“Prescription and Use of

Assistive Devices”
Presented by:
Hernan Cortez Labao 1, 2, PTRP, MSPT (Neuro), CPE
1 Lecturer, Department of Physiotherapy, Faculty of Health and Life Sciences, INTI
International University, Persiaran Perdana BBN, Putra Nilai, Nilai, Negeri Sembilan,
Malaysia
2 Adjunct Professor, College of Physical Therapy, Our Lady of Fatima University, Valenzuela
City, Philippines
 Labao, H., 2019©

QUESTION:
Which among these three is an
assistive device?

B
C
 Labao, H., 2019©

DEFINITION

Any device designed, made or ASSISTIVE

adapted to assist in performing DEVICE
a particular task

An equipment that assists or AMBULATION

aides mobility (i.e. WALKING)
of a person with injury or
DEVICE
illness
 Labao, H., 2019©

ANSWER:
ALL are ASSISTIVE DEVICES, but C
is an AMBULATION DEVICE

B
C
 Labao, H., 2019©

MAJOR INDICATIONS
STRUCTURAL INADEQUATE
DEFORMITY, INJURY OR BALANCE
DISEASE

MUSCLE WEAKNESS
OR PARALYSIS
 Labao, H., 2019©

ULTIMATE GOAL

For patient to
achieve the
HIGHEST level of
functional
INDEPENDENCE
 Labao, H., 2019©

FUNCTIONS OF AMBULATION AIDS

Reduces weight
bearing

Widen base of Improve balance

support and and provide
increases stability support
 Labao, H., 2019©

TYPES OF AMBULATION AIDS

MOST STABLE

Walker

Axillary Crutches
What shall I use
Forearm Crutches

Quad Cane

Standard Cane
LEAST STABLE
 Labao, H., 2019©

CANE
INDICATIONS

Hip, knee and ankle

pain

Poor balance
Paralysis of half side of
the body Note: Not intended for use with
restricted weight bearing status
 Labao, H., 2019©

CANE

Standard Cane Quad Cane

• Single point cane of • 4 points of contact
contact hence more stable
• Can transmit 20- • Not practical for
25% of person’s use in stairs
body weight
 Labao, H., 2019©

HOW TO FIT A CANE?

Elbow
should be
bent at CORRECT SIZE Too Long
Too Short
20-30
degrees Should be
at the level
of greater
trochanter

Should be
5-6 inches
from side
of foot
 Labao, H., 2019©

HOW TO USE A CANE?

Hold the cane
using hand
OPPOSITE to
the side
affected Advance the cane TOGETHER
with the affected leg

Hold the cane

CLOSE to the
body
 Labao, H., 2019©

HOW TO USE A CANE?

When moving When moving
UP DOWN
Move Move the Move the Move the
the BAD leg BAD leg GOOD
GOOD and and CANE leg after
leg up CANE up down

REMEMBER: UP with the GOOD, DOWN with the BAD

 Labao, H., 2019©

CRUTCHES
Axillary Crutches Non-Axillary Crutches

• Can transfer as much as • Can transfer as much as

80% of body weight 40-50% of body weight
• Better trunk support • Better maneuverability
• Difficult to free the hands • Can free one hand

Forearm Platform
Crutches Crutches
* Provides 2 contacts with
the body, used on both
sides of the body
 Labao, H., 2019©

CRUTCHES
Axillary Crutches Non-Axillary Crutches

Axillary Pad Forearm Crutches Platform Crutches

Forearm Cuff Hand Grip

Hand Grip

Hand Grip Forearm Rest

Double Upright
Single Upright Single Upright

Rubber Tip
Rubber Tip Rubber Tip
 Labao, H., 2019©

CRUTCHES
Forearm Platform
Crutches Crutches
• aka Loftstrand Crutches • aka Troughs
• Has single upright, • Weight is borne at the
forearm cuff and forearm
handgrip • For patients who
• Allows use of hand cannot bear weight at
without the crutches the wrist and cannot
getting disengaged straighten the elbow
 Labao, H., 2019©

HOW TO FIT CRUTCHES?

Axillary Crutches Forearm Crutches
Should be Should be at
2-3 fingers bent 20-30
degrees Elbow bent at
space
90 degrees

Measure the
distance from
tip of elbow to
a point 6
Should be 5-8 inches inches from
from side of foot side of foot
 Labao, H., 2019©

HOW TO USE CRUTCHES?

• Slow gait pattern
4-POINT GAIT PATTERN • Provide maximum stability

Left Crutch Right Foot Right Crutch Left Foot

 Labao, H., 2019©

HOW TO USE CRUTCHES?

• Faster than 4-point gait
2-POINT GAIT PATTERN pattern
• Provide good stability

Right Crutch Left Crutch

& &
Left Foot Right Foot
 Labao, H., 2019©

HOW TO USE CRUTCHES?

• For patients who cannot put
3-POINT GAIT PATTERN weight on one leg
• Faster but less stable

Crutches Good Leg

& Bad Leg
 Labao, H., 2019©

HOW TO USE CRUTCHES?

SWING GAIT PATTERN

Swing-To Pattern: Swing-Through

both legs are Pattern: both legs
advanced at the are advanced
SAME level as the BEYOND the level
crutches of the crutches
 Labao, H., 2019©

HOW TO USE CRUTCHES?

STAIR CLIMBING

2. Move the 3. Move the

crutches and crutches and
BAD leg up BAD leg down

1. Move the 4. Move the GOOD

GOOD leg up REMEMBER: leg down
UP with the GOOD,
DOWN with the BAD
 Labao, H., 2019©

WALKER

• aka Walking Frame

• Relatively stable and easy to use
• Functions:
1. Provide a wider base of support
2. Improve front and side stability
3. Allow arms to transfer body
weight to the floor
 Labao, H., 2019©

WALKER

TYPES OF WALKERS

Standard Walker
Rollator Walker
 Labao, H., 2019©

HOW TO FIT A WALKER?

Elbow bent at
20-30
degrees
Same
measurement
as Cane
Handgrip
should be at the
level of greater
trochanter
 Labao, H., 2019©

HOW TO USE A WALKER?

1. Advance 2. Move the 3. Advance

the walker weak leg the good
forward forward leg forward
 Labao, H., 2019©

SCAN ME TO GET A COPY