Walking Aids and Wheelchairs

Question 1

Why do we issue walking aids?

Answer 1

• increase mobility of patients whilst making it safe

- decrease weightbearing on lower limb

Question 2

what do we need to consider when issuing walking aids to patients?

Answer 2

1. safety of patients (most important)
2. are patients able to balance?
3. weight of patients
4. patient’s understanding of walking aid
5. strength of patients
6. domestic living arrangements
7. societal participation
8. other comorbidities that patients have
9. patient’s own preference
10. condition of the walking aid
11. which is more important? Mobility or stability?

Question 3

what do we need to teach patients when we issue them walking aids?

Answer 3

• how to use the walking aid safely and properly
• known hazards of using walking aids
• how to get up/down stairs
• how to go from sitting to standing

Question 4

Benefits and Disadvantages of walking sticks

Answer 4

benefits:
- offers great level of stability
- can be carried around everywhere easily
- cheap (low cost)
- when using 2, it offers relatively high level of stability

disadvantages:
- using 1 offers low level of stability
- only can be used for patients who can bear weight fully
- patients own supplied walking stick - often at wrong height

Question 5

Benefits and disadvantages of using elbow crutches

Answer 5

benefits:
- can be supplied to patients who range from NWB to FWB
- provides good stability and mobility to younger patients
- easily transportable
- can move into tight spaces/up and down stairs
- allows patients to have good societal participation

disadvantages:
- limited to patients who weigh less than 25 stone
- need to have good upper limb strength
- good coordination needed

Question 6

benefits and disadvantages of using axillary frames

Answer 6

benefits;

• gives great stability and mobility
• very strong so can be used by patients who are overweight
• easier to use for NWB

disadvantages:
- if not used properly, patients may experience axillary nerve injuries
- less transportable
- possible, but more difficult to go up and down stairs

Question 7

benefits and disadvantages of using zimmer frames

Answer 7

benefits:
- more stable
- provides more support for PWB or NWB patients (esp in older and less able patients)
disadvantages:
- decreases societal participation in younger patients
- can only be used on flat grounds
- cannot be used in narrow passageways/doors
- cannot be used on stairs

Question 8

Who would need a wheelchair?

Answer 8

• people with permanant bilateral loss of lower limb function
• patients with temporary bilateral NWB of lower limb
• patients with cardio-respiratory illnesses
• patients who are balanced disturbed
• patients who need to increase mobility to increase societal participation
• older patients who are easily fatigued

Question 9

what are the things to consider when issuing a wheelchair?

Answer 9

• width of patients hips, length of patients legs (ideal - 90 deg for hip and knee flexion, and ankle dorsiflexion)
• upper limb strength of patients (for self-propulsion)
• will they need extra support?
• intended use of wheelchair + type of wheelchair?
• folding/fixed wheelchair?
• domestic environment - accessibility?
• type of car they have
• etc

Question 10

what do we need to teach patients when using wheelchairs?

Answer 10

- how to do transfers? 
 = on/off toilets
 = on/off chairs and beds 
- maintenance of wheelchair 
- safety aspects of wheelchair 
- take apart and put back wheelchair 
- negotiating steps on stairs