Lecture Notes on Assistive Devices: Canes, Crutches, and Walkers

Introduction

• This lecture covers the use of assistive devices: canes, crutches, and walkers.
• Key exam topics include the proper fitting, usage techniques, and specific scenarios such as navigating stairs and sitting/standing with each device.
• There is a free quiz available to test your knowledge after watching the video.

Crutches

Proper Fit

• Adjust crutches based on patient's height.
• Ensure a 2-3 finger gap between the crutch rest pad and the axilla to prevent nerve damage.
• Hand grips should align with the hip line; elbows should be slightly bent at 30 degrees when using the hand grips.

Types of Gaits

• Two-Point Gait: Move injured side crutch and opposite foot together; then move the opposite crutch and foot together.
• Four-Point Gait: Move crutches and foot one at a time – right crutch, left foot, left crutch, right foot.
• Three-Point Gait: Move both crutches and injured leg together, then the non-injured leg.
• Swing-To Gait: Move crutches forward, swing feet to crutch placement.
• Swing-Through Gait: Move crutches forward, swing feet past crutch placement.

Navigating Stairs

• Going Up: Good leg goes first, followed by crutches and bad leg.
• Going Down: Crutches go first, followed by the bad leg, then the good leg.

Sitting and Standing

• Sitting: Back up to chair with non-injured leg touching chair, move crutches to injured side, sit with injured leg extended.
• Standing: Crutches on injured side, push up with non-injured leg and hand grips, position crutches.

Canes

Proper Fit

• Adjust cane height to align with great trochanter or wrist crease.
• Elbow should be flexed at a 15-30 degree angle.

Walking with a Cane

• Use a gait belt for safety and stand on the patient's weak side.
• Cane should be held on the strong side, 4 inches from the foot.
• Move cane and weak side together, then the strong side.

Navigating Stairs

• Going Up: Hold cane on strong side, move strong leg first, then cane and weak leg.
• Going Down: Cane and bad leg go first, then the good leg.

Sitting and Standing

• Sitting: Back up to chair, rest cane on the side, keep weak leg extended.
• Standing: Cane on strong side, use chair armrests to push up, stand with cane.

Walkers

Proper Fit

• Adjust walker legs for proper height.
• Elbow should be bent at 15-30 degrees; wrist crease should align with hand grips.

Walking with a Walker

• Use gait belt and stand on weak side.
• Do not look at feet while walking.
• Start with walker tips aligned with mid-foot.
• Move walker forward first, followed by weak leg, then strong leg.

Sitting and Standing

• Sitting: Back up to chair, extend weak leg, position hands on armrests, sit down.
• Standing: Lean forward, push up from chair, stand using walker.

Conclusion

• Remember to practice these skills safely and review through available quizzes.
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