Locomotion and Assistive Devices

It is very important to properly fit assistive devices for an individual. The assistive device could actually end up doing more harm to a person if they are inappropriately fitted. By providing the correct fit for an assistive device a person will have greater stability and should feel more confident in their ability to safely ambulate in their daily living. When fitting a client for an assistive device you always must ensure that it takes place in a safe environment. Fitting an assistive device such as a cane, you want the hand grip to be at the level of the wrist crease, ulnar styloid or greater trochanter. This should be done measured while the client is standing with their shoulders relaxed and elbows relaxed and flexed to about 20-30 degrees. This method should also occur when fitting a rolling walker for a client. A platform walker requires the same fitting but for the addition of the platform(s), you will want to make sure that the platform is adjusted for the client's forearm and hand are in neutral position and also are supported. To fit axillary crutches for a client you will again have the hand grip at the ulnar styloid, have the client's shoulders relaxed and the elbows relaxed and flexed to about 20-30 degrees but now you will also check to make sure that the axillary rest is about 5 cm below the floor of the axilla. When fitting Loftstrand crutches for a client, the same method will be used as fitting for a cane and walker. The armcuff of the Loftstrand crutch will wrap around the proximal forearm, and this will provide more support than a cane but less than that of axillary crutches. These steps for appropriately fitting assistive devices are essential when working with clients to ensure that they can safely return to functional and meaningful activities.