EVERYTHING YOU NEED TO KNOW ABOUT ASSISTIVE DEVICES By:Vanessa Niemeyer, PT, DPT

CRUTCHES:

  1. How to Properly Fit

    1. The amount of space between the top of your crutch and your armpit should be about 2 finger widths 

    2. When standing upright, the hand grips of your crutches should align with the crease of your wrist 

    3. The bottom of your crutches should be slightly more than shoulder width apart

  2. How to Properly Use 

    1. There should be a slight bend in your elbow as you grip your crutches

    2. Use your arms to accept your weight

    3. Follow your restrictions from your physician 

      1. Such as: non weight bearing (no weight allowed through your involved leg)

      2. Such as: weight bearing as tolerated (you are allowed to put your weight through your involved leg, as long as it is bearable) 

    4. Two crutches must be utilized if you are non - weight bearing and/ or you have weight bearing restrictions

    5. One crutch may be utilized once it is appropriate to progress to a normal gait

      1. This crutch would belong and the opposite side of your injury (i.e - with a right ankle injury, the crutch would be used on your left side) 

  3. Do’s and Don’ts

    1. Do not absorb all of your body weight through your armpits

    2. Do make sure your crutches have a rubber grip

    3. Do not use crutches if you feel faint/ dizzy/ drowsy

    4. Do follow your restrictions 

    5. Do consult a physical therapist (or appropriate health care provider) with questions/ concerns 

    6. Do ensure the crutches are sturdy and safe before each and every step

    7. Safety first 

CANE:  

  1. How to Properly Fit

    1. The cane belongs on the opposite side of your injury (i.e - with left knee pain, put your cane in your right hand)

    2. If you are using the cane due to weakness, put the cane on the opposite side of your weaker leg 

    3. When standing upright, the hand grip of your cane should align with the crease of your wrist

    4. There should be a slight bend in your elbow as you grip your cane

    5. Quad Canes are available - which have 4 tips and increase your base of support 

      1. The same rules apply, with the addition of ensuring the base is appropriately rotated 

  2. How to Properly Use

    1. Use your arm to help take some of the load off of your leg 

    2. Keep the cane slightly in front of you and slightly to your side 

      1. Putting the cane directly in front of you increases your fall risk 

    3. As you step forward with your injured leg, move the cane forward 

    4. As  you step forward with your “healthy” leg, use the cane to help you put weight through your injured leg 

  3. Do’s and Don’ts 

    1. Do make sure you have a rubber grip with tread

    2. Do not switch from a walker to a cane unless you are stable 

      1. A physical therapist can help you determine whether or not this is appropriate

    3. Do use to steady yourself 

    4. Do ensure that your cane is sturdy and safe prior to each and every step 

    5. Do not use a cane if you are non weight bearing, it is not appropriate

    6. Do use the device that is prescribed to you by your physical therapist and/ or physician

    7. Safety first 

WALKER

  1. How to Properly Fit

    1. When standing upright, the hand grips of your walker should align with the creases of your wrists

    2. There should be a slight bend in your elbow as your grip your walker

    3. Be sure to stand upright, and avoid folding forward

  2. How to Properly Use 

    1. Firmly grip your walker utilizing both hand grips

      1. Do not grip the walker in any other location

    2. Remain inside of your walker

      1. The walker should not be in front of you

      2. At all times, including: walking forward, backing up to sit and turning the corner

    3. Make sure all four legs of the walker are firmly on the ground

    4. When standing on your weaker leg, use the walker to help you decrease the amount of weight going through the weaker leg 

  3. Do’s and Don’ts 

    1. Do not walk with your walker out in front of you (remain inside of your walker)

    2. Do not pull up on your walker when you move from a sitting to a standing position

      1. Stand up and then grab your walker

      2. At least one hand should be pushing off from the surface in which you were sitting

    3. Do lock your brakes (if present) before you sit and as you stand 

    4. Unlock the brakes when you are walking

    5. Do ensure that all 4 legs are leveled and firmly on the ground at all times 



WHEELCHAIR

  1. How to Properly Fit

    1. Sit upright and avoid shifting to one side

    2. Your hips, knees, and ankles should all be aligned to 90 degrees

      1. Your knees should not be above or below your hips

      2. The backside of your thigh should not be digging in to the edge of your seat

    3. Hips should be all the way back (touching the back of the chair)

  2. How to Properly Use 

    1. Brakes are to be locked unless you are utilizing your wheelchair to get from point A to point B. 

    2. Brakes should be locked when getting into and out of your wheelchair.  

    3. To go straight - use both arms to pull forward

    4. To turn right, hold the right wheel handle still and pull the left wheel forward 

    5. To turn left, hold the left wheel still, and pull the right wheel forward. 

    6. To go backwards - use both arms and pull backwards

    7. When you are being assisted in your wheelchair, put your feet on the foot rests to avoid injury

  3. Do’s and Don’ts 

    1. Do not get out of your wheelchair without locking your brakes

    2. Do not get into your wheelchair without locking your brakes

    3. Do use your foot rests when someone is assisting you in getting from point A to point B 

    4. Do reposition every 20 minutes to prevent skin breakdown 

    5. Do check to ensure that you are not having any skin breakdown

      1. Bony areas are the most vulnerable 

    6. Do continue to remain active

      1. Perform activities that are safe for you to do

    7. Do remember safety first. 



FINAL THOUGHTS:

Safety is and will always be the number one priority.  Please be safe about the assistive device you are utilizing. If you have any questions/ concerns, please call your physical therapist and/ or appropriate health care provider.  This is in no way a tool to determine which assistive device you should be using.  The purpose of this is to provide you with information about how to fit a device and how to be safe with a device that you may be utilizing.  Physical therapists are qualified to help you find the best device for YOU and your individual needs.  

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