Locomotion and Adaptive Devices
In order for your client or patient to use an assistive device it must be appropriately fitted to them. One reason for this is so the patient can be comfortable while using the device. If it is too big or small then it would cause them discomfort while trying to use it. A good example of this would be if a wheelchair is not fitted appropriately for the patient then that could cause a lot of issues in regards to posture or uncomfortable rubbing against the skin. Another reason for the importance of appropriately fitting assistive devices is for the safety of the client. We want to ensure that the client will get the most out of his/her assistive device, and that they will be able to use it safely.
To fit canes you would want the hand grip to be at the level of the ulnar styloid, wrist crease, or greater trochanter. The elbow should be relaxed, and flexed 20-30 degrees. The shoulders should also feel relaxed and not elevated.
To fit axillary crutches, you should also adjust the hand grip to be at the level of the lunar styloid, wrist crease, or greater trochanter (same as above). You should also make sure the axillary rest is 5 cm below the floor of the axilla with the shoulders relaxed as well.
To fit Lofstrand crutches, you will want the arm cuff to be wrapped around the patient's proximal forearm. More specifically, the arm band should be positioned 2/3 of the way up the forearm. These will be more for patient's with long term disabilities. They will provide more support and stability than a regular cane, but less than axillary crutches.
To fit a platform walker, the forearms and hand need to be in neutral position while also being supported. The elbow should be flexed about 90 degrees, and the client should be able to relax their scapula. To avoid nerve compression, the proximal ulna should be positioned 1-2 inches off the platform surface.
To fit a rolling walker, the elbow should be flexed about 20-30 degrees. The handgrips should be in line with the wrist crease, ulnar styloid, or greater trochanter when their hands are resting at their side. You will need to estimate the height of the walker based on the client's height. They should be able to look straight ahead with their arms relaxed.
To fit canes you would want the hand grip to be at the level of the ulnar styloid, wrist crease, or greater trochanter. The elbow should be relaxed, and flexed 20-30 degrees. The shoulders should also feel relaxed and not elevated.
To fit axillary crutches, you should also adjust the hand grip to be at the level of the lunar styloid, wrist crease, or greater trochanter (same as above). You should also make sure the axillary rest is 5 cm below the floor of the axilla with the shoulders relaxed as well.
To fit Lofstrand crutches, you will want the arm cuff to be wrapped around the patient's proximal forearm. More specifically, the arm band should be positioned 2/3 of the way up the forearm. These will be more for patient's with long term disabilities. They will provide more support and stability than a regular cane, but less than axillary crutches.
To fit a platform walker, the forearms and hand need to be in neutral position while also being supported. The elbow should be flexed about 90 degrees, and the client should be able to relax their scapula. To avoid nerve compression, the proximal ulna should be positioned 1-2 inches off the platform surface.
To fit a rolling walker, the elbow should be flexed about 20-30 degrees. The handgrips should be in line with the wrist crease, ulnar styloid, or greater trochanter when their hands are resting at their side. You will need to estimate the height of the walker based on the client's height. They should be able to look straight ahead with their arms relaxed.
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