Fitting Assistive Devices

    Appropriately fitting your patient for an assistive device is very important because if you fit a device inaccurately it can lead to future injury. If the device is too short, it can decrease the stability of the client and they can become unbalanced which increases fall risk. Another reason it needs to be fitted properly is that, if the device is adjusted too high, it can increase the likelihood of an injury from the said device. For example, if axillary crutches are placed too high, they can cause brachial plexus nerve injuries. When fitting assistive devices, it's important to think about the following factors before assigning a device: the client's physical conditions, age, endurance, and physiological conditions. 

Canes

A cane is the least stable of the assistive devices. When fitting a cane, the handgrip must be facing back and it should be at the level of the ulnar styloid, wrist crease, or the greater trochanter. Their elbows should be flexed around 20-30 degrees with their shoulders relaxed and not elevated. 

Crutches 

Axillary crutch fittings are the same as the cane fittings, however, it's important to make sure the axillary rest is around 5 cm (4 fingers width) below the floor of the axilla (armpit) with shoulders relaxed to prevent nerve damage. These are more stable than canes. 

For Lofstrand crutches, the handgrips face forward with an arm grip that wraps around the proximal forearm. These are more stable than a cane but less stable than axillary crutches. 

Lofstrand crutches

Walkers

Walkers are the most stable of the listed devices. They are fitted the same way as canes and crutches, however, rolling walkers can be pushed easier and are for clients who are unable to lift a walker to due inadequate strength.

Platform walker 

If the client is unable to bear weight through their hand or wrist, a platform attachment may be needed to add to the walker. It consists of a platform that supports the forearm to operate the walker.