24&26-Feb Mobility Aids

 

Table of Contents:

1. Introduction to Mobility Aids
   • Definition and Types
   • Selection Factors
2. Function of Mobility Aids
   • Balance, Proprioception, Pain Reduction
   • Weight-Bearing, Muscle Weakness Compensation
   • Environmental Adaptation
   • Disability Indication, Example
3. Prescription of Aids
   • Considerations
   • Specific Aid Details
4. Types of Mobility Aids
   • Overview of Various Aids
5. Specific Aid Details
   • Detailed Insight into Each Aid

Introduction to Mobility Aids:

• Definition: Mobility aids are external appliances used to enhance stability and mobility for individuals experiencing difficulty in walking.

Types of Mobility Aids:

• Variety: There are various types of mobility aids available, chosen based on the patient's needs and condition.
• Selection Factors:
  • Diagnosis and Prognosis
  • Reason for Selection
  • Mobility Aid Type
  • Proprioception
  • Stability and Pain Relief
  • Patient's Strength
  • Grip Type (Cylindrical or Power)
  • Gait and Stability
  • Weight Bearing Relief Requirements
  • Coordination
  • Vision and Proprioception
  • Architectural Barriers
  • Additional Factors: Motivation, Age, Acceptance

Function of Mobility Aids:

• Balance Enhancement: Mobility aids help improve balance.
• Proprioception Support: They assist in enhancing proprioception.
• Pain Reduction: Mobility aids in decreasing pain.
• Weight-Bearing Reduction: They help reduce weight-bearing on injured or inflamed structures.
• Muscle Weakness Compensation: Mobility aids compensate for weak muscles.
• Environmental Adaptation: They adapt to the immediate environment for those with visual impairments.
• Disability Indication: Mobility aids indicate the individual's disability to bystanders.
  • Example: A white cane with a red tip indicates visual impairment.

Prescription of Aids:

• Considerations:
  • Height and Design of the Appliance
  • Repairability vs. Replaceability
  • Stability Provided
  • Grip Location Correspondence
  • Use of Rubber Ferrules for Surface Grip
  • Material Durability, Repairability, and Environmental Friendliness
  • Indoor vs. Outdoor Use
  • Inclusion in Therapy Programs
  • Cost

Types of Mobility Aids:

• Parallel Bars
• Walking Frames
• Crutches
• Canes
• Scouting Boards
• Tripods
• Wheelchairs
• Quadrupeds

Specific Mobility Aid Details:

Parallel Bars:

• Description: Rigid support along the length, enabling compensation for lower limb issues.
• Adjustment: Height set to the level of the greater trochanter.
• Additional Feature: Full-length mirror placed at one end.

Walking Frames:

• Description: More stable, and suitable for elderly individuals or those confined to home.
• Positioning: The front of the walker is positioned 12 inches in front of the patient, with the patient's elbows at a 20- to 30-degree flexion.
• Types: Standard, reciprocal, or rollator.
• Advantages: Stability, sense of security, lightweight, and adjustable.
• Disadvantages: Difficulty using stairs or through doorsteps or entrances.

Types of Walking Frames:

Standard Walking Frame:

• Description: Four aluminum tubes are joined on three sides by upper and lower horizontal tubes, with one side left open.
• Features: Hand grips on upper horizontal tube, rubber tips at lower end of vertical tubes.

Reciprocal Walk Frame:

• Description: It is identical to the standard frame, but each side of the frame can be moved forward independently.
• Additional Feature: SWIVEL joint between horizontal and vertical tubes.

Rollator:

• Description: Features two small wheels at the front and two legs without wheels at the back, or one at each leg.
• Benefit: It does not require lifting the whole device, suitable for elderly patients and children.

Canes:

• Description: Commonly made of aluminum or wood, transmitting 20-25% of body weight.
• Usage: Held in the hand opposite the involved side to increase stability and compensate for weak muscles.

Tripods:

• Description: Made of aluminum alloy or steel with three rubber tips at the corners of an equilateral triangle.
• Optimal Grip Position: Hand grip in the same plane as the line joining two legs nearest and parallel to the patient's foot, with the elbow at a 30-degree flexion for stability.

Quadrupeds:

• Description: Features four rubber-tipped legs with the hand grip vertically above two inner legs, providing increased stability.
• Adjustability: Hand grip height can be adjusted and used singly or in pairs.

Crutches:

• Factors Affecting Ability:
• Sense of balance
• Correct selection and adjustment
• Muscle strength
• Good vision
• Correct crutch tension
• Pattern of gait

Description of Axillary Crutches:

• Consists of a double upright joined at the top by a crutch pad as a hand grip and a rubber tip at the lower end.
• The axillary crutch pad rests against the chest wall and is 5 cm from the axillary apex.
• Hand grip adjusted to make 30-degree elbow flexion.
• Weight transmits down to the hand grip.
• Support up to 80% of body weight used when crutch walking is commenced.
• When non-weight bearing on one lower limb is indicated.
• More stable though cumbersome to use.
• The patient can release the hand grip and use the hand for other purposes.

Types of Axillary Crutches:

1. Adjustable
2. permanent
3. ortho crutches.

• Muscle involving crutches:
  • Finger flexor and thumb.
  • Wrist dorsiflexor.
  • Elbow flexor.
  • Shoulder flexor.
  • Shoulder depressor.
  • Shoulder adductor.
• Measurement:
  • Height minus 16 inches from axilla apex to lower margin of medial malleolus.
  • From anterior axillary fold to 6 inches in front and lateral to 5th toe.
  • From the anterior axillary fold to the bottom edge of the heel in the supine position.

Description of Elbow Crutches:

1. Made of aluminum alloy.
2. U-shaped cuff at the upper end to accommodate the forearm, made of rubber or plastic.
3. Converted hand grip, rubber tip at the lower end.
4. Adjustable length.
5. Transmit 40-50% of body weight.
6. Less cumbersome and more stable than a walking stick.
7. Suitable for patients who can take some weight on both feet and paraplegic patients.

• Crutch Accessories:

  • Crutch Tip:
    • Attached to the foot of the crutch.
    • Diameter of at least 1.5 inches.
    • Prevents slippage and acts as a shock absorber.
    • Types include
    1. suction crutch tip
    2. snow boot crutch tip
    3. rain guard crutch tip
    4. small crutch tip.
  • Hand Grip:
    • Sponge pad to relieve pressure.
    • Can be modified to accommodate stiff or deformed hands.
    • The grip can be increased with a rubber sponge.
  • Axillary Pad:
    • Made of sponge rubber.
    • Prevents undue pressure over nerves and blood vessels.
  • Tricep Band:
    • Metal or stiff leather.
    • Attached to the upper part of the crutch.
    • Helpful for those with triceps weakness.
  • Wrist Strap:
    • Made of leather or plastic.
    • For weak wrist extensors.
    • Assists in holding the hand grip.

  Scouting Board:

  • Wooden board with wheels below.
  • The patient sits on it and is pushed with the hand.
  • Popular among Indian housewives with residual polio.

  Gutter Crutches:

  • Single adjustable aluminum alloy tube.
  • Short horizontal metal gutter at the upper hand.
  • Vertical hand grip projecting forward from the gutter.
  • The lower end is protected with a rubber tip.