Crutches-PPT-1-1

1. CRUTCHES/ POINT GAIT Prepared by: Mary Ann Bayani MAN RN

2. CRUTCHES: • Crutches are a type of Walking Aids that serve to increase the size of an individuals Base of support. • It transfers weight from the legs to the upper body and is often used by people who cannot use their legs to support their weight (ex. short-term injuries to lifelong disabilities).

3. Indications: The use of crutches may be indicated if a patient: 1. Has lost the use of a limb (it is either injured or amputated). 2. Is having problems with Balance and impaired strength.

4. Purpose: - Increase area of support or base of support - Maintain center of gravity over supported area • Redistribute weight-bearing area by decreasing force on injures or inflamed part or limb - Can be compensate for weak muscles - Decrease pain - Improve balance

5. Crutch Type: There are three types of crutches; Axilla crutches, Elbow crutches and Gutter crutches. 1. Axilla or underarm crutches • positioned about 5 cm below the axilla with the elbow flexed 15 -30 degrees, approximately. 2. Forearm crutches • their design includes a single upright, a forearm cuff and a handgrip. The height of the forearm crutches are indicated from handgrip to the floor 3. Gutter Crutches These are additional types of crutches, which is composed of padded forearm support made up of metal, a strap and adjustable handpiece with a rubber ferrule. These crutches are used for patients who are on partial weight bearing like Rheumatoid disease.

6. Crutches: Need to know: 1. Crutches can be adjusted based on the height from the bottom and top. It has a height range indicated on the side of the crutches

8. 2. Crutches proper fit. Should have gaps 2-3 fingers width between axillae and rest pad . This is to prevent nerve damage 3. Hand grips should be even with the top of the hipline. Weight should be on this hand gri rather on the axillaera 4. Elbows must be 30 degrees relaxed

10. POINT GAITS: • What to do first? • 1. Ask yourself or assess first how many points are in the ground hands, how many foot on the ground, and how many crutches on the ground. • 2. Use a gait belt when starting • 3. A tripod position – where crutches are 6 inches diagonally from the feet

12. Two Point Gait - Weakness in both legs or poor coordination - It is faster than Four point gait • Can be difficult to learn by the patient • How to Use: • Move right crutch and left foot together (right foot is the injured side) • Then the left crutch and right foot together

14. Four Point Gait • -Weakness in both legs or poor coordination • - Provide excellent stability as there are always 3 points in contact with the ground • - Slow overall walking speed • How to use: • Move right crutch then left foot then left crutch then right foot

16. Three Point Gait • - Allows you maximum mobility while maintaining maximum protection on your injured leg • - Inability to bear weight on one leg • - eliminates all weight bearing on the affected leg • - Good balance is required • How to use: • Move both crutches and injured leg together then move the non injured leg

18. Swing –to-gait • -Used when you are first learning to walk with crutches • - Patient with weakness of both lower extremities • - Easy to learn • - Requires good upper extremity • How to use: • Both crutches forward then swing or move both legs forward and placed them at where the crutches are located

20. Swing Through Gait • - Non weight bearing • - Inabilty to fully bear wight on both legs • - Fastest among all point gait, easy movement • - Energy consuming and requires good upper extremity strength • How to use: • Both crutches forward then swing or move legs forward past where the crutch placement

22. Using Stairs: Remember : Good Up and Bad down - So when going up the stairs the good leg is going to go first up on the step followed by the crutches and the bad leg will proceed and go up the step - When going down the steps move the crutches down to the stair that will help provide stability followed by the bad leg because the bad leg is going to go down and then they’re going to move the good leg down onto the step

25. How to Sitdown and Get Up • - Patient going back up to the chair and feel the chair with the non injured leg and when h/ she feels th chair ,thy stop and move both crutches on the injured side for support then patient grip the handgrips and slightly bend the non injured leg and then sit while keeping the injured legextended

27. -When getting up from the chair patient going to take the crutches and put them on the injured side for support then he is going to keep the injured leg extended and push up on the non injured side then using the hand grip of the crutches then he is going to put the crutches in position

29. Precautions: • Have someone nearby for assistance until accustomed to use of crutches. • Frequently check that all pads are secured • Check screws at least once a week • Clean crutch tips to ensure they are free of dirt or stones. • Remove small , loose rugs from walking paths. • Never carry anything in hands use backpack • Beware of wet or waxed floor.