The best fit
Assistive devices are carefully fitted to each individual differently. Every individual has their own unique body shape and type and will need their assistive device to fit them properly. A few of the main factors to consider when finding the proper fit for your client is their stability and balance, and their strength. As an occupational therapist fitting a client to a device knowing their level of stability and balance is a big factor because based on their stability level determines the correct device to provide. If a client has poor stability they may need a rollator or a walker instead of a cane. Strength is important to consider because if your client fatigues easily they may need a device that rolls so they are not over exerting themselves by picking up the walker each time they take a step.
To fit a client appropriately for a cane the therapist should adjust the height of the cane so the handle is in line with the wrist crease, ulnar styloid, or greater trochanter. The therapist should also make sure the clients elbow is flexed approximately 20-30 degrees to allow for the correct fit.
When fitting for axillary crutches make sure the patient is standing and looking straight ahead with their arms relaxed. Next, make sure the arm rest is approximately 1-1/2 inches under the axilla floor and the hand grips are in line with the wrist crease, ulnar styloid, or greater trochanter. These type of crutches are advantageous because they are lightweight as well as inexpensive.
Loftland crutches are similar but not exactly the same to axillary crutches. Loftland crutches have a cuff that attaches around the forearm to allow for more stability than a normal cane. To fit a client for lofstrand crutches, the arm band should be positioned 2/3 up the forearm. This type of crutches allow for more control and the use of hands while using the crutches.
Platform walkers are ideal for patients with poor trunk control or cannot withstand weight applied to the wrists. When fitting a client for a platform walker they should be adjusted to the clients height while standing with arms relaxed. Next, make sure that the handgrips are in line with the wrist crease, ulnar styloid, or greater trochanter. The elbow should be slightly flexed to approximately 20-30 degrees. For a platform walker it is important that it is positioned for the client so the forearm can distribute the weight to the platform. The proximal ulna should be 1-2 inches off the platform surface to avoid nerve compression. The hand grips should be positioned medially for more comfort.
A rolling walker helps the client to have a proper gait pattern and is easier to transport. A rolling walker has two wheels on the front to allow for more stability.This type of walker is sized the same way as the platform walker when the platforms are not attached.
Nicely done! Just to clarify, a rollator is a type of rolling walker that has wheels on all of its legs, and some also have a chair. They are easy to maneuver and the ones with chairs are useful when someone needs to take rest breaks. But these are the least stable and not as easy to transport as standard walkers. A standard walker may have two front wheels, in which case it is also a type of rolling walker.
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