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Assistive Devices  The broad base comes in different

sizes. Like most adjustable canes, the


CANES
length can be modified according
Types the patient’s needs
- Disadvantages
- Crook-top cane  The wide base of support is not
- Adjustable metal cane practical to use on stairs. Likewise, it
- Functional grip cane also causes a slower gait pattern
- Quad cane 4. Seat Cane
- Seat cane - This type of cane can be converted into a
chair quickly. It is usually prescribed to
Components
patients who have decreased endurance
- Handle - Advantages
- Adjusting Knob for handle  It’s role as an assistive device plus
- Shaft the fact that it’s also a chair is a plus
- Adjusting Mechanism for height for most elderly patients.
- Rubber tip - Disadvantages
1. Single-Tipped Cane  Because of the chair component,
- It is similar to as standard wooden cane the patient would rather sit down
except that is has a telescoping design than ambulate, therefore, it’s not
which allows adjustments of cane length advisable during ambulation during
- Advantages training. Most seat cane are non-
 The single-tipped cane is quickly adjustable, heavier and more costly
adjustable. This is useful if than it’s counter-parts.
measurement is done prior to
Uses of Canes
altering the length
- Disadvantages - Increased base of support
 The point of support is anterior to the - Decrease loading and demand on the LE
hand and not beneath it. It’s also - Provide additional sensory information
more costly than the standard non- - Assist acceleration/deceleration during
adjustable cane locomotion
2. Single-tipped Offset Cane
- This type of cane is similar to the standard Measurement:
adjustable aluminum cane but the proximal
- Handgrip: 20-25° elbow flexion
component is offset anteriorly
- Measure from the greater trochanter to a
- Advantages
point 6 inches to the side of the toes
 Due to it is relative handle
orientation, the offset cane allows CRUTCHES
pressure to be borne over the center
Types
of the cane for greater stability. Like
most single-tipped canes, it is light - Axillary Crutches
weight, easily adjusted and fits on - Forearm Crutches
most stairs - Platform Crutches
- Disadvantages
 The offset cane, due to it’s more Components
complicated design is more costly
- Padded axillary piece (top)
3. Quad Cane
- Two upright shafts
- The quad cane provides a broad base with
- Handpiece
four points of contact with the floor. The legs
- Extension piece
closest to the body are generally shorter
- Rubber tip
and may be angled better to provide foot
clearance Components of Forearm Crutches
- Advantages
- Forearm cuff
- Forearm piece also employs a handle that is
- Molded handpiece contoured to adapt to deformities.
- Single aluminum tubular shaft - Disadvantages
- Rubber tip  The platform crutch due to it’s
1. Forearm Crutch limited production and complex
- The forearm crutch is made up of tubular design is more costly. Also, the hand
aluminum with a padded handgrip and a cannot perform tasks freely with the
forearm cuff which help to stabilize the platform attachment
forearm during weight bearing. The most 4. Ortho Crutch
popular brand is Loftstrand - The ortho crutch has a single upright that
- Advantages offsets proximally to come the axillary
 Since it closely resembles a cane, it cradle. The hand piece is adjustable
can be used unilaterally as a cane. - Advantages
The forearm support stabilizes the  Due to its simpler design, it’s more
wrist during weight-bearing making comfortable, cheaper and highly
ambulation easier and safer customizable. It is also lighter, thus
because the crutch is attached to the energy expenditure is less
the forearm, the hand can be free to - Disadvantages
perform tasks without dropping it  Since the technology for the ortho-
- Disadvantages crutch is relatively new, it’s not
 The flaw of the forearm crutch will available in most countries.
affect patients without trunk
Uses of Crutch
balance. It is also more difficult to
remove - Increase the BOS
2. Triceps Crutch - Provide moderate degree of stability
- The wooden Canadian Crutch together - Relieve weight-bearing on the LE
with aluminum Warm Spings Crutch and
Everest crutch are examples of triceps WALKERS
crutches. These crutches resemble axillary
Types
crutches with the modifications of forearm
cuff and a triceps cuff. It is originally - Lightweight walking frame
developed for poliomyelitis patients and - Folding walking frame
those with triceps weakness - Rolling walking frame
- Advantages - Forearm resting walking frame
 One of the advantages of the - Hemi-walking frame
triceps crutch is that it helps prevent - Reciprocal walking frame
elbow flexion (buckling) during gait. - Stair-climbing walking frame
It has greater stability than forearm 1. Reciprocal Walker
crutches - This type of walker has swivel joints, allowing
- Disadvantages reciprocal action as each side of the walker
 It requires greater strength and moves alternatively
endurance for patients - Advantages
3. Platform Crutch  Allows a longer stride and is less
- The platform crutch is usually indicated for awkward gait
patients with arthritis because of pain and - Disadvantages
deformities in the hand and wrist. Patient  Because of moving parts, some
with elbow flexion contracture will also inherent stability of the walker is lost.
benefit from this device. 2. Stair-climbing Walker
- Advantages - This type of walker has a climbing lever that
 One of the advantages of the allows the patient to gain an ability to climb
platform crutch is that the weight of stairs. It is primarily used by patients with
the body is borne on the forearm good balance and superior strength in their
and not on the hands. The design UE like young paraplegics
- Advantages
 This is the only walker that can allow 6. Hemi-walker
the patient to walk on level ground - The hemi-walker is actually a cane. It is
and stairs commonly used for patients with
- Disadvantages hemiparesis but are in need of a walker. It is
 It’s expensive, extremely slow and also used as an intermediate device from
cannot be used on spiral stair-cases parallel bars to quad cane.
3. Rolling Walker - Advantages
- Due to the casters in it’s front legs, the rolling  Due to its wide BOS, it is more stable
walker is naturally prescribed to patients with than a quad came. It also has a
UE and trunk incoordination smaller base than most walkers, thus
- Advantages it is less cumbersome
 Good for patient with weak UE. - Disadvantages
People with UE and trunk  Compared to a standard walker, it’s
incoordination who are unable lift less stable and due to its design, the
walkers can also avail of it’s weight is not distributed well on the
advantages. center. It is more costly, can’t be
- Disadvantages used in most stairs and has a slow
 The instability brought by the casters forward progression.
can be dangerous.
Attachments
4. Rollator
- Four wheels are attached to the legs of this 1. Casters
type of walker. To improve control, brakes - Walkers with detachable anterior legs can
are used whenever the patient wants to be replaced with casters for faster mobility
stop. Most models are equipped with a seat 2. Extension legs
and a basket - In case of wear and tear, legs can be
- Advantages replaced with extension legs.
 Because it can change direction 3. Platform Attachment
easily, it closely guides the patient - A standard walker can be attached with
into a near normal walking pattern this device whenever hand function is
- Disadvantages impaired
 Aside from the fact that it is unstable,
the patient tends to bear his weight
non on the rollator, but at the hip
level thus producing stress on the LE
upon walking
5. Walker with Platform Attachments
- This walker allows transfer of body weight
from the forearm via the platform
attachment down to the four legs of the
assistive device.
- Advantages
 This assistive device is helpful to
patient with flexion contracture of
the elbow. For patients with
wrist/hand pain and deformities, the
platform walker provides mobility
since the weight is transmitted to the
forearm. It can also be used for
below amputees
- Disadvantages
 Its heavier, can’t be used on the
stairs. The patient loses the use of the
triceps to elevate and maintain
body during swing phase