Locomotion and Adaptive Devices

There are several reasons to fit a client correctly to an assistive device. One of these is for comfort and confidence. Being comfortable will allow you to have more faith in yourself in operating your AD correctly without harm. Another reason is to provide a better posture alignment and center of gravity line. For example, if crutches are set too low for the client then he/she will possibly have an increased risk of Kyphosis due to the leaning forward that will be required. Also, with leaning forward, there is a higher chance of your line of gravity getting too far ahead and causing you to have to participate in ambulation or fall.

To fit canes and walkers, hand grip should be at the level of the ulnar styloid, wrist crease, or greater trochanter. Elbow will be relaxed, flexed 20-30 degrees. Shoulders should be relaxed and not elevated. To fit crutches you will do the same, but you will also have the axillary rest should be 5 cm below the axillary floor while the shoulders are relaxed. In addition, the arm cuff on a Loftsrand crutch should be placed around the proximal forearm. Lastly, a platform walker must be used for someone who has good upper body strength and balance while a rolling walker is used for someone who does not have good upper body strength and cannot lift a walker. It is important to note that someone using a rolling walker must be able to control the walker and have good balance, otherwise it is not safe for them to use.