to about 20-30°. It is important to make sure that the clients shoulders are relaxed down and not elevated towards their ears.
To fit axillary crutches, you will use the same points here as you do with fitting a cane. In addition, the axillary rest needs to rest about 5cm (4 finger length) below the floor of the axilla. Make sure the clients shoulders are relaxed here and not elevated when you are fitting the axillary crutches. If the axillary rests are too high or too low, this could cause the client a lot discomfort.
Loftstrand crutches are attached to the forearm and are just slightly more stable than a cane. These crutches are mostly used for individuals with long-term disabilities. To correctly fit these crutches, you will follow the same points as previously stated when fitting a cane. Since these crutches attach to the forearm, we need to make sure that the arm cuffs are placed just 1-2 inched below the elbow.
Platform walkers look very similar to platform crutches. However, platform walkers have 4 points of contact to the ground and crutches just have two. Platform attachments are mostly used for individuals who cannot bear any weight on their hands and/or their wrists. In order to correctly fit platform walkers to your clients you need to first start with the client's forearms in neutral position and have them flex their elbows to 90°. You fit these the same way as you would a cane, and it is extremely important that the platforms are at the same height so that the client's weight is equally on both sides.
Lastly, to fit rolling wakers, you follow the same points as a cane. Making sure the hand grip is at the level of the ulnar styloid, the wrist crease and/or the greater trochanter. The clients elbows are relaxed and flexed to 20-30° and the shoulders are relaxed, not elevated. These walkers are essential for those with weakness in their upper extremity and will not be able to lift a walker up to move it. With this walker, the client will be able to just slide on the floor.
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