Gait aids are tools designed to assist human movement and stability, providing support for individuals experiencing difficulty with walking. They are commonly used following an injury or surgery to facilitate recovery, or as a long-term solution for chronic conditions that affect balance, strength, or endurance. This article will define these devices, categorize the different types, and provide essential information on proper sizing and safe techniques for use.
Defining Gait Aids and Their Function
A gait aid is any device used to improve a person’s locomotion by enhancing support, stability, or balance while moving. These aids work primarily by increasing the user’s base of support, which is the area beneath their body that maintains balance. By widening this base, they help maintain the body’s center of gravity over a larger area, reducing the risk of a fall.
The use of an aid can reduce pain by shifting weight away from an affected limb, decreasing the load on injured joints, muscles, or bones. This allows for reduced weight bearing on a painful or weak extremity, which is important during rehabilitation. Gait aids also compensate for muscle weakness or poor coordination, improving the user’s confidence and conserving energy.
Categorizing Types of Mobility Aids
Mobility aids are broadly categorized based on the degree of stability and support they provide. Canes represent the simplest form, offering minimal support primarily for balance assistance or to offload a small amount of weight. Single-point canes are suitable for mild balance issues. Quad canes, featuring four feet, offer a broader base of support for users needing greater stability.
Crutches provide more substantial support, allowing a user to bear little to no weight on an affected lower limb, often required after acute injuries or surgeries. Axillary, or underarm, crutches are the most common. They are designed to transfer the body’s weight through the hands and arms, not the armpits, to prevent nerve damage. Forearm crutches, also known as Lofstrand crutches, provide support with a cuff around the forearm for individuals requiring long-term support.
Walkers offer the maximum level of stability and are typically used by individuals requiring extensive balance support or those with significant weakness. Standard walkers must be lifted to move forward, providing a stable, four-point base for users with severe balance impairment. Wheeled walkers, including rollators, allow the user to push the device rather than lift it, which is ideal for covering longer distances.
Ensuring Proper Sizing and Fit
The correct adjustment of a gait aid is important for safety and function, as an improper fit is a leading cause of misuse and potential falls. A general principle for all walking aids is that the handle or handgrip should align with the user’s wrist crease when standing upright with arms relaxed at their sides. This ensures the elbow is bent at an angle of approximately 15 to 30 degrees when grasping the handle, which is necessary for effective weight bearing and shock absorption.
For a cane, this wrist crease alignment determines the proper height. When using crutches, there are two adjustments: the handgrip height and the overall height. The top of the axillary crutch pad should be positioned two to three finger-widths below the armpit to prevent nerve pressure. Weight must always be placed on the handgrips, not the underarm pads, to avoid nerve damage.
Walkers should also be adjusted so the handgrips align with the wrist crease, allowing for that slight elbow bend. This height ensures the user maintains an upright posture and avoids hunching over. Correct sizing maximizes effectiveness, reduces strain on upper body joints, and promotes a safer walking pattern.
Safe Techniques for Movement and Navigation
Safe movement with a gait aid begins with employing the correct gait pattern, which depends on the user’s weight-bearing status. For maximum stability, the aid is typically advanced first, followed by the affected or weaker leg, and then the stronger leg. This three-point pattern allows the aid to bear the weight while the weaker leg moves, transferring the weight to the strong leg for the final step. The aid is generally held on the side opposite the affected leg to provide the best leverage and balance.
Standing up and sitting down safely requires using the arms of the chair for support, not the gait aid itself. The user should back up until they feel the chair against the back of their legs. They then place both hands on the chair’s armrests before lowering themselves down. The reverse process is used to stand, pushing off from the armrests with the strong leg slightly extended forward to maintain balance.
Navigating stairs and curbs requires a specific sequence of movements often summarized as “up with the good, down with the bad.” When ascending, the stronger leg steps up first, followed by the aid and the weaker leg. When descending, the aid and the weaker leg move down to the next step first, and the stronger leg follows.
Users should always use a handrail if available and keep the aid close to their body to maintain a stable center of gravity. Regular checks of the rubber tips, or ferrules, on the aid’s feet are necessary. Worn tips can significantly increase the risk of slipping, especially on smooth or wet surfaces.