Locomotion and Adaptive Devices
As future occupational therapist, we will more be fitting our clients for adaptive equipment day in and day out. This "fitting" is just as important as the therapeutic exercise and activities of daily living we will have the clients do. Find the right device and make sure it fits the client is important for functional purposes as well as security and stability. If the device is hard to use or doesn't "feel" right, the client will more than likely not use the device. This could lead to falls or readmission to the hospital. As we pick a device, we should consider their homes, driveways, surface changes in the home, if they grocery shop on their own, and even if they drive.
To fit a cane, first The person should be standing up straight with arms at their side. The cane should also be placed on the opposite side of the "weak" or affected side. The client's elbow should be relaxed and flexed 20-30 degrees with the shoulders relaxed as well. We should adjust the height of the cane so that the handle of the adaptive device is at the wrist height (palpate for ulnar styloid or greater trochanter if we are not exactly sure).
To fit axillary crutches, first the client should be standing straight up, with relaxed shoulders and elbows and hands by their sides. We should adjust the the legs so that the hand grips are in line with the wrist crease, ulnar styloid, or greater trochanter. The axillary rest should be about 5 cm below the floor of the client's axillary region with their shoulders relaxed. If these rests are too high or too low they will cause immense pain and discomfort. Also, they will give the client distorted posture.
To fit Lofstrand crutches, we use them same technique as fitting a client for a cane, with the addition of ensuring that the cuff on the arm is positioned 2/3 of the way up on the forearm.
To fit a platform walker, the client must have issues with weight-bearing through hands and wrists. The clients forearms and hands must be in a neutral position and supported by a platform. We would fit the client just like how we fit with the cane. We would also make sure the proper height of the platform is attached. The client's forearms must be flexed 90 degrees for this.
To fit a rolling walker, we would use the same technique for fitting a client with a cane. We would need to make sure the client has enough balance and stability to not topple over and to keep the walker under control.
To fit a cane, first The person should be standing up straight with arms at their side. The cane should also be placed on the opposite side of the "weak" or affected side. The client's elbow should be relaxed and flexed 20-30 degrees with the shoulders relaxed as well. We should adjust the height of the cane so that the handle of the adaptive device is at the wrist height (palpate for ulnar styloid or greater trochanter if we are not exactly sure).
To fit axillary crutches, first the client should be standing straight up, with relaxed shoulders and elbows and hands by their sides. We should adjust the the legs so that the hand grips are in line with the wrist crease, ulnar styloid, or greater trochanter. The axillary rest should be about 5 cm below the floor of the client's axillary region with their shoulders relaxed. If these rests are too high or too low they will cause immense pain and discomfort. Also, they will give the client distorted posture.
To fit Lofstrand crutches, we use them same technique as fitting a client for a cane, with the addition of ensuring that the cuff on the arm is positioned 2/3 of the way up on the forearm.
To fit a platform walker, the client must have issues with weight-bearing through hands and wrists. The clients forearms and hands must be in a neutral position and supported by a platform. We would fit the client just like how we fit with the cane. We would also make sure the proper height of the platform is attached. The client's forearms must be flexed 90 degrees for this.
To fit a rolling walker, we would use the same technique for fitting a client with a cane. We would need to make sure the client has enough balance and stability to not topple over and to keep the walker under control.
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