Crutches

Crutches

• Remove weight from one or both legs,enabling the patient to support

himself with his hands and arms.

• Prescribed for a patient with lower-extremity injury or weakness, crutches

require balance, stamina, and upper-body strength for successful use.

Equipments

Types:

• Standard

- These are used by patients with a sprain, strain or cast.

- Require stamina and upper body strength

• Aluminum

- Aluminum forearm crutches are used by paraplegic or other

patient using swing-through gait.

- They have a collar that fits around the forearm and a horizontal
hand grip that provides support.

• Wooden

- Also called Platform

- Are used bu arthritic patient who has an upper-extremity deficit

that prevents weight bearing through the wrist.
 - They provide padded surfaces for the upper extremities

Preparaton of Equipment

 After choosing the appropriate cructches, adjust their height with the
patient standing or, if necessary , recumbent position
Implementation

 Consult with the patients practitioner and physical therapist

to coordinate rehabilitation orders and teaching

 Describe the gait you’ll teach and the reason for your choice.
Then demonstrate the gait as necessary. Have the patient
give a return demonstration

 Place a walking belt around the patients waist, if necessary ,

to prevent falls

 Teach the four-point gait to the patient who can bear weight
on both legs, because three points are always in contact with
the floor , it requires greater coordination than the others
because of its constant shifting of weight.

Sequence:

Right crutch, left foot, left crutch, right foot

 Teach the three point gait to the patient who can bear
only partial or no weight on one leg. Instruct him
advance both crutches of six inches to eight inches
(15-20 cm) along the involved leg. Then tell him to
bring the uninvolved leg forward and to bear bulk of
his weight in the crutches.

 Teach the two-point gait to the patient with weak legs

but good coordination and arm strength, this is most
natural clutch walking gait because it mimics walking,
with alternating swings of the arms and legs. Instruct
patient to advance the left crutch and right foot
simultaneously and to swing legs parallel to and
beyond the crutches.

 Teach the swing through or swing to gaits. The fastest

ones. To the patient with complete paralysis of hips
and legs. Instruct patient to advance both crutches
simultaneously and to swing the legs parallel to or
beyond the crutches.

 Teach the patient who uses crutches to get up from

the chair, tell him to hold both crutches on right hand
with the tips resting firmly on the floor.

 To sit down, the patient reverses the procedure.

Instruct client to support himself with the use of his
crutches in one hand to lower himself with the other.

 Teach patient to ascend stairs using the three point

gait , leading with the uninvolved leg and then
followed with both crutches then the involved leg. To
 descend stairs, the patient should lead the crutches
and the involved leg and follow with the good leg. “
The good goes up, The bad goes down”

Special consideration

1. Encourage arm and shoulder strengthening exercises to prepare

patient for crutch walking.

2. Consult the physical therapy to teach patient two techniques: one

fast one slow

So he can alternate between them to prevent excessive muscle

fatigue and can adjust more easily to various walking conditions

Complications

1. Atrophy

2. Muscle Fatigue

3. Prolonged pressure points

Documentation:

- Type of gait the patient used

- Amount of assistance required

- Distance walked

- Patients tolerance of the crutches and gaits