Locomotion and Adaptive Devices

It is very important to appropriately fit each assistive device that you give a client. It is important that each device be fitted in order to increase the functionality and safety of the device for the user. If something is not properly fitted, the client may struggle to use it or struggle to use it safely. Also, each device should be fitted for the comfort of the client. For example, if a wheelchair is not fitted for the client’s size, there could be issues with joint placement, posture, and uncomfortable rubbing and skin tearing.

 

To fit a cane, you should adjust it so that the hand grip is at the same level as the wrist crease, ulnar styloid, or greater trochanter. This should situate the elbow in about 20-30 degrees flexion and allow the shoulders to remain relaxed.

 

To fit axillary crutches, you should adjust the hand grip to be at the same level as the wrist crease, ulnar styloid, or greater trochanter. The axillary rest should be about 1-1.5 inches below the axilla and allow the shoulders to remain relaxed. The handgrips should be in line with the wrist crease, ulnar styloid, or greater trochanter when hands are resting at the side.

 

To fit Lofstrand crutches, the arm band should be positioned 2/3 of the way up the forearm. The length of the crutches should be about the distance from the client’s forearm to the opposite hand’s fingertips.

 

To fit a platform walker, you should position the platform surface to allow weightbearing through the forearm. The elbow should be flexed to 90 degrees and allow the client to relax their scapula. It is important to allow 1-2 inches of the proximal elbow to rest off of the platform in order to prevent nerve compression

 

To fit a rolling walker, you should use the client’s height to estimate the necessary height of the walker. The walker should be at a height that allows the client to stand with their warms relaxed. The handgrips of the walker should also be in line with the wrist crease, ulnar styloid, and greater trochanter when the hands are resting. In use, the client’s elbows should be flexed to about 20-30 degrees.