Assistive Devices

Decreased balance, strength and stability are all reasons an individual may need an assistive device. Appropriately fitting our clients for the correct assistive device can be an extremely important step in the rehabilitation process. One reason this is so important is because we want to ensure the assistive device provides the client with the appropriate amount of stability given their diagnosis. This will vary depending on their physical condition, age, endurance, and psychological condition. Another reason it is important to appropriately fit our patient for an assistive device is that we want to prevent further injury with the assistive device. We want to make sure the device can maneuver in the environment and prevent falls.

When fitting for a cane, the client should be standing and looking straight ahead with arms at the side. The handle of the cane should be in line with the greater trochanter, ulnar styloid and wrist crease. The elbow should be slightly flexed. The cane will be used on the unaffected side.

When fitting for axillary crutches, the crutch length should be the same distance from the forearm to fingertips of opposite hand. In estimating height of crutch, the client should be standing with arms at the side, with the handgrips in line with the greater trochanter, or wrist crease. It is important that the arm pad be 2-3 finger widths under the axilla to avoid pressure upon the brachial plexus. 

Lofstrand crutches are fitted in the same way as the axillary crutches. For these crutches however, the arm band should be positioned 2/3 of the way up the forearm. 

In fitting for a platform walker, the platform should be positioned to allow weight bearing through the forearm when the elbow is at 90 degrees and the patient is standing tall with the scapula relaxed. The ulna should be positioned 1-2 inches off the platform surface. The handgrip should be turned slightly medially for a more comfortable grip. 

In fitting for a rolling walker, the client should be standing tall and looking ahead. The handgrip should be in line with the ulnar styloid or greater trochanter when the hands are at the side. The elbow should be slightly flexed at 20-30 degrees.