Mobility aids are the appliances or devices, which or useful for the mobility as well as stability purpose of an individual who cannot walk independently, these are also referred as walking aids, or Ambulatory assistive devices. There are different types of assistive devices - crutches/ canes/ walkers/ wheel chairs

1. By… Teja Polavaram [MPT sports medicine]
*MOBILITY AIDS

2. *
*The appliances or devices, which are
useful for the mobility and stability
purpose of an individual who cannot
walk independently without any
support, called as mobility or walking
aids.
*In simple – used for musculo skeletal
and neuromuscular
*These mobility aids reduce the weight
bearing.

3. *
*Pain
*Muscle weakness
*Problem in balancing
*Fractures
*Joint diseases
*Injured or inflammed limb
*Lack of proprioception

4. *
*Parallel bars
*Crutches
*Canes
*Walkers
*Wheel chairs
*Braces and splints (orthosis)
*Prosthosis

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. *
*Full weight bearing (FWB)
*Partial weight bearing (PWB)
*Non weight bearing (NWB)
*Toe touch weight bearing (TTWB)
*Weight bearing as tolerated (WBAT)

7. *

8. *
*These are rigid, made of wood or metal
*Support the patient through the length
of the bars
*Enables the patient to concentrate on
the lower limbs
*A full length mirror is placed at one for
visual proprioception
*Height of the bar should be at the level
of greater trochanter

9. *Elbows should be flexed between 25 to
30 degrees
*Hands should be placed on the bar 6
inches infront of the patient
*Helps in gait training and posture
correction
*Provides maximal stability, support,
and safety.

10. *Parallel bars are used to help people
to regain their strength, balance,
rom, and independence.
*These are also used for co ordination
exercises, task oriented exercise for
the neurological patients.
*These are also used for ambulation
exercises to improve patient ability
to walk independently.
*The training typically begins on
parallel bars and then progress to
crutches, walkers and canes.

17. *

18. *

19. *
*Crutches are used mostly to relieve the
weight bearing
*3 types of crutches are available
1.Axillary crutch
2.Elbow crutch
3.Gutter crutch

21. *
*Axillary crutch provides the maximum
stability and support to the patient
than any other crutches.
*It gives more than 80% of the stability
to the patient.
*This crutches are recommended to the
patient’s who are having marked
instability.
*It is made of aluminium, steel, wood.

23. *
*Axillary pad
*Hand grip
*Rubber ferrule

24. *Axillary pad:-
*It is situated in the top portion of the
crutch.
*It should be placed 5cm below the
axilla, if not pad compress in the axilla
cause neuropraxia of te axillary nerve,
radial nerve, or brachial plexus.

25. *Axillary pad is made up of metal and iss
covered by the cushion materials to
avoid the damage to the lateral aspect
of the chest wall.
*The axillary pad is placed laterally to
provide lateral stability.

26. *Hand grip:-
*It is made up of plastic material, and
sometimes covered by cushion
material.
*Hand grip normally comes around the
greater trochantric area of the person
using it.
*It has the adjustable screws or clips to
adjust the height.
*Some crutches have the adjustable
hand grip buttons.

27. *Rubber ferrule:-
*It is situated in the lower end of the
crutch.
*This rubber tip provides more grip for
the patient while walking in the
normal/slippery surface.

29. *
*Before giving crutch to the patient, it
should be measured perfectly because,
lengthier crutch may cause compression
over the axilla, which leads to
neuropraxia.
*Sometimes if it is small, the patients’s
gait pattern may change or it may cause
some other complication like back ache

30. *
 Shoes off
• Lying
• Standing
 Shoes on
• Lying
• standing

31. *
*Supine lying:- has to be measured from
the apex of the axilla to the medial
malleolus. This is the accurate
measurement
*Standing:- two inches below the axilla to
the two inches lateral and six inches
anterior to the foot when the patient is
standing

32. *
*Supine lying:- this type of
measurement is taken with the patient
wearing shoes. The measurement taken
from 5 cm below the apex of axilla to
the 20 cm lateral to the heel of the
shoe. This is not accurate method of
measuring crutch length
*Standing:- same like shoes off method
taken in standing position

33. *
*The measurement taken from the 5 cm
below the apex of the axilla to the ulnar
styloid process in the elbow in 20° – 30°
flexed position

35. *
*It gives less stability (60%) than the
axillary crutch.
*Elbow crutches are recommended to the
patient with minimal instability in
walking.
*It is made up of aluminium, metal, or
plastic.

36. *
*Fore arm cuff
*Single upright
*Hand piece
*Rubber ferrule

38. *Fore arm cuff:-
*It is made up of metals and is coated
by plastic or cushion materials, placed
just below the elbow joint.
*Single upright:-
*It has proximal and distal adjustable
press clips.
*Proximal one to adjust the height of
the fore arm cuff and the distal one to
adjust the height of the crutches.

39. *Hand piece:-
*It is present between the proximal and
distal adjustable clips, and it comes
around the greater trochanteric region
of the person using it.
*Rubber ferrule:-
*It is situated in the lower end of the
crutch.
*This rubber tip provides more grip for
the patient while walking in the
normal/slippery surface.

40. *
*The measurement taken from the ulnar
styloid process with the elbow in 20° -
30° flexion to the 20 cm lateral to the heel
or the heel of the shoe

42. *
*It is similar to the elbow crutch, having
extra with a padded fore arm support.
*These are mainly used for rheumatoid
hand or fracture of wrist/hand, who
require some form of support but cannot
take weight through hands, wrist, elbows
because of deformity and/or pain.

43. *
*Fore arm
supporting pad
with strap
*Single upright
*Hand piece
*Rubber ferrule

44. *
*Lying:- the measurement taken from
the point of flexed elbow to 20 cm
lateral to the heel (shoes on)
*Standing:- the measurement taken
from the elbow to the floor

46. *

47. *
*Canes are ambulatory assistive devices
used for improving postural stability.
*It is generally prescribed for the people
with moderate mobility impairement.
*It is typically used when minimal
stability is needed.
*Cane in the day to day life are called as
walking sticks.
*These are maade up of wood, metal, or
aluminium.

48. *
1.Standard canes
2.Standard adjustable canes
3.Standard adjustable offset canes
4.Tripod canes
5.Quadripod canes

50. *
*Hand grip
*Adjustable clips
*Rubber ferrule

51. *
*It is made up of wood, metal, or
aluminium.
*It has curved or half circled hand piece.
*It is not height adjustable, and made
according to the height of the patient.
*It is inexpensive and can be carried
easily anywhere.
*Normally, it is recommended for the
elderly patients.

53. *
*It is similar to standard canes, but has
adjustable press clips.
*It is made up of metal or aluminium or
may be having plastic covering.
*It has curved or half circled hand piece.
* it is also easy to carry and has the
advantage of adjusting to the person
height.

55. *
*Upper half of the cane is offset anteriorly
so that the log falls on the cane and it gives
stability.
*It may be available in the standard and
adjustable canes.
*Commonly all the sticks are having the hand
piece and the adjustable ferrule, except the
wooden made standard canes
*The hand piece comes up to the greater
trochanter level.

57. *
*It has the 4 or 3 leg with the rubber tip
and it gives the broader base, because of
this the BOS will be more.
*Available in offset and also in standard
models.
*Gives more stability than the other
varieties.

58. *This is more useful for neurological cases
like hemiplegia, and in some lower limb
injuries.
*Height adjustable screws are also
available.
*It is difficulty carry on the stairs if the
base is broader.

61. *

62. *
*Walkers are useful in non-weight
bearing, partial weight bearing, and full
weight bearing gait pattern.
*It gives more stability as it has boarder
base.
*Since the cog falls within the bos, it
gives anterior as well as lateral stability.

63. *The walker is having is having two
anterior and two lateral bars, the
horizontal bar connects all the vertical
bars in the three sides, and one side is
kept open.

64. *
*Rigid walking frame
*Foldable walker
*Gutter walker
*Reciprocal walker
*rollator

65. *

66. *
*Stability
*Security
*Light and adjustable

67. *
*Difficulty to use on stairs
*Difficulty through door step or entrance

68. *
*It is un foldable
*Consists four almost vertical
aluminum tubes joined on three sides
by upper and lower horizontal tubes
*One side is left open
*Hand grips present on upper
horizontal tube
*Rubber tubes present at lower ends of
vertical tubes

70. *
*It has all the feature of rigid walker,
except the folding nature.
*It can be easily foldable and can be
kept aside.
*It is also easy to carry while travelling

72. *
*It is also having the entire feature like
rigid walker and additionally it has the
fore arm platform instead of hand grip
*It is more helpful for the patient who
has the problem over the wrist(RA, wrist
fracture, or hand injuries)

75. *
*This is designed to allow unilateral
forward movement of one side of the
walker
*These type of walkers are useful for the
patients who cannot lift and walk with
the walker
*There will be swivel joints present
between the vertical and horizontal bars

76. *One side of the walker move forward
with the opposite side leg followed by
it, and other side of the walker with
the other leg
*So alternatively, each side of the
walker move forward

79. *
*The anterior vertical bars having the
caster and the lateral bars remains same
as in rigid walker.
*While walking the patient has to lift the
rear bars off the ground and the wheels
move forward and ends with the rear bar
placing on the ground.
*Some walkers have the wheel for each leg
*Care should be taken for elderly patients
*Commonly recommended for the children

84. *

85. *
*This is one of the variety of mobility
aids
*The patient who has both the lower
limbs non functioning or partially
functioning has to be recommended for
the wheel chair
*It is the secondary house for the
patient, because he has to spend more
time with it

86. *It may be modified depending on the
condition of the patient
*It gives 100% stability to the patient
*Normally, wheel chairs are recommended
for paraplegic, quadriplegic, muscular
dystrophy, spinal cord injuries, and
fracture conditions.
*It provides physical and as well as mental
support

87. *
*Wheels
*Tyres
*Wheel locks
*Casters
*Hand rim
*Foot rest
*Tilt bar
*Seat and back rest

89. *
*Rigid
*Foldable
*One arm driven wheel chair
*Powered wheel chair

90. *
*The rigid wheel chairs are having the
solid frame and also it is lighter
*It is difficult to carry while carrying
*These are designed to be pushed by
another individual because of user’s
inability to propel or operate manual
wheel chair in a functional or safe
manner

91. *Manual wheel chairs can be advised for
those who can propel and brake using
the upper limb
*Have a variety of frame types, weights
and transport feature

93. *
*Foldable wheel chair contains
foldable frames and it is very much
heavier
*It occupies less space, sp it is very
much easy to carry while traveling

95. *
*These wheel are chairs are used for the
patients who are not able to use their
one side upper limb main in paralysed
conditions
*This wheel chair is activated and steered
by one upper limb
*The wheel chair contains two hand rims
on one side
*

96. *One controls the same side wheel
(outer ring); another (inner ring)
controls the opposite side wheel
*If both the rings are simultaneously
used the wheel chair propels in
straight line

101. *
*These wheel chairs are sophisticated
one and used mostly in the developed
countries
*It can be steered, propelled, adjust
the seat hand rest, back rest by the
power control
*These are useful for the persons who
cannot sit for prolonged period of
time

102. *Some wheel chairs can also stand
erect, can be used both as the wheel
chair and standing frame
*These wheel chairs aids in
independence and productivity
*Helps in reduction of pressure sores
*Raising self esteem and
psychological well being

103. *

112. *

113. *Weight Bearing Restrictions:
*Weight Bearing as Tolerated
If you are weight-bearing as tolerated, that
means you can put as much weight through
your leg as is comfortable. Putting weight
through your legs should not significantly
increase or cause you pain.
*Partial Weight Bearing
If you are partial weight bearing then you can
put some weight but not all through your leg.
You should push through your hands on the
crutches to keep the full weight off of your
leg.

115. *Toe Touch Weight Bearing
If you are toe touch or foot flat weight-
bearing, then you may simply rest your foot
on the floor. Imagine there is an egg or a
cracker under your foot that you don't want
to crush. It's important to know that toe
touch weight bearing does not mean that
only your toe can touch the ground. It is
important to allow your entire foot to rest
flat on the ground.

117. *Non Weight Bearing
If you are non-weight-bearing then you can't put
any weight through your foot. You should push
through your hands on the crutches to keep the
weight off of your foot. As you walk, you should
be able to walk without your foot touching the
ground.
*No matter what your weight-bearing restrictions
are, make sure that you never lean on the tops of
your crutches. You can hurt a nerve causing
numbness and tingling in your arm. Put all of
your weight through your hands, not your
armpits.

119. *How to fit your crutches:
*Stand tall with your shoes on. Make sure your
shoes have low heels and good support.
*Put the crutches under your arms. Relax your
arms and let them hang down over the crutches.
There should be a two inch space between your
armpit and the top of the crutch with your hands
hanging relaxed.
*The hand grips should be at the level of your wrist
when holding the hand grips.
*Your elbows should be bent slightly to about thirty
degrees.

120. *Standing Up
To stand up, hold both crutches by the hand
grips in one hand and push up with the other
hand on the chair. Then put one crutch under
each arm.
*Sitting Down
To sit down, place both crutches in one hand
holding the hand grips together and reach for
the chair with your other hand to lower yourself
slowly.

121. *Walking
*To take a step, squeeze the crutches between
your upper arms and ribs put the weight through
your hands not your armpits.
*Move the crutches forward. Move your injured
leg forward and put your foot even with the
crutches. Put as much weight as you are allowed
on the injured leg, taking the rest of the weight
through your arms and hands.
*Step past with your stronger leg.
*In summary, move the crutches first, your injured
leg next, and then your stronger leg.

123. *Going Up Stairs
*To go upstairs with a handrail, place one crutch
under one arm and use the handrail with the other
arm for support.
*Step up with the stronger leg, then the injured leg,
and lastly bring up the crutch. Always make sure
the crutch tip is completely on the stair. If you do
not have a handrail be very careful as you could
lose your balance. Have someone help you or avoid
the stairs until you are stronger.
*Place one crutch under each arm. Step up with the
stronger leg then, then bring the injured leg and
your crutches up together.

125. *Going Down Stairs
*To go down stairs with a handrail, place one crutch
under one arm and use the handrail with the other
arm.
*For support, lower the crutch down to the step
below and move your injured leg down and then
bring your stronger leg down. Always make sure the
crutch tip is completely on the stair. If you do not
have a handrail, be very careful as you can lose
your balance. Have someone help you or avoid the
stairs until you are stronger.
*Place one crutch under each arm. Step down with
your crutches and your injured leg. Together then
bring your stronger leg down.