The cane is the most widely used assistive device, and in the United States alone, more than 4 million people use them. Canes support up to 25% of a person’s weight and may prevent falls. The two types of canes available are single-point canes and quad canes. A single-point cane provides minimal support during ambulation and is appropriate for people who have slightly decreased balance, poor endurance, poor coordination, or muscular weakness.
A quad cane is a cane with four points in contact with the ground. It is available with either a wide or small base. The quad cane is more stable than the single-point cane. People with significant muscle weakness in both the arm and leg on one side of the body, which often happens following a stroke or brain injury, may benefit from the use of a quad cane.
The different materials used in the shaft of the cane can change its weight and feel. Traditional wood is relatively heavy while aluminum is much lighter. We are also seeing newer, lightweight materials like carbon fiber.
Underarm Crutches, also known as Axillary Crutches, are by far the most commonly used type. The majority of temporary crutch users should use this style crutch. They require a minimum of training and substantially less upper extremity strength than other types of crutches and are generally less expensive. Crutches are most likely to be the appropriate walking aid when a person must not bear any weight on one leg, as would be the case with a broken leg, ankle, or foot.
Fitting Underarm Crutches
Proper fitting of underarm crutches requires two adjustments.
- Overall height (from rubber tip to underarm pad).
- The distance from the hand grip to the underarm support.
Adjust the Overall Height of the crutch first, With the user standing erect, looking straight ahead with shoulders squared, place the crutch tip 6 to 8 inches forward of the toes and the same distance out to the side. Then adjust the crutch height to bring the underarm pad up to a position approximately one inch below the front of the underarm. The height adjustment should not have the crutch pressed too tightly under the arm in order to avoid unnecessary pressure and irritation. However, it should not be so short as to cause the user to have to stoop in order to obtain support.
With the overall height adjusted properly, then adjust the handgrip position to provide approximately a 20 to 30 degree bend in the elbow. This can usually be achieved by again having the user stand straight as described above with eyes straight ahead, shoulders squared and arms hanging relaxed at the sides. Then place the crutch vertically beside the user and adjust the handgrip to a position slightly above the wrist. This adjustment technique will encourage the user to support most of the weight with the hands and arms, not the underarms. This is very important. Prolonged and excessive pressure on the underarm will cause severe soreness and possible numbness and paralysis of the arm.
If you have had the benefit of instruction by your Physician or Therapist follow those instruction carefully. There are several methods of using crutches. These methods are called crutch gaits. The choice of gaits and the gait training is usually performed by your Physician or Therapist.The most frequent need for crutches is to relieve all weight bearing on one leg. For this situation your Doctor or Therapist will probably want you to use the Three-Point Gait. This method might be described as an “Assisted Hop’.