Crutches
wood, aluminum, used in pairs for long term assistance w/ambulation
Axillary crutches
fit beneath axilla, temporary ambulatory assistance
-measure 1.5-2inches below axillary fold to point on floor in front of pt, 6inches laterally from side of foot
-measure from wrist crease to floor for hand grip, elbows flexed at 30degress when standing
Forearm crutches
have arm cuff, no axillary bar for permanent assistance w/ambulation
-measure from wrist crease to flow for hand grip
-measure forearm piece length 2.54cm from clenched fist to elbow crease
-cerebral palsy, congenital hip
Platform crutches
forearm cuff for individuals unable to bear full weight on hands, wrists
-rheumatoid, severe osteoarthritis, spina bifida
Crutch walking
begin in tripod position, crutches 6inches in front of feet
-good foot = weight bearing
-affected foot = non weight bearing
Two-point gait indication
bilateral weakness, cerebral palsy, arthritis
-have strength, coordination, balance
-partial weight bearing
-simulates normal walking
Two-point gait
one crutch + opposite foot move in unison, followed by remaining pair
-stand both fee together, move right crutch +right foot then left crutch + left foot
Three-point gait indications
amputee using prosthetics, minor injury one leg, healing injury, partial weight bearing status post hip arthroplasty
Three-point gait
both crutches advanced w/weaker leg, then stronger leg moved to be parallel w/weak leg
-stand both feet together, advance both crutches + affected leg, then advance unaffected leg
Three-point gait NON weight bearing indications
one amputated, disabled, injured leg
Three-point gait NON weight bearing
both crutches move forward followed by weight bearing leg (unaffected leg)
-stand tripod position w/affected leg bent, move both crutches bringing unaffected leg up to crutches
-no weight on affected leg, leave bent
Four-point gait indications
bilateral weakness, cerebral palsy or arthritis, but limited weight bearing/weakness
Four-point gait
one crutch then opposite foot, then second crutch, then remaining foot
-stand w/both feet together, advance right crutch, then left foot then left crutch, then right foot
Swing-To gait indications
pt w/weakness of both lower extremities but good upper extremity strength
Swing-To gait
both crutches moved forward and one or both legs advance to crutches
-advance both crutches forward then bearing all weight through both crutches swing both legs forward to NOT past crutches
Swing-Through gait indication
injury, disability to both legs = paralyzed with leg braces or amputee before prosthesis
Swing-Through gait
both crutches moved forward and one or both legs advance beyond crutches
-stand both feet together, advance both crutches, then advance both legs swinging forward past crutches
Crutch upstairs
-good leg on stairs
-crutches on stairs
-weight on crutches
-bad leg on stairs
Crutch downstairs
-place crutches and bad leg on stairs
-bring strong leg on stairs
Teaching points
-keep crutches close to side, stabilize under arm
-keep 2-3inches to side during ambulation
-use chair w/arm rests
-don't press axilla underarms = nerve damage
-ensure screws tight
-replace old, cracked rubber tips