Article

Training - Fitting Crutches

User Services

Training: Selecting and Fitting Crutches

 

 

Purpose

 

The purpose of this procedure is to instruct AT center staff members in the proper fitting of crutches and how to train the patient to use them properly

 

Why Crutches Are Prescribed

 

Crutches are prescribed for patients who need assistance to bear weight on their legs because of an injury or illness resulting in limited coordination, strength, balance, sensation or joint motion.  Crutches can support up to 50 percent of the user’s weight during walking.

 

The patient’s physician will prescribe the exact configuration for an assistive device for walking. In doing so, the doctor considers the patient’s illnesses and/or injuries, general condition, physical stability and balance. It is very important to provide exactly the specified device. The wrong device may slow healing, increase the possibility of a fall, or aggravate the patient’s existing limitations.

 

In addition to the physical conditions, the patient’s learning ability and social and emotional environments need to be considered. The patient must be able to learn new tasks and use sound judgment. It’s important to consider whether the patient has other needs that may make it difficult or impossible to use crutches (for example, use of portable oxygen.) What are the physical circumstances in the patient’s residence? Will giving crutches help or put him/her at increased risk for falls?

 

In addition to the proper device, the patient will need “gait training” to use the crutches in the most normal, efficient and safest walking pattern.

 

 Types of Crutches and Their Uses

 

Wooden crutches are still used for healthy people with short-term needs, but most needs are better filled with more easily adjustable aluminum crutches. These come in youth and adult models, adjustable for height. Crutches are also designed for different levels of load bearing, so the patient’s weight is critical in making the selection.

 

 

Choosing  Crutches

 

Type of crutch

Description of crutch

Best used for patient with

Axillary crutch

Traditional crutch with padded top held between chest and upper arms

Weaker arms

Forearm crutch

Flexible cuff that surrounds the forearm

Stronger arms; long-term needs

Platform crutch

Vertical handgrips to grasp and padded platforms for forearms

Gripping limitations or problem bearing weight in hand, write or forearm

 

 

Fitting Crutches

 

Type of shoes.  The user should be fitted in safe, comfortable walking shoes.

Distance from armpits: The top of the crutches should reach between one and two inches below the armpits while the user is standing with shoulders relaxed.

Handgrips: The handgrips of the crutches should be even with the top of the hip line.  Elbows should bend a bit when using the handgrips. The elbow should be flexed about 15 to 30 degrees – enough to fully extend the elbow when a step is taken.

Crutch length (top to bottom): The total length from crutch pad to tip should equal the distance from armpit to about six inches in front of the user’s shoe.

Tips/ Stability: All crutches need rubber tips to provide stability and to minimize falls. If the user lives in a climate with severe winters, an accessory called ice tips will be essential to maintaining stability on snow and ice. There are several different models of ice tips. All are easily attached and removed.

 

DISCLAIMER

This work is supported under a five-year cooperative agreement # H235V060016 awarded by the U.S. Department of Education, Office of Special Education and Rehabilitative Services, and is administered by the Pass It On Center of the Georgia Department of Labor – Tools for Life.  However, the contents of this publication do not necessarily represent the policy or opinions of the Department of Education, or the Georgia Department of Labor, and you should not assume endorsements of this document by the Federal government or the Georgia Department of Labor.

 

 

Attachments

Other Information

Title: Training - Fitting Crutches
Module: User Services
Author: Trish Redmon
Audience: Implementer
Sub Title:
Procedure: How to fit user with crutches
Organization Source: Pass It on Center
Last Reviewed: 01-22-2009 5:45 PM