4. Crutches, Canes & Walkers PDF

4. Crutches, Canes & Walkers Locomotion (human functioning): cast, traction, canes, crutches, walkers CRUTCHES: how do you measure? (for risk reduction so you do not cause nerve damage) Length of crutch: 2-3 finger widths below the anterior axillary fold to a point lateral to and slightly i...

4. Crutches, Canes & Walkers Locomotion (human functioning): cast, traction, canes, crutches, walkers CRUTCHES: how do you measure? (for risk reduction so you do not cause nerve damage) Length of crutch: 2-3 finger widths below the anterior axillary fold to a point lateral to and slightly in front of the foot Hand grip: when properly set, the elbow flexion will be about 30 degrees.. -How to teach how to use the different type of crutch GATES: 2 point: 1 crutch/opposite foot together.. other crutch/other foot together ○ Step One: Move one crutch and opposite foot together ○ Step Two: Move other crutch and other foot together ○ Remember: 2 points together for a 2 point gait ○ Examples: one knee replacement 3 point: moving 2 crutches & the bad leg ○ Step One: Move two crutches and bad leg together ○ Step Two: move good foot by self ○ Remember: 3 point is called 3 point because three points touch down at once ○ Examples: Stairs 4 point: move everything separately ○ Step One: One crutch ○ Step Two: Opposite foot ○ Step Three: Other Crutch ○ Step Four: Other food ○ Examples: total both knee right after surgery Swing-through: for two braced extremities ○ NON-weight bearing.. *amputations* plant the crutches & swing through ○ Example: arthritis braced legs WHEN TO USE EACH GAIT?? ○ Use the even numbered gaits (2&4 point) when weakness is evenly distributed (bilateral). Two point for mild problem; four-point for severe problem ○ Use the odd numbered gait (3 point) when one leg is odd (unilateral problem) ○ Examples of what crutch gait to use: Early stages of RA → 2 point Left above knee amputee → swing through 1st day post op R total knee replacement, partial weight bearing allowed → 3 point Advanced stages of ALS → 4 point Left hip replacement, 2nd day post-op, non-weight bearing → swing through  Bilateral total knee replacement,1st day post-op, weight bearing allowed → 4 point Bilateral total knee replacement, 3 weeks post-op → 2 point Stairs: ○ Which foot leads when going up and down stairs on crutches? Remember: UP with the good; DOWN with the bad ○ The crutches always move with the bad leg Cane ○ Hold can on the strong (unaffected) side ○ Advance cane with the weak side for a wide base of support Walkers ○ Pick it up, set it down, walk to it ○ Tie belongings to side of walker, not the front to prevent tipping over ○ Getting out of chair to walker- always push, never pull (same for cane, crutches) ○ No wheels/tennis balls ( per boards!)