Locomotion and Adaptive Devices
As an occupational therapist, you will come across clients who need to be fit with an assistive device. It is our job to make the client as comfortable as possible during and after the fitting as they will be using the device for an extended period of time. It is important to fit each client appropriately so that we may increase their safety when using the device and increase their confidence and comfort to perform everyday movements. If the client is not fit properly, this can cause misuse of the device and increase fall risk and injury to the client. In regards to comfort, the client will most likely be using this device every day. If they are not comfortable using this device, then it may decrease their confidence level in being able to perform certain activities and increase the risk of injury.
Canes are the least stable device you can give a client, but allow for the most freedom and are very inexpensive. To fit a client, the hand grip should be at the level of the wrist crease with the elbow relaxed and flexed to 20-30 degrees. The shoulders should also be relaxed and not tensed up or elevated.
To fit axillary crutches to a client, you will follow the same steps listed above in addition to one other step. The clients axillary floor (armpit) should be at least 5cm above the the axillary rest of the crutches with the shoulders relaxed. If this measurement is higher or lower than 5cm there can be increased pain for the client and an increase chance of poor posture while using the crutches.
Loftstrand crutches are for individuals with long-term disabilities and provide more support/stability than a cane but less than axillary crutches. These crutches come with a cuff that wraps around the forearm. To fit these to a client you can follow the same steps as to fit a cane, but we must also ensure that the forearm cuff is wrapped around the forearm approximately 2/3 of the way up.
Walkers are the most stable option for clients but they come with decreased agility and can potentially cause a negative shift in the clients normal gait pattern. Platform walkers are used for clients who cannot bear weight through their wrist or hand. To fit a client for a platform walker you can follow the same steps above for the cane. However, we must also ensure that the clients forearms are in a 90 degree flexed position with the shoulders relaxed so that we can adjust the platform to allow for maximum comfort in the clients forearms. A rolling walker is used for clients who are unable to lift a walker due to UE weakness. To fit a client for a rolling walker you can use the same steps as the cane but you have to also make sure the seat is adjusted high enough for the client. This ensures that they do not have to bend down as much to sit in the chair and which can potentially cause an injury.
Canes are the least stable device you can give a client, but allow for the most freedom and are very inexpensive. To fit a client, the hand grip should be at the level of the wrist crease with the elbow relaxed and flexed to 20-30 degrees. The shoulders should also be relaxed and not tensed up or elevated.
To fit axillary crutches to a client, you will follow the same steps listed above in addition to one other step. The clients axillary floor (armpit) should be at least 5cm above the the axillary rest of the crutches with the shoulders relaxed. If this measurement is higher or lower than 5cm there can be increased pain for the client and an increase chance of poor posture while using the crutches.
Loftstrand crutches are for individuals with long-term disabilities and provide more support/stability than a cane but less than axillary crutches. These crutches come with a cuff that wraps around the forearm. To fit these to a client you can follow the same steps as to fit a cane, but we must also ensure that the forearm cuff is wrapped around the forearm approximately 2/3 of the way up.
Walkers are the most stable option for clients but they come with decreased agility and can potentially cause a negative shift in the clients normal gait pattern. Platform walkers are used for clients who cannot bear weight through their wrist or hand. To fit a client for a platform walker you can follow the same steps above for the cane. However, we must also ensure that the clients forearms are in a 90 degree flexed position with the shoulders relaxed so that we can adjust the platform to allow for maximum comfort in the clients forearms. A rolling walker is used for clients who are unable to lift a walker due to UE weakness. To fit a client for a rolling walker you can use the same steps as the cane but you have to also make sure the seat is adjusted high enough for the client. This ensures that they do not have to bend down as much to sit in the chair and which can potentially cause an injury.
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