WALKING AIDS

                     ##WALKING AIDS

WHAT IS WALKING...??

•Walking also known as “Ambulation”.

•Manner or a way in which you move from one place to another. 

•Walking includes lower limb. 

•It is typally slower than running. 

•Highest level of motor control skill. 

REQUIREMENTS OF SUCCESSFUL WALKING AID

•Support body mass, by lower extremities. 

•Dynamic balance of the moving body. 

•Production of locomotors rhythm. 

PURPOSE

•Improves their walking pattern. 

•Maintain center of gravity , base of support or area of support. 

•Decrease pain. 

•Improve balance. 

•Safety while mobilising independently. 

They can also be a means of transferring weight from the upper limb to the ground.

TYPES

•Walkers

•Canes or Walking sticks

•Crutches

SELECTION

•Depends person to person. 

•Stability of the patient. 

•Strenght of the limbs. 

•Coordination of limbs (both upper and lower limb). 

•Degree of relief from weight bearing. 

DESCRIPTORS OF WEIGHT BEARING STATUS

•Full weight bearing (FWB): There are no restrictions and patient can bear 100% body weight on the lower extremities.

•Non-weight bearing (NWB): No weight is borne on the involved limb.

•Partial weight bearing (PWB): Patient is allowed to bear only a portion of body weight on lower extremities. It is sometimes expressed as a percentage of body weight (example 20% to 70%)

•Toe touch weight bearing (TTWB): Only the toes of the affected extremity contact the floor to improve balance

•Weight bearing as tolerated (WBAT): Weight bearing is limited by patient tolerance of weight borne on extremity.

WALKERS

A walker is a type of mobility aid that offers stability and support while walking. Walkers are more stable than crutches or canes. They have a wide base of support that gives stability front to back and side to side.

BENEFITS OF WALKER 

•Help with balance and lower the risk of falls

•Provide support when muscles are weak

•Limit weight bearing on the lower body

•Help patients move safely if they have reduced feeling or control in legs or feet

•Reduce pain or fatigue during walking or standing

•Assist in sitting down or standing up

FITTING A WALKER

A walker is safest and helps most when it fits well. A walker that is the wrong size can be hard to use, cause falls, or result in pain and soreness. It is important to have good posture when using a walker to prevent stress on the back or arms. A physical therapist can help adjust the height and width for proper fit. All 4 legs of the walker should be the same length.

To get the best fit, have the patient stand up straight. Check the height:

With arms relaxed at the side, the height of the handgrip should be at the level of the wrist.

When hands are placed on the handgrip, arms should be slightly bent at the elbow (20 degree bend in elbow).

TYPES OF WALKERS

There are different types of walkers for the patient. Also patient may attach apouch or a small and less weight box. Patient can put the things which they want.

Walkers given to the patient is advisable by a therapist according to the patient problem. 

There are three types :

1.Standard walkers

2.Rollator walkers

3.Reciprocal walkers

1. STANDARD WALKING FRAME

•The height and width are adjusted to fit the patient.

•Consist of four verticle aluminum joined on three sides by upper and horizontal tubes. 

•Handgrips on upper horizontal tubes. 

•Rubber tips at lower ends of verticle tubes. 

•This can help the walking pattern to be more natural.

2. ROLLATOR WALKERS 

Wheels can be placed on the front of the walker to provide a smoother walking pattern or more natural gait. Wheels may also be used if patients are unable to lift and move the walker.

•Best suited for children. 

•No need to lifting the whole device. 

•A therapist can help with walker is most suitable for the patient :

>Anterior rolling walkers

>Posterior rolling walkers

 3.RECIPROCAL WALKING FRAME

•Identical with standard frame. 

•Each side of the frame can be move forward.

•Swivel joints between horizontal and vertical tubes. 

•It has their own advantages and disadvantages. 

CANES/WALKING STICKS

•Canes or sticks come in different shapes and designs. 

•Commonly made of aluminum or wood. 

•Therapist should advise to hold the cane in hand opposite the involved side. 

•Elbow should be at 30°flexion. 

•Transmits 20-25% of body weight.

•It has many advantages.  

TYPES OF CANES

•Standard cane

•Tripods cane

•Quadrupeds 

•Hemi cane

•Rolling cane

CRUTCHES

Used most frequently to improve balance

Releive in weight bearing.

•Typically used billaterally – Increase base of support

•There are different types of crutches – 

Mostly used,  axillary crutches and forearm crutches. 

GAIT PATTERN OF CRUTCHES

•One Crutch 

When using one crutch, the crutch may be placed on the side of the unaffected leg or used to bear the load of the affected leg.

•Four-point gait

Those who can tolerate partial weight bearing on both legs usually use the four point gait. The sequence is right crutch, left leg, left crutch, right leg. This is the slowest of all gaits but also the safest in that three of the four points are in contact with the ground at any given time. 

•Two-point gait

Those who can tolerate partial weight bearing on both legs but require less support than a four-point gait usually use the two-point gait. The sequence is right crutch with left leg and then left crutch with right leg.

•Three-point gait

The three point gait is usually used by those who cannot bear weight on one leg. Both crutches are advanced while bearing weight on the unaffected leg. Then the unaffected leg is advanced while bearing weight on the crutches.

•Swing-to gait

A person with a non-weight bearing injury generally performs a "swing-to" gait: lifting the affected leg, the user places both crutches in front of himself, and then swings his uninjured leg to meet the crutches. A similar "swing-through" gait is when both legs are advanced in front of the crutches rather than beside them.