Finding Your Fit

Appropriate fitting of assistive devices is essential for a variety of reasons, such as increasing safety, comfort, and balance for the client. An assistive device that is well-suited for a client will more easily allow him/her to access and engage in meaningful activities. If not properly measured, an assistive device may make the client more susceptible to injury and potentially endanger him/her. Each device is unique to the individual. It is important to consider the client's physical, as well as cognitive, limitations and capabilities, and adjust accordingly. 

In order to properly fit clients for canes and walkers, a few things should be taken into consideration and are as follows: the grip of the hand should be level with the ulnar styloid process, the wrist crease or greater trochanter; elbow should relax at a flexed state of roughly 20-30 degrees; and the device should be adjusted in a way that permits shoulder relaxation as opposed to sustained shoulder elevation. When differentiating a platform versus a rolling walker, as well as a wide-based Quad Cane versus a narrow-based Quad Cane, it is important to consider a client's balance and upper extremity strength. A platform walker and narrow-based Quad Cane need less support and necessitate less balance as well as more upper extremity strength, respectively. On the other hand, a rolling walker and a wide-based Quad Cane are better suited for those with less balance and who experience upper extremity weakness and/or fatigue.

In addition to canes and walkers, standard/axillary crutches are fitted in a comparable manner, supplemented with an axillary (armpit region) rest positioned approximately 5 centimeters below the floor of the axilla. Lofstrand crutches bear less stability than the aforementioned axillary crutches, however, provide more support and stability than a cane, and are better suited for those with long-term disabilities. 

There are a variety of factors to account for when selecting an assistive device that may serve to maximize a client's potential to engage in meaningful activities.

~ Pam ♡

Image retrieved from: https://www.123rf.com/stock-photo/old_woman_cartoon.html?sti=le7jt8thlux10srjtw|&mediapopup=52882621

Mind Your Posture

Conscious practice of proper posture and body mechanics may not only contribute to optimal body function but may also subserve preventative benefits and effects to the body. The ideal body alignment is one in which an individual's center of gravity is centered over the base of support. This aids in the promotion of balance equalization and body stability. As previously mentioned, proper posture is a key contributor in preventative physical care. It reduces the risk of deformity and/or injuries such as kyphosis, lordosis, or scoliosis. Additionally, proper posture allows the body to perform at an ideal functional level with minimal energy expenditure. 

As an occupational therapy student or practitioner, it is important to inform and educate clients on ideal posture along with its benefits. A few options for a client who spends most of the day in sedentary conditions (e.g. sitting) may include an unsupported chair that helps to modify one's posture, a standing desk, or encouraging the client to take short breaks to stretch, stand, and/or walk. Alternatively, if a client spends most of the day on his/her feet, one may suggest imagining a string on the top of one's head and standing as if someone is pulling directly upward on the string. This supports the body in maintaining proper alignment, alleviating pressure on the vertebral column, and attenuating potential deformities and/or injuries, while simultaneously engaging and strengthening the muscles necessary for proper posture. 

~ Pam ♡

Image retrieved from: https://www.georgecorbett.net/?page_id=195

Common posture mistakes and fixes. (2016, January 7). Retrieved from https://www.nhs.uk/live-well/exercise/common-posture-mistakes-and-fixes/

Impact of Digital Absence

In Roald Dahl's story, "Man From the South", he shares a tale of a soldier who makes a bet with a perceivably wealthy man. The stakes are high with the potential loss of the wealthy man's vehicle or the loss of the soldier's pinky finger. To the soldier's fortune, the wealthy man's partner walks in and interrupts just before the challenge ends, and the soldier notices that she has lost all but a thumb and one finger on her hand. This could cause her to face potential challenges in her daily life such as self-care and navigating activities outside of herself, such as driving her partner's vehicle. 

Although the hand's digits (i.e. fingers) are small, they are constantly utilized and contribute a great deal to everyday life due to their intricate and delicate nature. The complexity of the digits allows for elaborate actions and manipulation of objects, and they must function in harmony in order to optimize strength, as well as stability. In regards to the woman in the story, she likely experiences difficulties with activities such as driving her partner's due to the absence of most of her digits, causing a deficiency in hand motor function. Grasping and guiding the steering wheel in addition to adjusting the gear could prove to be complicated without the assistance of her digits. In order to amend these circumstances, a steering wheel knob with a textured surface may be implemented. As opposed to grasping the entire steering wheel, a knob will allow her to wrap her two fingers around it, and as she maneuvers the vehicle, the knob will simultaneously rotate to accommodate for her motions. She may also place her palm on top of the knob, and the textured surface will provide extra traction so her hand does not slip. Because our digits are used incessantly, it is easy to dismiss the importance of their function and how impactful they are on our activities of daily living.

~ Pam ♡