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.
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
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
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