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 ♡

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