Fitting Assistive Devices

Assistive devices can be really important and useful for a client who wished to increase their functioning and independence in their day to day lives. Additionally, fitting your client for these assistive devices is also really important. Making the right adjustments and adaptions to the assistive devices your client may use helps ensure their safety and stability to make sure that there is no risk of them injuring themselves further. Another reason to make sure they are properly fitted is so that the client is comfortable.

One way to appropriately fit a client for a cane is to make sure the hand grip of the cane is level with the ulnar styloid process, the wrist crease, or the greater trochanter of the client. The OT would want to make sure that the client’s elbow and shoulders are relaxed (not elevated) when holding the cane and their elbow will be flexed between 20-30 degrees.

For axillary crutches, in addition to the same guidelines as the cane above, the OT should ensure that the axillary rest of the crutches is around 5cm below the floor of the axilla when the shoulders are relaxed.

With clients who may need Loftstrand crutches, an arm cuff is attached and wraps around the proximal part of the forearm. These provide the client with more stability. Like in the previous two devices, the hand grip will be at the same level as the ulnar styloid, wrist crease, or greater trochanter, as well as having the elbows and shoulders relaxed with the elbows flexed 20-30 degrees.

A platform walker is used with clients who cannot bear weight through their wrist or hand. The platform attachment supports the forearms in a neutral position so weight can be applied there instead of in the hands or wrists. The platforms are raised high enough so that the client’s elbows are flexed to 90 degrees.

Lastly, a rolling walker is used for a client who has upper extremity weakness and cannot lift a more typical walker. This is fitted the same way as the cane as and axillary crutches, where the hand grip is level with the ulnar styloid, wrist crease, or greater trochanter and the elbows and shoulders are relaxed. The OT wants to make sure there is proper weight distribution for the client as well.