6.6 Foot-anterior axillary fold linear techniques



#### Table 2.

Prediction of axillary crutch length (courtesy [32]).

6.4 Foot-head linear techniques

Available standard crutch length.

length.

Figure 10.

Prosthesis

Table 1.

crutch length.

crutch length.

axillary crutch length.

6.5 Arm-span techniques

74

• 77% of height of user is estimated to predict axillary crutch length.

Crutch placement (to support the affected limb) during stair case climbing using axillary crutches.

Pediatric 4<sup>0</sup>

Youth 4<sup>0</sup>

Adult 5<sup>0</sup>

Tall adult 5<sup>0</sup>

Axillary crutch Height range

<sup>0</sup>″–4<sup>0</sup> 6″

<sup>6</sup>″–5<sup>0</sup> 2″

<sup>2</sup>″–5<sup>0</sup> 10″

<sup>10</sup>″–6<sup>0</sup> 6″

• 75% of height of user is estimated to predict axillary crutch length.

• Height of user minus 16 inches (40.6 cm) is estimated to predict axillary crutch

• 77% of height of user plus footwear (2.54 cm) is estimated to predict axillary

• 75% of height of user plus footwear (2.54 cm) is estimated to predict axillary

• Height of user with FW minus 16 inches (40.6 cm) is estimated to predict

• 77% of arm span of user is estimated to predict axillary crutch length.


bearing status, functional capacity and learning ability. Prior to ambulation using

• The handgrips should be attached sturdily and not move when pressure

• There should be no dents, cracks or any irregularities on the crutch.

The following instructions should be given to the users before usage:

distance the crutch should be move should be within arm length.

• Axillary pads should be close to chest wall to improve lateral stability.

• Users should avoid pivoting when turning around, rather short circle

The following weight bearing status can be used with walkers: non-weight bearing (NWB), touch down weight bearing (TDWB), partial weight bearing (PWB), weight bearing as tolerated (WBT), full weight bearing (FWB) (Table 4). Progression of axillary crutch walking is from non-weight bearing to partial weight bearing. Three-point gait first followed by four-point gait then two-point

When in bed, the user first moves to a sitting position and maintain balance. The user then inches forward to the edge of the bed or the chair (users can also first transfer to an armless chair). The user picks up the crutches with upper limb of the affected side. Both axillary crutches are then placed upright and same side of the injured side. Using the armrest of the chair and the crutches handgrips as support, the user slowly moves the injured leg forward, moving out of the chair and rising up on the uninjured leg and the crutches. The user then position the crutches properly and then balances up in preparation to move, using any of the available weight bearing status that can be accommodated based on the user's condition.

On getting to the chair, the user is instructed to turn and back up against the chair, moving backward until the back of the legs touches the chair. While bearing weight on the uninjured leg, and the crutches on either side of the user, the injured

• Users should maintain good posture (hyper flexion of the head, neck and trunk

• Users should avoid resting (i.e., bearing body weight) on the axillary pad.

• Users should avoid moving the crutches too far away during ambulation. The

crutches, the following safety and precautions should be checked:

• The ferrules should not be loose or worn out.

Ambulatory Devices: Assessment and Prescription DOI: http://dx.doi.org/10.5772/intechopen.89886

• None of the component in the crutch should be loose.

applied.

should be avoided).

movement should be used.

6.11 Standing from lying position with crutches

gait (Figure 11).

6.12 Sitting with crutches

77

• All the push button should be made visible and at same level.

Table 3.

Available elbow crutch length.

The measurement of ideal axillary crutch length is measured in standing position. Potential user assumes a relax position (posture), measurement of a distance of 1.5–2 inches (3.8–5.1 cm) is made below the anterior axillary fold of the shoulder to a point 4–6 inches (10.2–15.2 cm) anterior and lateral to fifth toe of the ipsilateral limb.

Elbow crutch: this is also known as Lofstrand and Canadian crutch. It has the following components a single fore arm cuff (vinyl-coated, leather, plastic or rubber), a hand grip, and a single uprights vertical post (allow height adjustment) covered with a ferrule distally. The adjustment of the handgrip and upright bar are by using push button mechanism. The vertical bar is made of different materials such as wood, hard plastic, stainless steel, aluminum steel and iron.

Adjustment of height of the elbow crutch and the handgrip is standardized in an inch distance (2.54 cm). Adult elbow crutch range from 29 to 35 inches (74–89 cm). Only available in youth and adult range (Table 3).
