Assistive Devices -Biomechanics Blog 7
When a client is appropriately fitted for an assistive
device, the biggest variables to consider are the following: safety and
comfort. Safety is of the utmost importance because our client is going to be utilizing
this device very frequently, and we also do not want their ailment,
disabilities or situation become worse due to a poorly fitted assistive device.
We want the device to allow them to be more independent and useful in their
daily activities. On the other hand, comfort is going to be a big factor in
using an assistive device. If the client is not comfortable with their device
due to poor fitting, they have a few things that could take place... These
things can be that they will not use the device properly because of discomfort
or their specific condition worsens because they choose to not use the device
as recommended. These variables of safety and comfort are very important for
increased independence, improvement, and happiness for clients.
When we
discuss safety and comfort, one of the factors to always consider are the
proper fitting. Canes and walkers are fitted for clients in similar ways. For the
cane, standard walker and rolling walkers, the hand grip will be measured to be
in line with your specific client’s ulnar styloid or greater trochanter. When
they are holding the hand grip for one of these devices, the client’s elbow
will be relaxed with slight flexion as well as shoulders in a relaxed position.
On the other hand, when discussing axillary
crutches, they will be placed directly near the axilla (arm pit area). The hand
grip on the crutches will be the same measurement standard as the canes and
walkers; however, the difference lies in the axillary rest. It should be approximately
4 fingers from the floor of the axilla with the shoulders in a relaxed
position. If the axillary rest is not in the proper height, this can cause a
lot of discomfort on the brachial plexus – which is not what we want at all. The
other option of a crutch is the loft strand crutch. This specific crutch has a cuff
around the forearm area – there is no axillary rest. For safety and comfort
with loft strand crutches, the forearm cuff needs to be placed 2/3 of the way up
the forearm.
A conjunction of the crutches and
walkers is the platform walker. This specific walker provides a platform rest
from the elbow down the wrist with a handle grip at the end. The platform walkers
are great for clients who are having difficulty bearing weight in the wrist or
in the hand. The criteria of forearm support is important to consider when we
think about what will be the most safe and comfortable for our future clients. The
fitting for this platform walker will be similar to the other walkers; however,
the elbow will be positioned on the platform in a 90-degree angle for optimal support
during ambulation with the walker. Another tip is to have the proximal ulna approximately
1-2 inches off the platform surface. This will avoid any type of nerve
compression. The handle at the end of the platform should be situated a little more
medial for the most comfortable grip. Overall, proper fitting in canes, walkers
and crutches is essential when ensuring safety and comfort for our future
clients.
Comments
Post a Comment