Sizing for Assistive Devices

Sizing for an assistive device is very important. Without an appropriate “fit” for the patient, the assistive device can be a safety hazard and cause the patient to lose their balance and have an increased risk of falling. It can also place too much pressure on certain body parts and cause the patient to have nerve damage. An example of this is having axillary crutches that are too tall for the patient; The increased pressure in the axillary (armpit) area can cause the patient to have damage to their brachial plexus! Listed below are the appropriate ways I would select the correct sizing for a cane, axillary crutches, Lofstrand crutches, a rolling walker, and a platform walker 

• Cane: When trying to select the appropriate size, the patient should be standing and looking straight ahead with their arms relaxed by their sides. When holding the cane, the patient’s elbow should be slightly flexed to about 20 or 30 degrees.  The handles should be in line with the wrist crease with elbows slightly flexed, ulnar styloid, or greater trochanter. In order to adjust the cane, use the pushpin. 

*For a quad cane, you want the wider legs to point away from the patient. If they are not, this can be fixed by rotating the base 180 degrees. 

•Axillary crutches: Like the cane, makes sure the patient is standing tall and looking straight ahead with their arms relaxed. Sometimes the crutches will have heights listed next to each hole. This is helpful to use as an estimate, but it is still important to make sure that their arm pads are placed about 5 cm below the axilla. Like the cane, the handgrips should be in line with the wrist crease, ulnar styloid, or greater trochanter when hands are resting and elbows are slightly flexed. 

         *For Lofstrand crutches, the armband should be positioned 2/3 of the way up the forearm. The handgrips should be pointing forward. 

•Rolling Walker: 

The patient should look straight ahead with arms relaxed. The handgrip should be in line with the wrist creases, ulnar styloid, or greater trochanter. The elbow should be slightly flexed about 20 to 30 degrees when looking for these bony prominences. 

Platform Walker: The platform should be positioned to allow weight-bearing through the forearm when the elbow is bent to 90 degrees. The proximal ulna should be 1 to 2 inches off the platform; The handles of the platform should be positioned slightly medially.

Sizing for these devices should be done with the patient’s shoes on.