Assistive devices for ambulation (for nursing assistant training)

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.

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. 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.