Assistive Devices
sizes. Like most adjustable canes, the
CANES
Types
- Crook-top cane
- Adjustable metal cane
- Functional grip cane
- Quad cane
- Seat cane
Components
- Handle
- Adjusting Knob for handle
- Shaft
- Adjusting Mechanism for height
- Rubber tip
1. Single-Tipped Cane
- It is similar to as standard wooden cane
except that is has a telescoping design
which allows adjustments of cane length
- Advantages
 The single-tipped cane is quickly
adjustable. This is useful if
measurement is done prior to
altering the length
- Disadvantages
 The point of support is anterior to the
hand and not beneath it. It’s also
more costly than the standard non-
adjustable cane
2. Single-tipped Offset Cane
- This type of cane is similar to the standard
adjustable aluminum cane but the proximal
component is offset anteriorly
- Advantages
 Due to it is relative handle
orientation, the offset cane allows
pressure to be borne over the center
of the cane for greater stability. Like
most single-tipped canes, it is light
weight, easily adjusted and fits on
most stairs
- Disadvantages
 The offset cane, due to it’s more
complicated design is more costly
3. Quad Cane
- The quad cane provides a broad base with
four points of contact with the floor. The legs
closest to the body are generally shorter
and may be angled better to provide foot
clearance
- Advantages
 The broad base comes in different
length can be modified according
the patient’s needs
- Disadvantages
 The wide base of support is not
practical to use on stairs. Likewise, it
also causes a slower gait pattern
4. Seat Cane
- This type of cane can be converted into a
chair quickly. It is usually prescribed to
patients who have decreased endurance
- Advantages
 It’s role as an assistive device plus
the fact that it’s also a chair is a plus
for most elderly patients.
- Disadvantages
 Because of the chair component,
the patient would rather sit down
than ambulate, therefore, it’s not
advisable during ambulation during
training. Most seat cane are non-
adjustable, heavier and more costly
than it’s counter-parts.
Uses of Canes
- Increased base of support
- Decrease loading and demand on the LE
- Provide additional sensory information
- Assist acceleration/deceleration during
locomotion
Measurement:
- Handgrip: 20-25° elbow flexion
- Measure from the greater trochanter to a
point 6 inches to the side of the toes
CRUTCHES
Types
- Axillary Crutches
- Forearm Crutches
- Platform Crutches
Components
- Padded axillary piece (top)
- Two upright shafts
- Handpiece
- Extension piece
- Rubber tip
Components of Forearm Crutches
- Forearm cuff
- Forearm piece
- Molded handpiece
- Single aluminum tubular shaft
- Rubber tip
1. Forearm Crutch
- The forearm crutch is made up of tubular
aluminum with a padded handgrip and a
forearm cuff which help to stabilize the
forearm during weight bearing. The most
popular brand is Loftstrand
- Advantages
 Since it closely resembles a cane, it
can be used unilaterally as a cane.
The forearm support stabilizes the
wrist during weight-bearing making
ambulation easier and safer
because the crutch is attached to
the forearm, the hand can be free to
perform tasks without dropping it
- Disadvantages
 The flaw of the forearm crutch will
affect patients without trunk
balance. It is also more difficult to
remove
2. Triceps Crutch
- The wooden Canadian Crutch together
with aluminum Warm Spings Crutch and
Everest crutch are examples of triceps
crutches. These crutches resemble axillary
crutches with the modifications of forearm
cuff and a triceps cuff. It is originally
developed for poliomyelitis patients and
those with triceps weakness
- Advantages
 One of the advantages of the
triceps crutch is that it helps prevent
elbow flexion (buckling) during gait.
It has greater stability than forearm
crutches
- Disadvantages
 It requires greater strength and
endurance for patients
3. Platform Crutch
- The platform crutch is usually indicated for
patients with arthritis because of pain and
deformities in the hand and wrist. Patient
with elbow flexion contracture will also
benefit from this device.
- Advantages
 One of the advantages of the
platform crutch is that the weight of
the body is borne on the forearm
and not on the hands. The design
also employs a handle that is
contoured to adapt to deformities.
- Disadvantages
 The platform crutch due to it’s
limited production and complex
design is more costly. Also, the hand
cannot perform tasks freely with the
platform attachment
4. Ortho Crutch
- The ortho crutch has a single upright that
offsets proximally to come the axillary
cradle. The hand piece is adjustable
- Advantages
 Due to its simpler design, it’s more
comfortable, cheaper and highly
customizable. It is also lighter, thus
the energy expenditure is less
- Disadvantages
 Since the technology for the ortho-
crutch is relatively new, it’s not
available in most countries.
Uses of Crutch
- Increase the BOS
- Provide moderate degree of stability
- Relieve weight-bearing on the LE
WALKERS
Types
- Lightweight walking frame
- Folding walking frame
- Rolling walking frame
- Forearm resting walking frame
- Hemi-walking frame
- Reciprocal walking frame
- Stair-climbing walking frame
1. Reciprocal Walker
- This type of walker has swivel joints, allowing
reciprocal action as each side of the walker
moves alternatively
- Advantages
 Allows a longer stride and is less
awkward gait
- Disadvantages
 Because of moving parts, some
inherent stability of the walker is lost.
2. Stair-climbing Walker
- This type of walker has a climbing lever that
allows the patient to gain an ability to climb
stairs. It is primarily used by patients with
good balance and superior strength in their
UE like young paraplegics
- Advantages
  This is the only walker that can allow 6. Hemi-walker
the patient to walk on level ground - The hemi-walker is actually a cane. It is
and stairs commonly used for patients with
- Disadvantages hemiparesis but are in need of a walker. It is
 It’s expensive, extremely slow and also used as an intermediate device from
cannot be used on spiral stair-cases parallel bars to quad cane.
3. Rolling Walker - Advantages
- Due to the casters in it’s front legs, the rolling  Due to its wide BOS, it is more stable
walker is naturally prescribed to patients with than a quad came. It also has a
UE and trunk incoordination smaller base than most walkers, thus
- Advantages it is less cumbersome
 Good for patient with weak UE. - Disadvantages
People with UE and trunk  Compared to a standard walker, it’s
incoordination who are unable lift less stable and due to its design, the
walkers can also avail of it’s weight is not distributed well on the
advantages. center. It is more costly, can’t be
- Disadvantages used in most stairs and has a slow
 The instability brought by the casters forward progression.
can be dangerous.
Attachments
4. Rollator
- Four wheels are attached to the legs of this 1. Casters
type of walker. To improve control, brakes - Walkers with detachable anterior legs can
are used whenever the patient wants to be replaced with casters for faster mobility
stop. Most models are equipped with a seat 2. Extension legs
and a basket - In case of wear and tear, legs can be
- Advantages replaced with extension legs.
 Because it can change direction 3. Platform Attachment
easily, it closely guides the patient - A standard walker can be attached with
into a near normal walking pattern this device whenever hand function is
- Disadvantages impaired
 Aside from the fact that it is unstable,
the patient tends to bear his weight
non on the rollator, but at the hip
level thus producing stress on the LE
upon walking
5. Walker with Platform Attachments
- This walker allows transfer of body weight
from the forearm via the platform
attachment down to the four legs of the
assistive device.
- Advantages
 This assistive device is helpful to
patient with flexion contracture of
the elbow. For patients with
wrist/hand pain and deformities, the
platform walker provides mobility
since the weight is transmitted to the
forearm. It can also be used for
below amputees
- Disadvantages
 Its heavier, can’t be used on the
stairs. The patient loses the use of the
triceps to elevate and maintain
body during swing phase