Assistive Devices

An assistive device is any device that is designed, made, or adapted to assist a person in performing a particular task. Examples of these devices are canes, crutches, wheelchairs, and walkers. A person may need an assistive device for numerous reasons: to improve balance, for pain prevention, or because their endurance is low. For whatever reason, fitting your patient for the use of an assistive device is critical for their safety, health, and well-being of life.

For the fitting of a cane, there are a few factors to consider for your patient to have the right fit. Canes are for people who have pretty good balance. This is important to consider before giving your patient a cane because they are the less stable than a walker. When measuring your patient for a fitting, the hand grip should be at the level of the of the ulnar styloid, wrist crease, or greater trochanter, the elbow should be relaxed and flexed 20-30 degrees, and the shoulders should be relaxed and not elevated.

Before giving your patient axillary crutches, it is important to look at their trunk balance and arm strength, because they must have a decent amount of both to use these types of crutches. Axillary crutches are good for a patient who needs to be restricted in LE weight bearing. When fitting your patient for these, the axillary rest should be ~5 cm below the floor of the axilla with the shoulders relaxed and the hand grip should be at the level of the greater trochanter.

Lofstrand crutches, like axillary crutches, also require a good amount of trunk balance and arm strength from your patient. These types of crutches have an arm-cuff that wraps around the proximal arm to provide more support/stability than a cane, but less than axillary crutches. Although they provide less stability than axillary crutches, Lofstrand crutches are useful for people with long-term disabilities who don't need that pressure in the axillary region that could cause pain or injury to the brachial plexus over time. The fitting of Lofstrand crutches is fairly similar to axillary crutches. The hand grip should still be in line with the greater trochanter, the arm-cuff should be 2/3 up the forearm, and the grips should be pointed forward. 

A platform walker provides a great amount of stability for individuals that are unable to bear weight through wrist or hand. It comes with a trough or platform to support the forearm during ambulation. To fit a patient for a platform walker, the forearms and hands should be in a neutral and supported position.

A rolling walker is useful for individuals that can not lift a walker due to UE weakness or impaired balance. The fitting for a rolling walker is the same as a standard walker, so the hand grips should be at the level of the ulnar styloid, wrist crease, or greater trochanter, the elbow should be relaxed and flexed to 20-30 degrees, and the shoulders should be relaxed and not elevated.