Wednesday, April 23, 2014

Canes and Walkers Require Fitting

One device does not fit all!!

According to  “The United States Census Bureau report issued in 2008 indicates that more than 10 million adults used a cane, crutches or a walker to assist with ambulation.”  Assistive devices for walking can help people stay active in their homes and community, with a better quality of life, and keep them from falling.  However, that depends on if these devices are being used appropriately and efficiently.

As a Physical Therapist for over 20 years, I have come across many instances of people using the wrong assistive device for them, or using the appropriate assistive device for them but incorrectly.   I’ve witnessed it both in my practice as well as out in public (because I can’t help but analyze people’s walking pattern when out in public).   Many people don’t realize that not all assistive devices are appropriate for everyone.  I often have a client come in with a “hand me down” cane from a relative or friend that is too short or too tall for them, it’s the wrong device for them, or they are not using it safely because they weren’t trained how to use it correctly.  When someone is thinking about using an assistive device to help with their mobility, it’s important that the correct device is chosen specifically for them, it is adjusted for their height accordingly, and they are taught to use it appropriately.   That’s what Physical Therapists do.

Canes:  A single point cane is meant for light support and is appropriate for someone with increased speed of walking.  The small based and large based quad canes are more appropriate for people who need a little more support and don’t walk as quickly.  If someone with a quick pace tries to walk with a quad cane, it often gets tangled up in their feet and could trip them, or it ends up behind them as they walk, which doesn’t serve its intended purpose. 

Walkers:  A rolling walker versus a standard walker without wheels can come in handy so that people can walk with a more continuous stride and not have to lift the walker between steps.  However, if people have poor balance, that rolling walker may be harder for them to control, and they end up walking with it way too far in front of them.  Again, that defeats its purpose.  Rollator walkers are 4 wheeled walkers with seats.  These come in handy for long distance walking if someone needs to rest.  However, again, the walker can get away from people easily if their balance is too poor. 

It’s very important for any assistive device to be fitted for each person’s height.  If it’s too tall, it interferes with a person’s stride.  If it’s too short, it will cause the person to bend over too far when walking. 

Many times people begin using a walker or cane on the advice of their doctor, family or friends.  However, if they have not been trained in the appropriate technique of walking with the device, it can be more dangerous than helpful.  There is a specific sequence when walking with a cane and appropriate  ways to use either canes or walkers to step up on a curb or negotiate regular steps.

So, if you are considering using a cane or walker to help with your mobility, ask your doctor if you can see a therapist to determine the appropriate device for you.  It should only take a few visits and could make a big difference for you to keep moving safely.