The document discusses various mobility devices used to increase patient mobility. It describes devices from ancient times like canes made from tree branches to modern devices with aluminum, steel, plastic and rubber. Key devices discussed include canes, crutches, walkers, wheelchairs and scooting boards. The document provides details on appropriate usage, measurements, adjustments and positioning for different mobility devices.

1. BY-
Dr Amit kumar mallik
Dptt. Of PMR
RIMS, IMPHAL
INDIA

2. “Devices used to increase the mobility of a patient”

3.  2830 BC- Carvings at tomb of Herkuf
 Before 18th century
Canes- First made from cuttings of tree
branches
Crutch- Single piece of wood with a crossbar
 18th century- introduction of different designs
 20th century- Aluminium and steel tubes, plastic,
foam, rubber as accessories

4.  Improve balance
 Give proprioception
 Decrease pain
 Reduce weight bearing on injured or inflamed structures
 Compensate for weak muscles
 Scan the immediate environment

5.  Stability of the patient
 Strength of upper and lower limbs
 Co-ordination of upper and lower limbs
 Required degree of relief from weight-bearing

6. Parallel bars
Walking frames
Canes
Tripods
Quadrupeds
Crutches
Scooting boards
Wheelchairs

7. Parallel Bars
 Rigid
 Support through
the length of bars
 Enables patients to
concentrate on
lower limbs
 A full length mirror
placed at one end
 Adjustment: height of the bar should be at the level of
greater trochanter

8.  More stable
 For debilitated/elderly people confined to home
 Patients with fear of falling
 Front of the walker at 12 inches in front of the patient
 Patient’s elbow at 20-30° flexion

9. Advantage:-
 Stability
 Sense of security
 Light and adjustable
Disadvantage:-
 Difficult to use on
stairs
 Difficult through a
doorstep or entrance
1. Standard 2. Reciprocal 3. Rollator
Types:-

10.  Consist four almost vertical aluminium
tubes joined on three sides by upper and
lower horizontal tubes
 One side is left open
 Handgrips on upper horizontal tube
 Rubber tips at lower ends of vertical tubes

11.  Identical with standard frame
 Each side of the frame can be
moved forward
 Swivel joints between horizontal
and vertical tubes

12.  Two small wheels at front and two
legs without wheels at back
or one wheel at each leg
 No need for lifting the
whole device
 Care to be taken for
elderly patients
 Best suited for children

13. Other Variants of Walking Frame
Gutter frame Pulpit frame
Gutter frame Pulpit frame

14.  Most common mobility aid
 Commonly made of wood or aluminium
 Transmits 20-25% of body weight
 Held in hand opposite the involved side
 Increase stability
 Compensates for muscle weakness
 Relieves pain
 Elbow at 30° flexion

15. Measurement:
 Upside down
 Handle at shoe heel and Lower end at greater
trochanter or radial styloid in standing
Adjustible canes Non Adjustible canes

16.  Made of aluminium alloy or steel
 Three rubber tipped legs at
corner of an equilateral triangle
 Handgrip in same plane as a line
joining two legs nearest and parallel
to patient’s foot
 Elbow at 30° flexion
 More stable

17.  Has four rubber tipped legs
 Handgrip vertically above two
inner legs
 More stable
 Adjustable hand grip height
 Can be used singly or in pairs

18.  Sense of balance
 Correct selection and
adjustment of crutches
 Strengths of the muscles
 Good vision
 Correct crutch stance
 Pattern of gait envisaged
The patient’s ability to use crutches depends on

19.  Consists of double upright joined at top by
crutch pad, a handgrip and a rubber tip at
lower end
 Axillary/crutch pad rest against chest wall
and 5cm from axillary apex
 Hand grip adjusted to make 30° elbow
flexion
 Weight transmitted down arm to hand grip

20.  Support upto 80% of body weight
 Used when crutch walking is commenced
 When non weight bearing on one lower
limb is indicated
 More stable though cumbersome to use
 Patient can release a handgrip and use that
hand for other purpose

21. A. Adjustable
B. Permanent
C. Ortho crutch
A B
c

22.  Finger flexors and thumb
 Wrist Dorsiflexors
 Elbow extensors
 Shoulder flexors
 Shoulder depressors
 Shoulder adductors

23. Measurement:
1. Height minus 16 inches
2. From apex of axilla to lower margin of
medial malleolus
3. From anterior axillary fold to 6 inch
in front and lateral to 5th toe
4. From anterior axillary fold to bottom
edge of shoe heel in supine position
5. From tip of middle finger to olecranon
of opposite

24. Position
 Patient in standing and wearing shoes
 Crutch under each arm
 Palm of hand on handgrip
 Tip of the crutches 6 inches in front and lateral to tip
of toes
Checking overall length
 3 fingers between anterior axillary fold and axillary
crutch
 Slide crutch extension to correct length

25. Checking handgrip position
 Palm on top of the handgrip and wrist in 90° dorsiflexion
 Elbow in 30° flexion with shoulder depressed
 Move the handgrip to the correct position after removing
uppermost wing nut and bolt
 Check elbow is in 30° flexion
 Tighten nut and bolt

26.  Made of aluminium alloy
 U shaped cuff at upper end to
accommodate forearm
 Rubber or plastic covered handgrip
 Rubber tip at lower end
 Adjustable length

27.  Transmit 40 to 50% of body weight
 Less cumbersome
 More stable than walking stick
 For patients who can take some
weight on both feet
 Paraplegic patients

28. Position
 Standing with shoes
 Armband around the arm with hand on the handgrip
 Crutch tip at 6 inches front and lateral to tip 5th little toe
Checking overall length
 Elbow at 30° flexion
 Slide lower part after pressing the spring loaded double
ball catch
Position of armband
 2 inches gap between armband and flexor crease of
elbow

29.  Single adjustable aluminium alloy tube
 Short horizontal metal gutter at upper end
 Vertical handgrip projecting forward from
gutter
 Lower end protected with rubber tip

30.  Fixed flexion deformity
 Weakness of muscle controlling elbow
joint or hand
 Deformity of hand
 Pain in hand or wrist

31.  Elbow lies at or just behind the posterior
edge of gutter
 Elbow at 90° flexion
 Palm on the handgrip
 Tip of the crutch 6 inches anterior and
lateral to tip of toes
 Adjustable height with spring loaded
double catch ball

32.  Crutch tip
 Hand grip
 Axillary pad
 Tricep band
 Wrist strap

33.  Attached to the foot of
crutch
 Crutch tip diameter of at
least 1.5 inches
 Prevent slippage
 Act as shock absorber
Types
1. Suction crutch tip
2. Snow boot crutch tip
3. Rain guard crutch tip
4. Small crutch tip
1
2 3 4

34.  Sponge pad to relieve pressure
 Can be modified to accommodate a
stiff or deformed hand
 Can increase the girth with rubber
sponge

35. Axillary pad
 Made of sponge rubber
 Prevent undue pressure over nerve and vessels
Tricep band
 Metal or stiff leather and attached to upper part of crutch
 Helpful for those with tricep weakness
Wrist strap
 Leather or plastic
 For weak wrist extensors
 Assist in holding the hand grip

36.  Basically a wooden board with wheels below
 Patient sitting on it and pushing forward with hands
 Popular among Indian housewives with residual
polio