Walking aids Handling and Transfer
Learning Outcomes You will be able to: Identify the correct walking aid for a given patient, based on health social circumstances and specific mobility problem. Use correctly Elbow crutches, sticks and frames. Ensure that the walking aid is safe. Measure the correct height of the aid. Teach the patient to walk, sit stand negotiate stairs and curbs with the aids Instruct the patient in the safe use of an appropriate walking aid
Base of support and Walking aids In pairs : 1-Define Base of support and factors affecting it. 2-Why patients use walking Aids. Feedback to the whole group.5 minutes
NB the large base of support with the FRAME Ferrule
NB the large base of support with the FRAME Base of support Ferrule
2 x Walking sticks. NB slightly smaller base of support compared to the frame. = Walking stick
2 x Walking sticks. NB slightly smaller base of support compared to the frame. Base of support = Walking stick
2 x Walking sticks positioned poorly. NB the smaller base of support (less stable). Base of support = Walking stick
1 x Walking stick. NB Smaller Base of support = Less stability
Which side should a single stick go on? Good side or bad? Why
Where is the base of support? Injured leg weight bearing Swing through phase
Where is the base of support? Swing through phase Injured leg weight bearing
Which has the biggest area of support? Swing through phase Injured leg Swing through phase
So why give walking aids Weight bearing Balance Motor pattern Confidence Endurance
Gait pattern with walking aids Gait with single aid Four point gait Three point swing through gait Three point swing to gait (the feet are advanced by a much shorter distance and placed behind the level of crutches) Two point gait
A general guide 4 point gait Balance and confidence / full weight bearing 3 point gait Balance and/or partial weight bearing 2 point gait non weight-bearing Stairs Sit to stand Kerbs and corners
Sticks/Canes
Sticks/Canes Measure from the wrist crease to a point on the floor about 15cm from the outside of the Patient s foot. The patient's elbow should be bent at 15-30 degrees when holding the stick and standing upright.
Sticks/Canes
Elbow crutches Elbow crutches partial weight-bearing and occasionally non depending on the patients weight. Measure in standing (normal method) or lying from the ulnar styloid to a point 20 cm lateral to the heel of the shoe.
Axillary crutches Now fast becoming obsolete due to the potential injury/nerve damage
Forearm crutche
Gutter frame For partial or non weight bearing. Ideal for patients unable to take weight through the hands. Measure in standing from a flexed elbow to floor.
Walking frames For partial or non weight bearing. Measure in standing with a slightly flexed elbow
Rollator frames (Mobilators) For partial or non weight bearing. Measure in standing with a slightly flexed elbow
Other walking aids Tripod frame Pulpit frame Delta frame
Safety What safety points have to check?
Safety General condition Metal/plastic Ferrules (rubber tips) are not worn to the point where no tread is showing. Correct prescription / type Correct use and instruction Crutches are a matching pair. Do not issue a mismatched pair. Spring clip tips are located into both holes (for axillary crutches make sure the nuts and bolts are tight). Adjustment mechanism adjusts freely (elbow crutches).
Which leg to lead first. The good lead up to heaven The bad lead down to hell Based on - Going up stairs the leading leg does most of the work, but going down the trailing leg does most of the work.
Practice In groups of 4 (Physio-Patient and 2 observers to give feedback ) Practice the following activities.
Things to cover Elbow crutches PWB / FWB Frame NWB / PWB / FWB One stick Walking sit to stand and turning. Stairs with and without a banister. Walking, sit to stand and turning Walking, sit to stand and turning Two sticks Walking, sit to stand and turning