CRUTCH WALKING

DEFINITION PURPOSES

Crutches are artificial supports and assists To assist client who cannot bear any weight
patients who need aid in walking because of on one leg.
disease, injury, or a birth defect.
To assist client who have full weight bearing
on both legs.
Prevent injury to client who has difficulty in
ambulation
PRINCIPLES EQUIPMENT

Assess client’s physical limitations to Gait belt

determine safety and comfort.
Tape measure
Take time to show patients how to walk with
crutches for them to learn Crutches

Maintain proper body mechanics. Sturdy footwear, properly fitted

 Crutch Walking
 Inform the client you will be teaching crutch ambulation.
Rationale: Reduces anxiety. Helps increase comprehension and cooperation, promotes client independence.
Assess the client for strength, mobility, ROM, visual acuity, perceptual difficulties and balance. Note: nurse and therapist often
collaborate on this assessment.
Rationale: Helps determine the clients capabilities and amount of assistance required.
Adjust crutches to fit the client. With the client supine, measure from the heel to the axilla. With the client standing, set the crutch
position at a 4-5 inches lateral to the client and 4-6 inches in front of the client. The crutch pad should fit 1.5 – inches below the axilla (3
finger width). The hand grip should be adjusted to allow for the client to have elbows bent at 30 degree flexion.
Rationale: Provide broad base of support for the client. Space between the crutch pad and axilla prevents pressure on radial nerves. The
elbow flexion allows for space between the crutch pad and axilla.
Lower the height of the bed.
Rationale: Allows the client to sit with feet on the floor for stability.
Have the client dangle legs. Assess for vertigo.
Rationale: Allows for stabilization of blood pressure, thus preventing orthostatic hypotension.
Instruct the client to position crutches lateral to and forward to feet. Demonstrate correct
positioning.
Rationale: Increases client comprehension and cooperation.
Apply the gait belt around the client’s waist if needed.
Rationale: Provides support, promotes client safety.
Assist the client to a standing position with crutches.
Rationale: Standing for a few minutes will assist in preventing orthostatic hypotension.
  FOUR-POINT GAIT  THREE-POINT GAIT

Position crutches to the side and in front of each foot. Advance both crutches and the weaker leg
Move the right crutch forward 4 to 6 inches. forward together.
Move the left foot forward, even with the left crutch.  Move the stronger leg forward, even with
Move the left crutch forward 4 to 6 inches. crutches.
Move the right foot forward, even with the left crutch. Repeat three-point gait.
 Repeat the four-point gait.

Rationale: The four point gait provides greater stability. Rationale: The three point gait provides a
Weight bearing is on three points at all times. The client strong base of support. This gait can be used if
must be able to bear weight with both legs. the client has a weak or non-weight-bearing leg
  WALKING UP STAIRS
 TWO-POINT GAIT

Move left crutch and right leg forward 4 – 6
inches.
Move right crutch and left leg forward 4 – 6
inches.
Repeat two-point gait.
Rationale: The two pint gait provides a strong
base of support. The client must be able to
bear on both legs. This gait is faster than four-
point gait
Instruct the client to position the crutches as
if walking.
Place the strong leg on the first step.
Pull weak leg up and move the crutches up to
the first step.
Repeat for all steps
Rationale: Prevents weight bearing on the
weaker leg.
Walking down stairs
Position the crutches as if walking.
Place weight on the strong leg.
Move crutches down the next lower step.
Place partial weight on hands and crutches.
Move the weak leg down to the step with crutches.
Put the total weight on arms and crutches.
Move strong leg same step as weak leg and crutches.
Repeat for all steps.

Rationale: Prevents weight bearing on weaker leg

Set realistic goals.
Rationale: Crutch walking takes up to 10 times the energy required for unassisted ambulation.
Consult with a physical therapist.
Rationale: The physical therapist is the expert on the health care team for crutch-walking
techniques.
Wash hands.
Rationale: Reduces the transmission of microorganisms.
THANK YOU 