Assistive Devices: One size does NOT fit all

Walkers, crutches and canes – oh my! Assistive devices are great tools to help those who need them increase both functional ability and safety. When someone is in need of a particular assistive device it is important to not only choose the right device for their needs, but to also make sure that it is adjusted appropriately in order to provide them with optimal function and safety. Often, people are either given or go out and buy an assistive device without any guidance on how to size it correctly. Using a device that isn’t appropriately fitted can cause safety hazards but also can put strain on other parts of your body. Below you will find general guidelines to adjusting common assistive devices.

Walkers 
– Use the buttons on the legs of the walker to make them shorter and longer.
– Make sure each leg leg of the walker is set to the same level.
– The handgrip of the walker should be at the level of the crease of your wrist with your arms down at your sides.
– If the walker is too high it will cause increased bending of the elbows and cause increased strain on the shoulders.
– If the walker is too low it will cause the person using it to slump forward, causing strain to the back.

Canes
– Similar to walkers, the height of a cane should be set to where the handle of the cane is at the level of the crease of your   wrist with your arms down at your sides.
– The potential consequences of setting a cane too high or too low are the same as with walkers with the addition of possible leaning of the trunk which can cause a higher risk for falls.

Crutches
– When sizing crutches, the bottom tips should be a few inches in front and to the side of your feet.
– Similar to walkers and canes, the hand grips the crutches should be level with the crease of the wrist with your arms down at your sides.
– The top of your crutches should be about 2 inches below your armpit.
– If crutches are adjusted too high, it can cause the top of the crutch to put increased pressure on the armpit which can lead to possible nerve damage.
– If adjusted too low, it can cause the individual to slouch over which can put strain on the back but also have an impact on the person’s balance.

These are only the guidelines for a few of the most common assistive devices seen in the community. There are many other types of devices that each have their own sizing standards for optimal use. If you or someone you know needs assistance in sizing a device, please consult a physical therapist to assist you to ensure a proper fit.

Written by: Dr. Taylor Ryan