The use of walking aids during rehabilitation and participation in activities of daily living is invaluable. Crutches, Walkers and modified canes are three of the commonest aids. This article describes these aids and suggests ways for using them for optimal safety and outcome. Registered Nurses and Physiotherapists in your area will be able to help you with more personalized knowledge in relation to your needs or disease.
Crutches are walking aids which are generally made of wood. They are inserted under the shoulders to support the weight of an injured lower limb or limbs. A picture of a pair of crutches is shown below. Crutches come in many different lengths. However, the length can be “fine tuned” by making adjustments at the lower end. This is done by undoing the winged nut and bolt system and reinserting them at a different level. A person using crutches should not have to bend over to put his/her weight on them.
Picture 1. A Pair of Crutches.
The crutches shown in this picture are made of wood. Nowadays, It is possible to obtain crutches which are made of aluminum, and/or bamboo. The “crutch” part is padded to prevent pressure sores from developing. The “foot” part has a rubber cap to increase friction. This prevents slippage and the rubber also acts as a shock absorber. If the rubber cap is missing the crutch should not be used because the patient may fall and injure himself. Faulty tools should not be given to a patient because they can cause more harm.
Each institution has its own policy about “giving” / lending crutches to patients. In Australia, most institutions give the crutches to the patient. The cost of the crutches is borne by the Health Service. In Canada the crutches are loaned to the patient. He is required to return them when these they are not needed. Some hospitals ask for a small deposit which is refundable upon returning the crutches.
Crutches are not suitable for all patients who need some help during injury. Other devices like a walker or cane may be more suitable for other patients.
Picture 2. A walking Frame.
A Walker. This is an aluminum frame made specifically for assisting a person to walk. A picture of a walker is shown below. In some newer models there are two small wheels which help the patient push the walker forward. This avoids the lifting which must be done with all wheel-less walkers. The rigid frame is able to support the weight of the patient and give him a firm support when he needs it most.
How to use a walker: The patient places both hands on the handles and lifts the frame up and places about one foot forward. Then he leans forward thereby reducing the amount of weight his legs have to bear. He moves his legs forward. Small steps are easier and safer for the patient. When he has reached the foot of the frame he stabilizes himself and moves the frame forward to repeat the process until he reaches his destination.
In the clinical situation help should be nearby to assist the patient back to bed if he tires out or if he feels feint. If this happens it is best to place the patient on a wheelchair and help him to get to his destination.
Picture 3. (As above) shows a walking cane with a quad base to increase stability.
A Walking Cane with a quad base. This walking aid is a modified walking cane. Historically, walking canes used to be called walking sticks. I am sure you have seen many and will see many more as our society lives longer each year.
The modified metal frame (aluminum) is light weight and hence easier to carry. Further, the quad base of this item provides more support and stability for the patient. Canes made of wood or metal, with only one “foot” provide less stability and are of lesser utility for the patient who is really ill.
For comfort the handle can be made of soft plastic or leather. The feet are best made of later rubber to absorb shock and to increase friction with the floor. The increased friction and cushioning effect of the Rubber enhances safety for the patient.
Regular maintenance consists of replacing the rubber “foot stoppers” which deteriorate with time and usage. A metal walking cane may also require the repairing and replacement of worn out handles.
How to use: The cane is held in the hand of the injured side. It is lifted up and placed forward in the direction of motion. The patient then leans forward and places some weight on the cane. This is done at the time when the injured limb is lifted and placed forward at the desired and most stable position for the patient.
