Walking aids

WALKING AIDS

Walking aids is a device designed to assist walking

and improve the mobility of people who have
difficulty n walking or people who cannot walk
independently.
 Purpose of walking aids

Increase area of support or base of support

Maintain centre of gravity over supported area
Redistribute weight bearing area by decreasing force
on injured or inflamed part or limb.
Can be compensate for weak muscles
Decrease pain
Improve balance
Improves proprioception
 Different types of walking aids

Canes
Walker
Crutches
 Selection

Stability of the patient

Strength of upper and lower limbs
Co-ordination of upper and lowerlimbs
Required degree of relief from weight bearing
Clinical descriptors of weight bearing status

Full weight bearing (FWB)

Non weight bearing (NWB)
Partial weight bearing ( PWB)
Toe touch weight bearing (TTWB)
Weight bearing as tolerated (WBAT)
 Parallel bars
Rigid
Support thorough the
length of bars
Enables patients to
concentrate on lower
limbs
A full length mirror
placed at one end
Adjustment : height of the
bar should be at the level
of greater trochanter
 Canes

images

 Most common mobility aid

 Commonly made of wood or
aluminium
 Trasmit 20-25 % of body
weight
 Held in hand opposite to the
involved side
 Compensates for muscle
weakness
 Relieves pan
 Elbow at 30 degree flexion
 ADVANTAGES

Improves balance or postural stability

Reduces biomechanical load on LE joints
Widens BOS with less lateral shifting of COM
Reduces forces on hip while walking
Reduces knee pain in OA knee Patients
Restricted in NWB & PWB
 Types of cane

Standard cane
Tripods
Quadrupeds
 Standard cane

Single point or straight cane

Made of wood or acrylic
Has half circle or t- shaped handle
Inexpensive & fits any where
Not adjustable
 Tripods
Made of aluminium alloy
or steel
Three rubber tipped legs
at corner of an equilateral
triangle
Hand grip in same plane
as a line joining two legs
nearest and parallel to
patient’s foot
Elbow at 30 degree
flexion
More stable
 Quadrupeds
 Has four rubber tipped legs
 More stable
 Adjustable hand grip height
 Provides broad base
 Each point is covered with
a rubber tip
 Disadvantage – pressure
exerted on handle may not
be centered, causes
instability ; may not be
used in stairs ; slower gait
pattern
 Measuring canes

Cane is placed approximately 6 inches from the lateral

border of the toes.
2 important landmarks for measurement are greater
trochanter & angle of elbow
Top of cane should come at the level of greater
trochanter & Elbow flexed to 20 to 30 degrees ( allows
arm to shorten & lengthen during gait cycle ; provides
shock absorption mechanism)
Height should be considered with regards to patients
comfort & cane’s effectiveness in accomplishing
purpose
Gait pattern with cane
 Walking frames

Used to improve balance & relieve weightbearing

Greatest stability
Provides wide BOS , improve anterior & lateral
stability, allows UE to transfer body weight to floor.
Typically made of aluminium with modulated vinyl
handgrip & rubber tips
Adjustable adult size – 32 -37 inches ( 81-92cms)
 Features

Glides
Folding mechanism
Hand grips
Platform attachment
Wheel attachment
Braking mechanism
Tripod rolling water
Storage attachment
Seating surface
 Types

Standard
Reciprocal
Rollator
 Standarad walking frame
Consist four almost
vertical aluminium tubes
joined on three sides by
upper and lower
horizontal tubes
One side is left open
Handgrips on horizontal
tube
Rubber tips at lower ends
of vertical tubes
 Reciprocal walking frame
Identical with standard
frame
Each side of frame can be
move forward
Swivel joints between
horizontal and vertical
tubes
 Rollator
Two small wheels at
front and two legs
without wheels at back or
one wheel at each leg
No need for lifting the
whole device
Care to be taken for
elderly patients
Best suited for children
 Crutches

Used most frequently to improve balance & to relieve

weight bearing ( fully / partially )
Typically used bilaterally – to increase BOS ,
Improve lateral stability , allows UE to transfer body
weight to the floor.
2 basic designs of crutches in clinical use are
< Axillary crutches
< forearm crutches
 Prerequisties for crutches

Good strength of upperlimb muscles is required

Range of Motion of upperlimb should be good
Muscle group which should be strong are
shoulder flexor, extensors and depressor
shoulder adductors
Elbow and wrist extensors
finger flexors
 Axillary crutches / under arm crutches

Referred as standard crutches.

They are made of light weight wood or metal with an
Axillary bar, a head piece and double uprights joined
distally by single leg covered with rubber suction tip
Single leg allows height variations
Both the over all height of the crutch & height of the
hand grip can be adjusted.
Adjustable adult crutch size is 40 – 60 inch.
Advantages
improve balance & lateral stability
provide functional ambulation with restricted
weight bearing
Easily adjustable
in expensive
can be used for stair climbing easily
Disadvantages
awakened in small areas – may compromise safety
when using in crowded place
limited upper body freedom
axillary crutches require good standing balance by
the patient.
Tendency to lean forward on axillary bar ( pressure
on radial groove – potential damage to vascular
structures )
 Precautions

Have someone near by for assistance until

accustomed to the crutches
Frequently check that all pads are securely in place
Check screws at least once per week.
Clean out crutch tips to ensure they are free of dirt
and stones.
Remove small, loose rugs from walking paths.
Beware of ice, snow , wet or waxed floors
Avoid crowds .
Never carry any thing In hands, use a back pack.
 Plat form attachment
 Also reffered as forearm rest
or troughs.
 Also used with walkers.
 Function – to allow transfer
of body weight from forearm
to assistive device.
 Used when weight bearing is
contraindicated through wrist
or hand.
 Forearm piece is usually
padded, has a dowel or hand
grip , has hook or loop strap
to maintain position of
forearm
 Measurement of length

Several methods are used but most common in

standing & supine position.
Measurement in standing is most accurate &
preffered.
Supported standing – from 2 inches bellow the axilla
to 2 inches lateral & 6 inches anterior to the foot.
With shoulder relaxed adjusted the hand piece to
provide 20 to 30 degrees of elbow flexion.
General estimate – subtract 16 inch (40- 64cms)
from’s patient height .
Supine –
 from the axillary fold to a point 6-8 inches lateral
from the border of the heel.
 Measurement of axillary crutch

Measurement can be taken in two views

lying
with shoes off
measure from apex of axilla to the lower marigin of
medial malleolus
With shoes on
5cm/2 inches vertically down from apex of axilla 20 cm lateral
to the heel of the shoe
In standing
Shoes on and shoes off
2 inches below the axilla to the 2 inches anterior and 6 inch
lateral to the foot in standing position
 Forearm crutches
 Also known as
lofstrand/elbow/canadian
crutches.
 They are made of aluminum.
 Design includes a single upright,
a forearm cuff & a hand grip.
 It adjusts both proximally
(position of forearm cuff ) &
distally ( height of crutch)
 Generally adult sizes are 29-35
inches (74-89cms)
 Distal end of the crutch is covered
with rubber suction Tip.
 Forearm cuffs are available wth
either medial or anterior opening.
Advantages
< forearm cuffs allows use of hands
< easily adjusted & allows functional stair climbing
< most functional for patients with bilateral KAFO’s
< using forearm crutches requires no more energy,
increased oxygen consumption or heart rate than
axillary crutches.
< there is no risk of injury to the neuro vascular
structures in the axillary region when using this type of
crutches.
 MEASUREMENT

Position of choice – supported standing

From 1- 1.5 inches below the elbow to distal end at a
point 2 inches lateral & 6 inches anterior to the foot.
Shoulder should be relaxed & elbow maintained at
20 – 30 Degrees flexion.
Cuff placement at the proximal third of the forearm.