Assistive Devices

As an occupational therapist, one of our priorities when working with clients who need assistive devices is to properly fit them to this device. This will allow optimal comfort, stability, mobility, and reduce injury. For example, if someone using lofstrand crutches were not fitted properly, they may not be able to reach the arm cuffs, which will provide them with less stability, and in turn may lead to injury. Another example may be if someone were using a platform walker and the platform was not adjusted to the correct position, the client could experience nerve compression in their forearm. 

There are many details when it comes to fitting an individual to their assistive device, but therapists will mainly look at certain measurements, specific bony landmarks when fitting the device, and the client should be standing tall and wearing shoes when being fitted. For fitting a cane, the hand grip should be positioned at the ulnar styloid, wrist crease, or greater trochanter. Additionally when fitting the device, the shoulders should be relaxed, as well as the elbow should be relaxed and flexed 20-30 degrees and the wider feet on the cane should be facing away from the client. The client should use the cane on the unaffected side.

For axillary crutches, the hand grip measurements will be the same as the cane. The hand grip should be positioned at the ulnar styloid, wrist crease, or greater trochanter and the axillary rest should be 5 cm below the floor of the axilla with shoulders relaxed. The lofstrand crutches vary slightly from the axillary as the arm cuff must be located about 2/3 up the forearm, and the hand grips should be placed at the ulnar styloid, wrist crease, or greater trochanter. When using the lofstrand crutches, the client must face the hand grips forward.

To fit a platform walker, have a patient stand straight to be able to adjust the legs accordingly to their height. When hands are resting at their side, the hand grips will be the same as previous devices, in line with ulnar styloid, wrist crease, or greater trochanter (when only one platform is added to walker). Additionally to fit the platforms, have client stand tall with the elbows flexed at 90 degrees and platforms should be placed on forearms for optimal weight bearing. The proximal ulna should be positioned 1 to 2 inches away from surface and the handle of the platform should be turned medially.

For a rolling walker, the hand grips will be placed in the same position as the platform walker. When hands are resting at their side, the grips will be the same as previous devices, in line with ulnar styloid, wrist crease, or greater trochanter which will allow their elbows to be flexed 20-30 degrees when walking. It is important to ensure that when the leg heights are adjusted, each leg is at the same height and buttons are clicked in place. 

Each of these steps is an important key to correctly fit an individual to their device. These factors will ensure optimal positioning to allow the greatest mobility and comfort.