Adaptive Devices

Comfort and independence are two of the most important reasons for ensuring the appropriate "fitting" for patients using assistive devices. If the assistive devices are not appropriately fitted they can cause pain or discomfort and may do more harm than good. The goal of using assistive devices would be to enhance independence in ADL's. The appropriate fit is necessary to accomplish this goal. 

Here are a few examples of how adaptive devices should be fitted for patients to achieve optimal success in ADL's:

To fit a patient with a cane the handle should be in line with the wrist crease, ulnar styloid or greater trochanter. Adjustments can be made by releasing the locking mechanism and pushing the button to move the cane to the correct height. The correct height will correspond to 20-30 degrees of elbow flexion. 

For axillary crutches the length should be approximately the same length as the distance from the patients forearm to the finger-tips of the opposite hand. The arm pad should be about 1 to 1.5 inches under the axilla. The handgrips should be in line with the wrist crease, ulnar styloid or greater trochanter when the hands are resting at the side. 

For Loftstrand crutches the arm band should be positioned 2/3 of the way up the forearm. The handgrip should align with the wrist crease in order allow slight elbow flexion when the handgrip is grasped. 

The platform walker should be positioned to allow weight-bearing through the forearm when the elbow is bent to 90 degrees and the patient is standing tall with the shoulders relaxed. The handle of the platform should be positioned slightly medially to allow for a comfortable grip when the forearm is resting on the platform.

For the rolling walker we will estimate the appropriate height of the walker based on the patient's height. The handgrips should be in line with the wrist crease, ulnar styloid or greater trochanter when hands are resting at the side. The elbows should be slightly flexed at approximately 20-30 degrees.