Assistive Devices for Ambulation

Aging brings with it both good things and bad things.  While some individuals age gracefully, some will not be as fortunate.  With age one will experience physical changes that prove to increase the risk for injury.  Some of these changes or injuries may require us to modify the ways we use to get from one place to another.  Not being able to just get up and go wherever you want, or being unable to do things as quickly as you once did can take a shot at your pride.  In order to compensate for any physical limitations, in your future you may be introduced to assistive devices to help you get through your daily routines. 

Assistive devices include things such as crutches, canes, and walkers.  Total Home Health has a program that will fit all your needs and mesh smoothly with your life.  Our healthcare professionals understand that promotion of your independence and safety are top priorities in your care, which means we will educate you on how to use assistive devices in order to maximize how well you can get around on your own.  Read on to gain insight and tips on each of these assistive devices so that you can be ahead of the game if one is ever recommended for you!

Crutches are recommended and prescribed for individuals who are required to bear partial weight or no weight at all on their affected extremity.  In order to be a good candidate for crutches, an individual must have good balance, good upper body strength and an adequate cardiovascular system due to the increased work it requires to use crutches compared to other assistive devices.  A huge deal related to crutches is to make sure they are the right height for you because if not they could do more harm than intended.  Typically, individuals are fitted for crutches in the following way: 

·      With the crutch tip extended 6 inches diagonally in front of the foot, 2 to 3 finger widths should be able to fit between the armpit and the top of the crutch to prevent nerve damage.

Individuals using crutches should also be informed that there are different walking techniques depending upon what type of problem you suffer from, including:

·      Two-point gait – this technique permits limited weight bearing on both extremities.  Simply, the right leg will move simultaneously with the left crutch and the left leg will move simultaneously with the right crutch.

·      Three-point gait – Non-weight bearing or partial weight bearing is allowed on the affected leg in this technique.  Both crutches and the affected leg will move together, that way the body weight will be supported on the unaffected leg.

·      Four-point gait – This technique permits weight bearing on both legs.  The crutches and feet will move alternately, meaning the left crutch and right foot will move and then the right crutch and the left foot will move.

·      Swing through – If no weight bearing is permitted on the affected legs this is the correct technique.  During the swing through, both crutches move forward and both legs will swing through between the crutches.  The weight of the body is borne by the crutches.

·      Stairs – This is the technique to maneuver stairs.  The individual should lead with the unaffected leg, then the affected leg and crutches will move forward together.  For going down stairs, the individual should lead with the crutches and the affected leg.  **Go up the stairs with the good leg first and go down the stairs with the bad leg first.**

Canes are the least stable of the assistive devices and should not be used for any amount of weight bearing activities.  Rather, a cane is recommended when individuals need a greater sense of balance and support.  Typically there are three types of canes:  a quad cane (one with four feet), an adjustable cane, and an offset adjustable cane.  Here is how to adjust a cane to allow for the proper fit for you:

·      To determine the proper length of the cane, individuals should be lying on their back or standing up with the arms straight down at their side.

·      The handgrip of the cane should be level with the greater trochanter bone (just below the waist at the head of the femur).

·      The cane should be placed parallel to the femur and tibia with the tip of the cane on the floor, basically the cane should be about hip height.

Walkers may be indicated if there is a need for balance, stability and decreased weight bearing.  Walkers provide both anterior and lateral stability, while allowing a wide base of support.  When a walker is properly adjusted for the height of the individual, it will allow for 20 to 30 degrees of elbow flexion.  The three types of walkers are standard, folding and rolling.  Instructions for using walkers for partial or non-weight bearing are as follows:

·      Advance the walker an arm’s length with each step

·      Ensure all four legs of the walker stay on the ground at all times

·      Advance the affected leg first

·      Push the remaining weight of the body through with your arms

·      Finally, advance the unaffected leg

·      With each stride, two complete steps should be taken into the walker

Ultimately, we never know when we may require the use of an assistive device to get us through our daily routines.  Take comfort in knowing that Total Home Health is always prepared to get you on your way to the correct use of the device that is recommended for you.  Enroll today to learn your technique and be on your way to maximizing your mobility!