Assistive devices for ambulation

Definitions & Key takeaways

Assistive devices for ambulation are used to improve the mobility of people with physical disabilities. There are many different types of devices, but they all have one goal in common: to help people walk independently.

Some common devices include canes, crutches, and walkers. Each type of device has its own set of benefits and drawbacks, so it's important to consult with a healthcare professional to see which type is right for you.

In general, assistive devices can help improve mobility by providing support, stability, and balance. They can also help reduce fatigue and joint pain, which can make it easier for people to walk longer distances.

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Intro0:00–0:36

Assistive devices for ambulation, or just ambulation devices, are tools used to aid in walking. The most common types include walkers, canes, and crutches.
You need to know when each of these are appropriate and assess if the patient is using them correctly. Remember that a patient’s ambulation device is ordered to fit them specifically, kind of like glasses, so they should not be shared with other patients.

Walkers0:36–1:49

Let’s start by looking at walkers. These are movable, lightweight devices that consist of a metal frame, 2 hand grips, and 4 legs.
Walkers provide great stability due to their wide base, so they are great for people who can bear weight on their feet but have trouble walking due to weakness of the legs or balance issues.
When assessing the proper fit of a patient’s walker, make sure that the hand grips are at the patient’s waist level. Check the legs because they should have non-slip tips like a rubber cover.
To use a walker, the patient should stand straight while holding the hand grips. When moving forward, they lift it up and move it another 6-10 inches in front of them and set it down.
Because many patients have difficulty lifting a walker, many models now have wheels on the front legs. However, these are prone to rolling forward, so brakes are usually built in.
So, when the patient is going to stand for a while, make sure the brakes are locked. Using the walker as support, they should move one leg forward and then the other.
Once balance is reestablished, repeat the process. Next up, we have canes.

Canes1:49–3:02

These are also movable, lightweight devices made of a strong material like wood or metal. Canes consist of a handle, a shaft, and legs.
There are single leg, triple leg or quad leg canes, and the ones with multiple legs provide more stability but are also more cumbersome.
Canes are used by patients who could bear weight but have weakness in one of their legs, like a stroke patient or those with paralysis in one leg.
Crutches and walkers are better for people with two weak legs. A properly fitted cane should have the handle at the patient’s hip level.
The tips should also be non-slip. When using a cane, hold it on the strong side, or the side without weakness.
The cane tip should rest flat on the ground at the start and then lifted and moved forward 6-10 inches before being placed flatly on the ground again.
Step forward with the weaker leg first, using the cane for support. After balance is established, move the stronger leg forward.
The most vulnerable point is when only the weak leg and the cane are on the ground. Crutches are the last kind of common ambulation device.

Crutches3:02–5:19

They are either single or paired and are used by people who cannot bear weight on one or both legs. There are two common types of crutches: underarm, or axillary, and forearm crutches.
Axillary crutches stretch from the armpits, or axilla, to the ground. They provide better balance but require more upper body strength to use.
They are often used temporarily, like when someone is recovering from leg injuries.Forearm crutches are shorter, reaching from the elbow level to the ground.
They have a hand grip and a cuff for the arm. The cuff lets the crutch stay attached to the arm when the person needs to use their hands for other tasks.
This is one of the reasons that this type is preferred for people with permanent leg weakness. For proper fit, axillary crutches should leave 2-3 finger widths between the top of the crutch and the arm pit.
This prevents compressing the nerves found in the axilla. The person should be able to reach the handle with their elbows slightly flexed.
Forearm crutches are often adjustable. With the arms relaxed and slightly flexed, the hand grip should be at the level of the hand, and the cuff should be at the level of the elbow.
Check the bolts on the crutches to make sure they’re tight, that the non-slip tip is intact, and that there are no cracks or other deficits.
The proper usage of crutches should be taught to the patient by a nurse or a physical therapist, but here are some general considerations.
Crutches should be squeezed between the arms and chest. They should be about shoulder-width apart when they reach the ground.
There are four different types of gait. In a 4 point gait, the left crutch moves forward, followed by the right leg.
Then the right crutch moves forward, followed by the left leg. In a 3 point gait, both crutches move forwards, followed by the strong leg and then the weak leg.
In the 2 point gait, the left foot and right crutch moves forward together, followed by the right foot and left crutch. Finally, for the swing-to gait, both crutches move forwards, then using them as support, both legs are lifted and swing to the crutches position.All right, as a quick recap… Ambulation devices are used by people who have trouble walking.

Recap5:19–5:56

If they can bear weight on their legs, a walker or cane is ideal. Walkers offer more stability but are more cumbersome, so they are used by people with balance problems.
Canes offer less stability but are smaller and easier to carry. They are used by people with weakness in one of their legs.
If weight bearing is an issue, like with someone recovering from bone fractures in the foot, crutches are the best option.
Whichever ambulation device is used, make sure it’s a proper fit for the person and