Overview
This lecture covers essential information about crutches, including proper fitting, types of gait patterns, stair navigation, and safe methods for sitting and standing, which are important for nursing exams.
Proper Fit of Crutches
- Crutches must be adjusted to the patient’s height at both the top and bottom, using the available height range.
- There should be a 2-3 finger width gap (about 1-1.5 inches) between the crutch pad and axilla (armpit).
- Patients should support their weight on the hand grips, not underarms, to avoid nerve injury.
- Hand grips should align with the top of the hip line, causing the elbows to bend at about 30 degrees.
Types of Crutch Gait Patterns
- Start ambulation with a gait belt and the tripod position (crutches 6 inches diagonally from feet forming a triangle).
- 2-point gait: Move right crutch and left foot together, then left crutch and right foot together (2 points on ground at a time).
- 4-point gait: Move right crutch, left foot, left crutch, then right foot separately (each moves separately).
- 3-point gait: Move both crutches and the injured leg together, then move non-injured leg.
- Swing-to gait: Move both crutches forward, then move both legs to the crutch placement.
- Swing-through gait: Move both crutches forward, then swing both legs past the crutch placement.
Navigating Stairs with Crutches
- Going upstairs: Lead with the good leg, followed by crutches and the bad leg ("good up").
- Going downstairs: Move crutches down first, then bad leg, then good leg ("bad down").
Sitting and Standing with Crutches
- To sit: Back up to the chair with non-injured leg, move both crutches to the injured side, feel for the chair, and sit with the injured leg extended.
- To rise: Place both crutches on the injured side, keep the injured leg extended, push up with the non-injured leg and crutch hand grips, then position the crutches.
Key Terms & Definitions
- Gait belt — safety belt used to assist patients while walking.
- Tripod position — stance with crutches 6 inches from feet, forming a triangular base.
- Point gait — pattern describing how many limbs and crutches are in contact with the ground at once.
Action Items / Next Steps
- Take the free quiz on crutches to test your understanding.
- Watch upcoming videos on canes and walkers.