Lecture Notes: Canes, Crutches, and Walkers

Introduction

• Overview of assistive devices: canes, crutches, and walkers.
• Importance of knowing how to properly use these devices for nursing school exams.
• Focus of the lecture: crutches. Upcoming topics include canes and walkers.

Crutches

Proper Fit

• Adjust crutches based on patient's height.
• Key Measurements:
  • Gap between crutch pad and axilla should be 2-3 fingers width (1-1.5 inches).
  • Hand grips should align with the top of the hip line.
  • Elbows should bend at a 30-degree angle when using hand grips.

Types of Gaits

• Tripod Position: Starting position, crutches 6 inches out from feet.
• Gaits:
  • Two-Point Gait: Injured side crutch and opposite foot move together.
  • Four-Point Gait: Each point moves independently (right crutch, left foot, left crutch, right foot).
  • Three-Point Gait: Both crutches and injured leg move together, then non-injured leg.
  • Swing-To and Swing-Through Gaits:
    • Swing-To: Move crutches forward, swing legs to crutch placement.
    • Swing-Through: Move crutches forward, swing legs past crutch placement.

Navigating Stairs

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

Sitting and Standing

• To Sit: Back up to chair, feel with non-injured leg, move crutches to injured side, lower with non-injured leg.
• To Stand: Crutches on injured side, push up using non-injured leg and crutches.

Canes

Proper Fit

• Adjust cane based on patient's height.
• Key Measurements:
  • Top of the cane should align with the greater trochanter or wrist crease.
  • Elbow flexed at 15-30 degrees when holding the cane.

Walking with a Cane

• Use gait belt for safety.
• Cane held on the strong side.
• Move cane with weak side together, then move strong side.

Navigating Stairs

• Going Up: Good leg first, followed by cane and bad leg.
• Going Down: Cane and bad leg first, then good leg.

Sitting and Standing

• To Sit: Back up to chair, let cane rest on the side, use armrests to lower.
• To Stand: Lean forward, use cane and armrests to push up, move weight to strong leg.

Walkers

Proper Fit

• Adjust walker at the bottom.
• Key Measurements:
  • Elbows bent at 15-30 degrees when holding walker.
  • Wrist crease aligns with hand grips.

Walking with a Walker

• Use gait belt for safety.
• Stand on patient's weak side.
• Lift walker, ensure all points on ground, move weak side, then strong side.

Sitting and Standing

• To Sit: Back up to chair, extend weak leg, use armrests to lower.
• To Stand: Lean forward, push up with hands on armrests and strong leg.

Conclusion

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