Keep you moving! Mobility Aids| Disabled Living | Walking Equipment

MOBILITY AIDS

A mobility aid is a device designed to assist walking or otherwise improve the mobility of people with a mobility impairment. These devices are mostly prescribed for the below mentioned cases:

• Pain
• Muscle weakness
• Problem in balancing
• Fractures
• Joint Diseases
• Injured or inflamed limb
• Lack of proprioception 

There are a numbers of aids available to assist people who have difficulty in walking or who cannot walk independently without one.These external aids are

• Crutches 
• Canes
• Walkers
• Wheelchairs
• Braces and splints.(orthosis)
• Prothosis

CRUTCHES

There are three basic types of crutches and they are used to reduce weight-bearing on one or both legs ,or to give additional support where balance is impaired and strength is inadequate.

• Axillary crutch
• Elbow crutch
• Gutter Crutch

1. Axillary Crutches

They are made up of wood with an axillary pad, a hand piece and a rubber ferrule. The position of the hand piece and the total length are usually adjustable.

The axillary pad should rest against the chest wall approximately 5 cm.

Axillary Crutch Measurement

 Before giving the crutch to the patient, it should be measured perfectly because lengtheir crutch may cause the compression over the axilla,which leads to neuropraxia .Sometimes if it is small,the patient's gait pattern may change or it may cause some other complication like back ache.

 Measurement

1. Shoes off

• Lying
• Standing                

      2. Shoes On

• Lying
• Standing

Shoes Off

Supine lying : while patient is in bare foot this type of measurement has to be taken the measurement from the apex of the axilla to the medial malleolus. It is the accurate method to measure the crutch length.

Standing: 2 inches below the axilla to the 2 inches lateral and the 6 inches anterior to the foot when the patients is standing.

Shoes On

Supine lying:This type of measurement taken to the patient wearing the shoes . The measurement taken from the 5 cm below the apex axilla to the 20 cm lateral to the heel of the shoes .It is not accurate method of measuring the crutch length.

Standing Same like the shoes off method measurement has to be taken in the standing position.

 Hand grip Measurement

The measurement taken from the 5 cm below the apex of the axilla to the ulnar styloid process in the elbow in 20° - 30° flexed position.

Weigh Transmission

Elbow is extended and the weight is transmitted to the hand piece.So that the pressure over the axilla is reduced.

 2. Elbow Crutch

   It gives less stability than the axillary crutch. It renders 60 percent of stability to the patient using it .So, elbow  crutches recommended for the patient having the minimal in stability in walking. It is made up of aluminium or plastic sometime stainless steel metals.

  Weight Transmission

Same like axillary crutches the weight is transmitted to the hand piece when the elbow is extended.

 

Elbow Crutch Measurement

The Measurement taken from the unstyloid process with the elbow in 20°- 30° flexion to the 20 cm lateral to the heel or the heel of the shoes.

   3.  Gutter Crutch

This also made up of metals and it contains the forearm pad with supporting strap, adjustable hand piece and rubber ferrule. These types of crutches are mainly used for the rheumatoid hand and those who cannot weight bear through the wrist and hand for example, fracture wrist or dislocation, The length of the crutch and hand piece position can be adjustable.

Measurement

In Standing: The measurement is taken from the elbow to the floor.

In lying: The measurement taken from the point of the flexed elbow to 20 cm lateral to the heel (shoes on) .

CANES

Canes are not normally recommended for the non-weight-bearing cases.It is useful for increasing the base of support and to improve the balance . Canes are preferred to provide opposite to the affected side. During the normal gait, the stance hip abductors counterbalances the swinging hip and prevent it from tilting . It may create the compressive force in the stance hip. Providing the canes in the stance side upper limb reduces this force and straining in the stance side hip.

 Types  Of Canes

1. Standard Canes
2. Standard Adjustable Canes 
3. Standard Adjustable Offset Canes
4. Tripod Canes 
5. Quadruped Canes 

Standard Canes

• It is also made up of aluminium and may be having the plastic covering .
• It has the curved or half-circled hand piece.
• It is having the height adjustable press clips.
• This is also easy to carry anywhere else.

Adjustable Aluminium Offset Canes

• Upper half of the cane is offset anteriorly  so that the LOG falls on the cane and it gives more stability . It may be available in the standard and standard adjustable canes. 
• It tool has the adjustable  screws or press clips.

Commonly all the sticks are having the hand piece and the rubber ferrule except the wooden made standard canes. The hand piece comes up to the greater trochanter level for the person using it.

Quadruped And Tripod Canes

• It has the 3 or 4 leg with the rubber tip and it gives the broader base. As the result the base of support in this varieties of canes are huge
• sometimes the upper portion of the cane is offset anteriorly.
• It gives more stability than any other varieties .
• This is more useful for neurological cases like hemiplegia and other elderly patients who had the injury of the lower limb.
• Height adjustable clips or screws are available.
• It is difficult to carry the cane in the staircase if the base is broader.

  

  
  

  

WALKERS AND WALKING FRAMES

It may be useful for the non-weight-bearing, partial weight-bearing, and the full weight-bearing gait pattern. It gives more stability as it has the broader base. Since the centre of gravity falls with in the base of support, it gives anterior as well as lateral stability. The walker is having two anterior and two lateral bars,the horizontal bar connects all the vertical bars in three sides, and one side is kept opened.

Normally the therapist and the doctor avoid prescribing walker to the patients because if the patients practice with the frame  never walk proper gait pattern , while progressed to the cane, crutches,sticks.It takes more time to adopt other walking aid by the patient.

1. Rigid walking frame
2. Foldable walker 
3. Gutter walker 
4. Rollator 
5. Reciprocal walker

Rigid Walker

 This is the standard type with above said features it has the handgrip and rubber ferrule.

The patient has no lift and place it front and walk. It is difficult to carry easily in and out of the house.

Foldable Walker

It has all features of rigid walker except the folding nature . It is easily foldable and kept in a store place . It is also easy to carry while taveling.

Gutter Walker

It is also having the entire feature like rigid walker and additionally it has the forearm platform instead of the handgrip. It is more helpful for the patient who has the problem over the wrist (RA, wrist bone fracture, wrist or hand injuries).

Reciprocal Walker

This is designed to allow unilateral forward movement of one side of the walker. These movement of one side of the walker . These types of walkers are useful for the patients who cannot lift and walk with the walker . There will be  swivel joints present between the vertical and horizontal bars . One side of the walker moved forward with the opposite side leg followed by it , and the other side of walker with the another leg. So alternatively , each side of the walker moves forward.

WHEEL CHAIR

This is one of the variety of the mobility aids. The patient who has both lower limbs non-functioning or partial functioning has to be recommended  for the wheel chair. It is the secondary house for the patient, because  he has to spend most of the time with it. It may be modified depends on the condition of the patient. It gives 100 percent stability to patient. Normally , wheelchairs are recommended for paraplegic, quadriplegic, muscular dystrophy, spinal cord injuries, and fracture conditions .It provides physical as well as mental support to the patient.

Types Of Wheel Chairs

1. Rigid 
2. Foldable
3. One Arm Driven Wheel Chair
4. Powered Wheel Chair

RIGID

The rigid  wheel chairs are having the  the solid frame and also it is lighter. It is mainly used for the sports It is difficult to carry while traveling.

FOLDABLE

 Foldable wheel chair contains foldable frames and it is very  much heavier. It occupies less space , so it is very much easy to carry while traveling also.

ONE ARM DRIVEN WHEEL CHAIR

One arm driven wheel chair  are used for the patient those who are not able to use their one side upper limb mainly in hemiplegia. This wheel chair is activated and steered by one upper limb. 

POWERED WHEEL CHAIR

 Powered wheel chair  are the sophisticated one and are more used in the developed countries like the united states, United kingdom, European countries .It can be steered, propelled, adjust the seat hand rest ,back rest by the power control.

INDICATIONS:

1. Quadriplegia 
2. Paraplegia
3. Hemiplegia
4. Spinal Cord injury 
5. Muscular dystrophy
6. Amputation
7. Lower limb fractures.

Measurements:

Seat width(A) : 1 or 2 inches added with the width of the widest part of the buttocks.

Seat  height (B) : Two inches added with the distance between the bottoms of the heel to the popliteal area.

Seat depth (C) : Two inches added with the measurement taken from the popliteal area to the level of the buttocks.

Backrest Height (D) : Two inches less than the distance between the inferior angle of scapula and the inferior part of the buttocks .

Arm rest Height (E) : Elbow kept in 90° flexion and the measurement taken from the buttocks level to the elbow level.