USE OF ASSISTIVE DEVICES FOR AMBULATION

At the end of this module, you will be able to:

 Understand the different types of assitive devices, its uses and indications.
 Demontrate correctly the use of assistive devices, specifically the use of cane, wlaker and
crutches.

There are available divices used to aid ambulation or walking. These are called assitive devices
or just ambulation devices. The most common types include canes, walkers and crutches. You need to
know when each of these are appropriate and assess if the client is using them correctly.

Canes. These are movable, lightweight devices made of a strong material like wood or metal. Canes
consist of a handle, a shaft, and legs. There are single leg, triple leg or quad leg canes, and the ones
with multiple legs provide more stability but are also more cumbersome. Canes are used by clients
who could bear weight but have weakness in one of their legs, like a stroke patient or those with
paralysis in one leg. Crutches and walkers are better for people with two weak legs. A properly fitted
cane should have the handle at the client’s hip level. The tips should also be non-slip.

Walkers. These are movable, lightweight devices that consist of a metal frame, two hand grips, and
four legs. Walkers provide great stability due to their wide base, so they are great for people who can
bear weight on their feet but have trouble walking due to weakness of the legs or balance issues.

Crutches .

They are either single or paired and are used by people who
cannot bear weight on one or both legs. There are two
common types of crutches: underarm, or axillary, and
forearm crutches.
Axillary crutches stretch from the armpits, or axilla,
to the ground. They provide better balance but require more
upper body strength to use. They are often used temporarily,
like when someone is recovering from leg injuries.
Forearm crutches are shorter, reaching from the
elbow level to the ground. They have a hand grip and a cuff
for the arm. The cuff lets the crutch stay attached to the arm
when the person needs to use their hands for other tasks.
This is one of the reasons that this type is preferred for
people with permanent leg weakness.

CLICK THE LINK to watch the video of:

Use of assistive devise for ambulation: canes, walkers and crutches

  https://youtu.be/k2-w3LZlCVk

AMBULATIONUSINGCANEANDWALKER

NAME: __________________________________________ DATE: ______________

DEFINITION
__________________________________________________________________________________
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PURPOSE
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EQUIPMENT
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THINGS TO CONSIDER
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PROCEDURE RATIONALE 5 4 3 2 1

● Explain the procedure to the patient.

● Assess the patient’s strength, mobility,

range of motion, visual acuity, perceptual
difficulties, and balance.
(The nurse and physical therapist often
collaborate on this assessment.)
A. AMBULATION WITH CANE

● Grasp the cane in the hand opposite the

affected leg.
● Slide hips forward in the chair.

● Grasp the arm of the chair with the free

hand then push to a standing position.

 ● When the patient is standing, encourage
to pause in place.

● Move the cane forward about 4-6 inches.

● The weak leg is moved ahead opposite
the cane. Place weight on the weak leg
and the cane.
● Move the strong leg forward. The steps
of both legs should be equal.

● Repeat pattern.
B. AMBULATION WITH WALKER
● Place the walker in front of the seated
patient.
● Let the patient place both hands on the
arms of the chair.
PROCEDURE RATIONALE 5 4 3 2 1
● Transfer the hands to the handgrips of
the walker.
● The walker and the weak leg are
simultaneously moved ahead 4-6 inches.

● Place weight on the arm for support.

● Move the strong leg forward.

● Repeat pattern.

NAME: __________________________________________ DATE: ______________

 CRUTCH WALKING
DEFINITION
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__________________________________________________________________________________
__________________________________________________________________________________

PURPOSE
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__________________________________________________________________________________
EQUIPMENT
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__________________________________________________________________________________
__________________________________________________________________________________
THINGS TO CONSIDER
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

PROCEDURE RATIONALE 5 4 3 2 1

1. Identify and explain the procedure to the

patient.
2. Assess the patient’s strength, mobility,
range of motion, visual acuity, perceptual
difficulties, and balance.
(The Nurse and therapist often
collaborate on this assessment.)
3. Adjust crutches to fit the patient. Place
the patient in a supine position, measure
from the heel to the axilla.
4. Let the patient stand, position the crutch
4-5 inches laterally and 4-6 inches in
front of the patient.
5. The crutch pad should fit the 1.5-2 inches
below the axilla. The hand grip should be
adjusted to have elbows bent at 300
flexion.

6. Instruct patient to position crutches

lateral to and forward of the feet.
Demonstrate correct positioning.
7. Assist the patient to a standing position
with crutches (tripod position).
Four-Point Alternate Gait
1. Move the right crutch ahead a suitable
distance, such as 10 to 15 cm (4 to 6 in.).
2. Move the left front foot forward,
preferably to the level of the left crutch.
3. Move the left crutch forward.

4. Move the right foot forward

Three-Point Gait
1. Move both crutches and the weaker leg
forward.

2. Move the stronger leg forward.

Two-Point Alternating Gait
1. Move the left crutch and the right foot
forward together.
2. Move the right crutch and the left foot
ahead together.

Swing-To Gait
1. Move both crutches ahead together.
2. Lift body weight by the arms and swing
to the crutches.
 The affected leg is always supported by
the crutches.
4. Repeat steps 2 and 3 until the client
reaches the top of the stairs
Going Downstairs
1. Assume the tripod position at the top of
the stairs
2. Shift the body weight to the unaffected
leg, and move the crutches and affected
leg down onto the next step
3. Transfer the body weight to the crutches,
and move the unaffected leg to that step.
The affected leg is always supported by
the crutches.
4. Repeat steps 2 and 3 until the client
reaches the bottom of the stairs.

Ability to answer questions

TOTAL SCORE
FIGURE 1. CRUTCH WALKING GAIT PATTERNS
Assistive devices for ambulation: Clinical skills notes 2022, accessed 21 February, 2022
<https://www.osmosis.org/learn/Assistive_devices_for_ambulation:_Clinical_skills_notes#:~:t
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