Ambulation Aids

Question 1

4 reasons to use an ambulation aid

Answer 1

1. Pain
2. Impaired balance, strength, ROM
3. Reduced weight bearing
4. Limb loss

Question 2

3 Goals of using ambulation aids

Answer 2

1. Protection (allow healing)
2. Prevention (negative adaptive patterns)
3. Improvement of mobility (functional and safe)

Question 3

3 categories of ambulation aids

Answer 3

Walkers, crutches, canes and poles

Question 4

Walkers Pros and Cons

Answer 4

Pros: Maximum stability and balance, lightweight and easily adjustable, can relieve weight bearing
Cons: unsafe for stairs, bulky, prevent natural gate pattern (no arm)

Question 5

Measuring ambulation aids

Answer 5

Walkers - rear supports at heels, wrist to handle or 20/30 deg flex.
Cane - Directly at side, wrist crease at handle or 20-30 deg flex.
Crutches - held slightly to the side and in front of feet, axillary pad a few inches below axilla and handle at wrist crease or in 20-30 deg flexion. forearm brace below elbow 1.5 inches.

Question 6

Walker variations comparison

Answer 6

standard, 2 wheel, and 4 wheel most common. Progressively exchange stability for more mobility and natural gate patterns (lifting the standard vs pushing wheeled). 4 Wheeler has resting seat.

Question 7

Crutches pros/cons

Answer 7

Pros: Relieve weight bearing, usable on stairs, functional ambulation, improved stability via BOS
Cons: Requires upper body strength, coordination, and less supportive than a walker.

Question 8

Axillary vs forearm crutches

Answer 8

Forearm crutches allow the use of hands and are more functional on stairs and more portable, but require more arm strength, less lateral support, and cosmetically look rehaby.

Question 9

Canes pros/cons

Answer 9

Pros: Widen BOS and improve stability, simple/small, cool look.
Cons: Not weight bearing, least stable aid.

Question 10

Types of canes (notes)

Answer 10

Standard (support ant to hand = instability), ortho (support under hand = stable), 4 point (wider BOS, difficult on stairs, unsteady if pressure not even)

Question 11

Walking poles (2 types and notes)

Answer 11

Nordic - fitness focused, support upright posture and relieve joint pressure.
Activator - Clinical use during rehab. Held with arm at 90 deg flexion.

Question 12

Weight bearing options

Answer 12

FWB - full
WBAT - without undue discomfort (50-100%)
PWB - prescribed amount (usually up to 50)
FeWB/TTWB - toe touch no weight
NWB - no weight

Question 13

4 steps to instructing on ambulation aids

Answer 13

1. Explain task and determine weight bearing status.
2. Demonstrate ambulation
3. Observe client ambulating
4. Provide feedback