Crutches walking Assisting patient to walk using crutches while providing support and as a convenient method of getting from one place to another.

1. HEMAMALINI R
NURSING TUTOR
DEPARTMENT OF MENTAL
HEALTH NURSING
SHRI SATHYA SAI
COLLEGE OF NURSING
AFFILIATED BY SRI BALAJI
VIDYAPEETH UNIVERSITY-

2. OBJECTIVES
 Define Crutch walking
 List out the purpose of Crutch walking
 Explain the types of walking aids
 Explain the types of crutches
 Enumerate Measurement of crutches
 Enlist the types of crutch walking gait
 Enlist the patient education to help cope with
disabilities

3. DEFINITION
Crutches walking:
Assisting patient to walk using crutches
while providing support and as a convenient
method of getting from one place to
another.
Gait:
Gait is a term to describe human
locomotion; it is pattern of walking or a
sequence of foot movements

4.  Walking aids
Walking aid is a device designed to
assist walking and improve the mobility of
people who have difficulty in walking or
people who cannot walk independently..

5. Purpose of walking aids:
•Increase area of support or base of support
•Maintain centre of gravity over supported
area
•Redistribute weight-bearing area by
decreasing force on injured or inflamed part or
limb
•Can be compensate for weak muscles
•Decrease pain
•Improve balance

6. Different Types of Walking Aids:
 Walker
 Cane/ stick
 Crutches

7. Crutches These are devices which are used to
reduce weight bearing on one or both legs
and also give support where balance is
impaired and strength is inadequate
 Types of crutches:
1. Axillary crutches/ under arm crutches
2. Elbow crutches or Lofstrands crutches
3. Forearm support crutches (gutter crutches)

8. Axillary crutches
 They are made of wood or metal with an Axillary
pad, a hand piece and a rubber ferrule.
 Two upright shafts connected by axillary piece on
top.
 Hand piece in the middle
 Extension piece below
 Extension piece and shafts has numerous holes at
regular intervals so the total length of crutch and
height of handle is easily adjustable.

9.  A large suction tip (rubber ferrule) is attached
to extension piece to allow total contact with
floor.
 The Axillary pad should rest beneath the apex
of axilla and hand grip in slight flexion when
weight is not being taken.
 When weight is being taken through axillary
pad, the elbow will go into extension and
weight is transmitted down the arm to hand
piece

10.  A large suction tip (rubber ferrule) is attached
to extension piece to allow total contact with
floor.
 The Axillary pad should rest beneath the apex
of axilla and hand grip in slight flexion when
weight is not being taken.
 When weight is being taken through axillary
pad, the elbow will go into extension and
weight is transmitted down the arm to hand
piece

11. Advantages of Under Arm Crutches:
 Convenience for temporary injuries
 A large degree of support for the lower
body
 Available at low cost.
 Axillary crutches allow the patient to
perform a greater variety of gait patterns
and ambulate at a faster pace.

12. Disadvantages of Under Arm Crutches:
 Limited upper body freedom
 Axillary crutches require good standing balance
by the patient.
 Improper use of crutch can cause injury to
axillary region, and Strain on the arms and upper
body which can lead crutch paralysis.
 Geriatric patient may fell insecure or may not
have the necessary upper- body strength to use
axillary crutches

13. Precautions:
 Have someone nearby for assistance until
accustomed to the crutches.
 Frequently check that all pads are securely in place
 Check screws at least once per week.
 Clean out crutch tips to ensure they are free of dirt
and stones.
 Remove small, loose rugs from walking paths.
 Beware of ice, snow, wet or waxed floors
 Avoid crowds, leave class early

14. Elbow crutches /Lofstrand crutch:
 They are made of metal an aluminium tubular shaft
with a handgrip and have a metal or plastic
forearm band.
 Forearm piece bent backward and extended to 2
inches below the elbow.
 Both handgrip and forearm piece are adjustable in
length by means of a press clip or metal button and
have a rubber ferrule.
 These crutches are suitable for patients with good
balance and coordination with strong arms.
 Weight is transmitted exactly the same way as for
axillary crutches.

15. Advantage of elbow crutches:
 Light weight
 Easily adjustable
 Freedom for hand activities
 Using forearm crutches requires no more
energy, increased oxygen consumption or
heart rate than axillary crutches.
 Being easily stored and transferred.
 There is no risk of injury to the
neurovascular structures in the axillary
region when using this type of crutches

16. Disadvantages of forearm crutches:
 Forearm crutches are less stable.
 They require good standing balance and
upper-body strength.
 Geriatric patient sometimes feel insecure
with these crutches. They may not have
the necessary upper-body strength to use
forearm crutches.

17. Forearm support crutches/gutter
crutches
 They are made of metal with a padded
forearm support Platform, Velcro strap an
adjustable hand piece and a rubber ferrule.
 These are used for patients with Painful wrist
and hand condition or elbow contractures,
or weak hand grip
 Elbow flexed 90 degrees, the hand rests on a
grip which can be angled appropriately,
depending on the user's disability

18. Advantages:
 As similar like elbow crutch
 These are easily adjustable.
 More cosmetic than other crutches.
 Disadvantages:
 Provide less lateral support due to
absence of axillary pad.
 Cuffs may be difficult to remove
 These can be expensive

19. Measurement of crutches
*Crutch pad distance from armpits: The
crutch pads (tops of crutches) should be
1½" to 2" two finger widths) below the
armpits, with the shoulders relaxed.
*Handgrip: Place it so that the elbow is
slightly bent enough so one fully extends the
elbow when taking a step.

20. Crutch length (top to bottom): The total crutch
length should equal the distance from armpit to
about 6" in front of the shoe. Crutches that are
too tall or too short can affect and also cause
back pain. Incorrectly fitted crutches or poor
posture can cause a disorder called crutch
palsy in which the nerves under arm mostly
radial nerve (brachial plexuses) are or
permanently damaged, causing weakened
hand, and forearm muscles

21. Types of crutch walking gait:
 NWB - Non weight bearing TDWB (OR)
TTWB - Touch down weight bearing (OR)
Toe touch weight bearing
 PWB - Partial weight bearing
 WBTT - Weight bearing to (or) tolerance
 FWB - Full weight bearing

22.  Non weight bearing walking instructions:
Place no weight on the affected limb Do not
touch the ground with the affected limb while
standing or walking. Bear the full weight
through the normal limb and crutches while
standing and walking.
 Balanced standing (Tripod position): Use this
position when at start or end a gait or when
standing for any length of time. Move
crutches to the front about 12 inches. find the
balance. Don't rest the armpits on the crutch
pads. Bear weight through normal limb and
the hand grips of the crutches

23. Non weight bearing:
 Stand on unaffected leg, lift both crutches at
the same time and place the crutches one
step’s length in the front.
 Push down on the handgrips with hands while
squeezing the top of the crutches between the
chest and upper arms.
 Putting the weight through the handgrips, hop
forward with the unaffected leg to meet the
crutches.

24. Touch down weight bearing (or) toe touch weight
bearing walking instruction:
 Standing on the unaffected leg, lift both crutches at
the same time and place the crutches one step’s
length in front.
 Bring the affected leg forward so that it is in line with
the crutches. Only put toes down on the ground up
to a maximum of 4 kg of pressure.
 Push down on the handgrips with hands while
squeezing the top of the crutches between chest
and upper arms.
 Putting weight through the handgrips, hop forward
with unaffected leg to meet the crutches, or slightly
ahead of the crutches, making sure that only 4 kg of
pressure is put through the affected leg.

25. Partial weight bearing walking instructions:
 Bear some weight about 50 per cent on affected
limb as one walks. Standing on unaffected leg, lift
both crutches at the same time and place the
crutches one step’s length in front.
 Bring the affected leg forward so that it is in line with
the crutches. Only put up to 50% of body weight on
this leg as place it on the ground.
 Push down on the handgrips with hands while
squeezing the top of the crutches between your
chest and upper arms.
 Putting your weight through the handgrips, hop
forward with unaffected leg to meet the crutches, or
slightly ahead of the crutches, making sure that only
50% of body weight is put through the affected leg.

26. Full weight bearing walking instruction:
 Bear most of the weight on affected limb as
tolerated. Place only a little remaining weight
on crutches.
 Standing on both legs with crutches at the
side for support, lift both crutches at the same
time and place the crutches one step’s length
in front.
 Bring the affected leg forward so that it is in
line with the crutches

27. Ascending the stairs:
 Face the stairs holding onto crutches and standing on
affected leg. Only put as much weight as allowed as per
orders on the affected leg. If non weight-bearing – one can
chose to keep knee in bent position as shown in the diagram if
possible.
 Put pressure through crutch handgrips as hop up with your
unaffected leg onto the next step.
Descending stairs:
 Stand at the top of the stairs with the toes of unaffected leg
close to the edge of the step and holding onto two crutches,
one on either side.
 Place crutches onto the lower step, bringing affected leg
forward at the same time. Only put affected leg down on the
step if allowed.
 Putting weight through your crutches, slowly lower unaffected
leg onto the lower step, remembering to only put weight
through affected leg if allowed as per doctor’s orders

28. Patient education to help cope with disabilities:
Take control of your life:
 Face the reality of your disability.
 Emphasize areas of strength.
 Remain outward looking.
 Seek inventive ways to tackle problems.
 Share concerns and frustrations. Maintain and improve
general health.
 Plan for recreation.
Have well-defined goals and priorities:
 Keep priorities in order; eliminate activities.
 Plan and pace your activities.

29. Organize your life:
 Plan each day.
 Organize work.
 Perform tasks in steps.
Control your environment:
 Try to be well organized.
 Keep possessions in the same place, so that they can
found with a minimum of effort.
 Store equipment in a box or basket.
 Use energy-conservation and work-simplification
techniques.
 Keep work within easy reach and in front of you.
 Use adaptive equipment, self-help aids, and labordevices.
 Recruit assistance from others, delegate when
 Take safety precautions.

30. THANK YOU