This document provides information on gait training and mobility aids. It discusses different types of walking canes, including standard, adjustable, offset, quadruped/four-prong, and rolling canes. The advantages and disadvantages of each type are described. Guidelines are provided for measuring and selecting an appropriately sized cane. Instructions are given for proper gait patterns when using a cane, including hand placement and cane position relative to the body. Reasons for prescribing assistive devices to aid mobility are outlined.

2. GAIT TRAINING
Mobility aids or assistive
devices
PREPARED BY:
DR RAB NAWAZ
DPT(KMU), PN(AIOU)
LECTURER SIAHS (SUIT)

3. LEARNING OBJECTIVE
 WHAT ARE WALKING AIDS?
 REASONS TO PRESCRIBE ASSISTIVE DEVICES
 CANE
 TYPES OF CANES
 ADVANTAGES AND DISADVANTAGES OF DIFERENT CANES
 MEASUREMENT OF CANE
 GAIT
 GAIT PATTERN FOR USE OF CANES

4. Walking aids
• Number of aids available to assist people who have difficulty in walking hence improve
mobility of peoples with mobility impairments
• They cant walk independently with out one
• Stick / canes
• parallel bar
• Crutches
• Frames
• Wheelchairs and scooters
• Stair lifts and similar devices
• Braces
• Splints
• Technical advances can be expected to increase the scope of these devices considerably, for
example by use of sensors and audio or tactile feedback

5. Reasons to prescribe assistive device
• Balance problem
• Pain
• Fatigue
• Weakness
• Joint instability
• Excessive skeletal loading
• Cosmesis
• Wt bearing fully or partially on LE
• unloading occurs by transmission of force from the UEs to the floor by
downward pressure on the assistive device.

6. Canes
Widen BOS and improve balance
Canes are not intended for use with restricted weight
bearing gaits non- or partial-weighlbearing.
Contra lateral positioning is important in reducing forces
created by the abductor muscle

7. Canes
• prevents tilting of pelvis on contra lateral
• Use of a cane in UE opposite affected hip will
reduce these forces
• downward pressure of body
• Weight on cane counter balances gravitational
movement at affected hip
• Tension In abductor muscle reduced. with dec in
jt compressive forces

8. TYPES OF CANES

9. Standard cane
• Regular conventional cane
• Aluminum Or wood or plastic
• Half circle crook handle
• Rubber tip distally 1 in. in diameter
• Advantages
• Inexpensive
• Fit easily in stairs or any surface
• Disadvantages
• Not adjustable,
• Point of support anterior to hand not directly
beneath it

10. Standard adjustable aluminum Cane
• Aluminum
• Half circle handle with molded plastic covering
• Height adjusted using push button
• Available height range27 to38.5 in(68 to98cm)
• Advantages
• Quickly adjustable height
• Light weight
• Fit easily on stair
• Disadvantage
• Point of support anterior to hand not directly
beneath it
• Costly then standard cane

11. Adjustable Aluminum Offset Cane
• proximal component of body (shaft) of this cane is
offset anteriorly creating a straight (or offset) handle.
• made of aluminum tubing with a plastic or rubber
molded grip-shaped handle
• design allow height to be adjusted (27 to 38.5 In. by
a push-button
• Distal rubber tip 1 inch

12. Adjustable Aluminum Offset Cane
• Advantages
• The design of this cane allows pressure to be borne over the center of
the cane for greater stability.
• This cane also is quickly adjusted. lightweight. and fits easily on stairs.
• Disadvantage
• This cane is more costly than standard or adjustable aluminum canes.

13. Quad(Quadruped Four-Prong cane)
Aluminum and aluminum tubing is available in a variety of
designs
Both large-based quad canes (LBQC) and small -based
quad canes (SBQC) are commercially available
they provide a broad base with four points of floor
contact.
Each point (leg) is covered with a rubber tip.
The legs closest to the patient's body are generally
shorter and may be angled to allow foot clearance.
May proximal portion of is offset anteriorly. The hand
piece is usually contoured plastic grips.
allows for height adjustments 28 10 38 in. 71to91cm

14. Quad (Quadruped or Four-Prong Cane)

15. • Advantages
• Broad base support, Base of different sizes
• Easily adjustable
• Disadvantage
press exerted by the patient's hand may not be centered over
cane and may result in patient complaints of instability.
Broad BOS not use on stairs
Slower gait pattern
If faster forward progression is used. cane often "rocks" from
rear legs to front legs.
Patients should instructed to place all four legs of cane on the
floor obtain maximal stability.

16. WALK CANE OR HEMI CANE
• aluminum and aluminum tubing
• broad base with four Points of flour contact.
• point (leg) is covered with a rubber tip.
• legs farther from patient's
• body are angled to maintain floor contact
and to improve stability.
• handgrip is molded plastic around
• Walk Canes fold flat and are adjustable in
height from 29to37in. 73to94cm

17. Walk cane
• Advantages
• Broad BOS , more stable then quad
• Can fold flat for travel or storage
• Disadvantage
• handgrip placement may not
• allow pressure to be centered over cane.
• Walk canes cannot be used on most stairs.
• require use of a slow forward progression
• More costly than quad canes.

18. Rolling cane
• aluminum and aluminum tubing
• provides a wide wheel base allowing un interrupted
forward progression.
• Contoured handholds.
• easy height adjustment 28 to37in.(71to94 cm)
• pressure-sensitive brake built into handle
• engaged using pressure from base of the band

19. • Advantages
• wheeled base allows weight to be continuously applied
as the need to lift and place the cane forward is
eliminated.
• provides for a faster forward progression .
• second and third handles placed between the uprights
can assist in rising to standing (brake engaged).
• Disadvantage
• Costly then quad
• Require UE grip strength for breaking
• Not suitable for pt propulsive gait pattern(parkinsonism)

20. Hand grip
• General hand grip for all canes
• Crook hand grip
• Straight( or off set) hand grip
• Shovel hand grip
• Pistol hand grip
• Other several hand grip style

21. Measuring cane
• Cane or center of broad based cane placed approximately 6 in.
from the lateral border of the toe.
• landmarks typically are used greater Trochanter and angle at
Elbow 20 to 30 degree
• top of the cane should come to approximate level of the greater
trochanter.

22. Measuring Canes
 Put on the user's walking shoes.
 Have the user stand naturally upright as much as
possible.
 Have their arms fall to the sides naturally with a
normal relaxed bend at the elbow. ( ...
Using a tape measure, measure the distance from
their wrist joint (bottom crease at the wrist) down to
the floor.

23. Human gait may be define as “ the translatory progression
of the human body as a whole, produced by coordinated,
rotatory movements of the body segments” is known as
gait or human locomotion.

24. Gait Pattern for the Use of Canes
• Cane close to body
• Too far need trunk to
bend laterally or
forward

25. When bilateral involment exist decision must be made as to
which side of the body the cane will be held
• On which side cane most comfortable
• Is one placement superior In term of improving balance or
ambulatory endurance
• If gait deviation exist is one position more effective
• Safty influence by cane placement( during transfer stairs
outdoor surfaces etc)
• Is difference in grip strength
• Are two cane needed for stability