Assistive Devices

“A health caregiver who

prioritizes patient safety and uses
proper techniques is the patient’s
best assistive device.”
Assisting the
patients with the
use of crutches,
cane and walker
• Crutches
• Cane
• Walker
 CRUTCHES
• Crutches are tools that provide support and
balance when you walk.
• You may need 1 or 2 crutches to help support
your body weight.
• You may need crutches if you had surgery or an
injury that affects your ability to walk.
 Three primary types of
crutches:
Underarm Crutches:
• Also called axilla crutches
and are the most common
type of crutch.
• These crutches are placed
in your underarm for use
and can be adjusted for
Forearm crutches:
• Also called lofstrand or
elbow crutches.
• Has cuffs that goes
around the forearm and
handles for hand to
grip.
• Most often used by
people who need long-
Forearm support
crutches:
• Also called adjustable
arthritic crutches,
platform crutches, or
gutter crutches.
• Has padded forearms
and adjustable handles.
 Safe use of Crutch
• Support your weight with your arms
and hands.
• Do not support your weight with
your armpits. This could hurt the
nerves that are in your armpits.
• Keep your elbow bent when the
crutch is in place under your arm.
• Walk slowly and carefully with crutches.
• Go up and down stairs and ramps slowly,
and stop to rest when you feel tired.
• Get up slowly to a sitting or standing
position. This will help prevent dizziness
and fainting.
• Use your crutches only on firm ground.
• Wet or waxed floors and smooth
cement floors can be slippery.
• Watch out for small rugs or cords.
 How to Walk with Crutches

●Place both crutches under your

arms, and place your hands on the
hand grips of the crutches. Place
your crutches slightly in front of you.
• The top of the crutches should be
about 2 fingers side-by-side
(about 1½ inches) below your
armpits.
• Place your weight on your hands.
The top of the crutches should
not press into your armpits.
•If you have one leg that is injured,
keep it off the floor by bending your
knee.
•Lift the crutches and move them a
step ahead of you. Put the rubber ends
of the crutches firmly on the ground.
•Move the foot that is not injured
between the crutches. Place that heel
• If you are using your crutches for
balance, move your right foot and
left crutch forward. Then move
your left foot and right crutch
forward. Keep walking this way.
 How to go upstairs with crutches?
●Face the stairs. Put the crutches close to the first
step.
●Push onto the crutches and put your uninjured leg on
the first step.
●Put your weight on your uninjured leg that is on the
first step. Bring both crutches and the injured leg onto
the step at the same time.
How to go down stairs with crutches?
• Stand with the toes of your uninjured leg close
to the edge of the step.
• Bend the knee of your uninjured leg. Slowly
lower both crutches along with the injured leg
onto the next step.
• Lean on your crutches. Slowly lower your
uninjured leg onto the same step.
• Place both crutches under one arm while
you hold onto the railing with the other arm.
How to sit in a chair with crutches?
●Turn and back up to the
chair until you feel the edge
of it against the back of your
legs. Keep your injured leg
forward.
●Take your crutches out from
under your arms. Sit while
bending your uninjured leg
How do I get up from a chair with
crutches?
●Sit on the edge of your chair.
●Push up with your hands
using the crutches or arms of
the chair. Put your weight on
your uninjured foot as you get
up.
●Keep your injured leg bent at
the knee and off the floor.
The four point crutch gait
It uses two crutches and both legs to offer maximum
stability while walking.
●Indication: Weakness in both legs or poor coordination.
●Pattern Sequence: Left crutch, right foot, right crutch,
left foot. Then repeat.
●Advantages: Provides excellent stability as there are
always three points in contact with the ground.
●Disadvantages: Slow overall walking speed and may be
cumbersome to manage.
Four-Point Crutch Gait
DID I? YE N
S O
1.Left crutch,
2.Right foot,
3.Right crutch
4.Left foot.
Three-Point Crutch Gait
•If you are unable to bear weight
on one leg, you may benefit most
from using the three-point crutch
gait.
•This allows you maximum
mobility while maintaining
• Indication: Inability to bear weight on one leg.
(fractures, pain, amputations).
• Pattern Sequence: First move both crutches and
the weaker lower limb forward. Then bear all
your weight down through the crutches, and move
the stronger or unaffected lower limb forward.
Repeat.
• Advantages: Eliminates all weight bearing on the
affected leg.
• Disadvantages: Good balance is required.
Three-Point Crutch Gait

DID I? YE N
S O
1.First move both crutches
2.Move the injured/weak foot
forward
3.Move the stronger or unaffected
foot forward
Two-Point Crutch Gait
DID I? YES N
O
1.Move the Left crutch and
right foot together
2.Move the right crutch and
left foot together
•The two-point crutch gait may disrupt
your normal walking pattern. When
people walk, they typically swing their
opposite arm and leg - as the left leg
moves forward, your right arm swings
forward.
•The two-point crutch gait pattern alters
this, and it may make returning to normal
ambulation challenging once you no
• Indication: Weakness in both legs or poor
coordination.
• Pattern Sequence: Left crutch and right
foot together, then the right crutch and left
foot together. Repeat.
• Advantages: Faster than the four point date.
• Disadvantages: Can be difficult to learn the
Swing-Through Crutch Gait
DID I? YE NO
S
1.Move both crutches forward
2.Swing both legs forward at the
same time past the crutches
• Most people who are non-weight bearing and
using crutches use the swing-through crutch
pattern.
• Indications: Inability to fully bear weight on both
legs. (fractures, pain, amputations).
• Pattern Sequence: Advance both crutches forward
then, while bearing all weight down through your
hands on both crutches, swing both legs forward at the
same time past the crutches. Land on your unaffected
(strong) leg while holding your injured leg up in the
air.
• Advantage: Fastest gait pattern of all six. Ease of
movement.
• Disadvantage: Energy consuming and requires good
Swing-To Crutch Gait
DID I? Y N
ES O
1.Move both crutches forward
2.Swing both legs forward at the
same time right to (not past) the
crutches.
• The swing-to pattern is often used when you are first
learning to walk with crutches.
• Indications: Patients with weakness of both lower
extremities.
• Pattern Sequence: Advance both crutches forward
then, while bearing all weight down through your
hands on both crutches, swing both legs forward at
the same time right to (not past) the crutches.
• Advantage: Easy to learn.
• Disadvantage: Requires good upper extremity
 Walking with One Crutch
• Indications: Used for weaning from two crutches and
when starting to gain full weight bearing after surgery or
injury.
• Pattern Sequence: Advance your weak leg with the crutch
on the opposite side. Place your weight through your hand
on the crutch, and advance your strong leg.
• Advantage: The crutch helps support your body weight
with your injured or weak leg. Easy to learn.
• Disadvantage: May make you slightly unstable, especially
immediately after coming off partial weight bearing status.
Cane • An assistive device
prescribed to provide
support during
ambulation and
transfers for
individuals with
weakness, instability,
pain, or balance loss.
It may also be used to
unload a lower
extremity joint or to
• An assistive cane is a walking stick
used as a crutch or mobility aid.
• A cane can help redistribute weight
from a lower leg that is weak or
painful, improve stability by
increasing the base of support, and
provide tactile information about the
ground to improve balance.
Parts of Cane
2TYPES OF
CANE
1.Standard straight-
legged cane
• To support and
balance a patient with
decreased leg
strength. Usually used
for elderlies with
arthritis.
2.Quad cane-
• It has 4 feet and
provides the
most support.
Used mostly for
elderlies with
hemiplegia of
right side or left
side body
weakness.
USING THE CANE
• Hold the cane with the stronger hand on the
stronger side of the body.
PURPOSE OF USING CANE
• To provide maximum support.
• To provide adequate and appropriate body
alignment.
Fitting The Cane
• The hand grips of the cane should be
even with the wrist crease.
• When the patient holds onto the hand
grips of the walker, the elbows should flex at
about 15–30-degree angle.
TYPES OF GAIT IN USING CANE
•3-point-gate cane (TRIPPLE LEG)
•2-point-gait cane (DOUBLE LEG
3-point-gate cane (TRIPPLE LEG)
•For maximum support
1. Move the cane forward
2.Move the affected or weak leg
forward towards the cane.
3.Then move the stronger leg forward
ahead of the cane and the weak leg.
2-point-gait cane (DOUBLE LEG)
• For lesser support
1.Move the cane and weak leg forward
simultaneously.
2.Move the stronger leg forward.
How to go up the stairs with a cane?
1. The patient will move the “good” leg up
onto the step first.
2. Then move the “bad” leg and the cane up
together.
How to go down the stairs with a cane?
1. The patient will move the cane
down onto the step.
2. Then move the “bad” leg down.
Then followed by the good leg.
WALKER
 A walker is an assistive device that has
four points of contact with the ground,
and usually has three sides with the
side closest to the elderly being open.
 It provides a wider base of support.
 It helps with weight-bearing.
 It allows elderlies to take some
weight off their legs by pushing
down on the walker with their arms.
 This alleviates leg weakness and
pain, besides correcting posture and
gait.
Types of Walker
Standard walker
• Designed for individuals with mobility
problems that can be handled
independently.
• It helps elderly control their body and
learn to maintain an upright posture.
• For movement, the elderly must pick up
and move the device before every step.
2-wheel walker also known as a
hybrid rolling walker
•This device is best suited for individuals
with limited strength and mobility.
•It benefits a slow walker as the casters
can help enhance their pace.
Rollator/ rolling walker
•Rollators are best suited for people whose:
• arms are too weak to hold a traditional
walker
•individuals with limited upper body strength
to push a standard walker
•and those that need to make frequent stops
while walking.
Fitting of walker
•The hand grips of the walker should
be even with the wrist crease.
•When the patient holds onto the hand
grips of the walker, the elbows
should flex at about 15–30-degree
angle.
Assisting patients with wheelchair
transfer
•WHEELCHAIR
 Things to remember when
pushing the wheelchair
•Always make sure that the breaks are on when the
chair is not being pushed.
•Make sure your passenger’s feet are safely on the
footplates and elbows and all clothing are tucked in
safely.
•Look well ahead for possible hazards.
•Always let the person in the wheelchair know you are
going to tilt them or turn them.
Getting down on a Curb
•Curb- It is stone or concrete
edging to a street or path
•Go down on a curb
backwards.
•Back the wheelchair to the
edge of the pavement.
•Pull the rear wheels gently
Entering lifts/Elevator
• Enter the elevator backwards so that you
don’t have to turn around in a confined
space.
• Go down a ramp backwards.
• Sometimes it depends upon your strength
and the steepness of the ramp.
 Assistive technology (AT)
• It is a term for assistive, adaptive, and
rehabilitative devices for people with
disabilities and the elderly.

• Activities of Daily Living (ADLs)are self-

care activities that include toileting, mobility
(ambulation), eating, bathing, dressing,
grooming, and personal device care.
Assistive technology can ameliorate the
Assistive technology/devices promotes
greater independence by
• enabling people to perform tasks
they were formerly unable to
accomplish, or had great difficulty
accomplishing
• by providing enhancements to, or
changing methods of interacting
Gait Belt
Gait Belt
• A Gait Belt is used for safe handling and
mobility.
• These are sturdy belts. A patient must be at least
partially ambulatory, that means, they must be
able to handle their own weight to some extent
to use the belt.
• It allows the caregiver to offer assistance to
TRIPOD POSITION
Degree of Paralysis
Monople A paralysis that affects one limb
gia only such as one arm or one leg.
Hemiple A paralysis that affects one side of
gia the body such as the leg and arm of
the same side of the body.
Diplegia A paralysis that affects the same area
of the body such as both arms or both
side of the body.
Paraplegi A type of paralysis that affects
a both legs and sometimes parts
of the trunk.
Quadri A type of paralysis that affects
plegia both arms and both legs and
sometimes the entire area from
the neck down. The function of
the heart, lungs and other organs
might be affected.