Who, What, When, Where, Why, How?? Assistive Devices

Assistive devices help people keep their independence, and allows you to move around on your own, most of the time, without help from others. Doctors, and physical therapists may recommend and prescribe you to get an assistive device, but you do not need their recommendation to get one if you feel as if you need one on your own.

WHO needs an assistive device?

  • Typically seen in the geriatric population, especially for people who have fallen or are at risk for falls
  • Can be prescribed to post-surgical patients by their Dr. to help them move around easier and protect surgical site
  • Any populations that have a genetic condition, (such as muscular dystrophy, cerebral palsy…etc.) that hinders their ability to move around under their own power

WHAT is an assistive device?

  • Any device that ASSISTS people in moving around throughout the day
  • Typically seen devices include, but are not limited to,
    • Wheelchairs
    • Walkers
    • Rollators
    • Crutches
    • Quad Canes/Single Point Canes
    • Power Wheelchairs.

WHEN do I need to use an assistive device?

  • Whenever you feel like you need it. There is no right or wrong answer here and comes down to your comfortability moving around your surroundings, whether in your own home or in public spaces

WHY do I need an assistive device?

  • Your doctor prescribes it for you after a surgery, to allow the surgical site and procedure to heal properly
  • You have fallen, or are at risk for falls, ADs may help prevent further or future falls and give you the confidence to move around
  • Your ability to move around has become impaired, whether is from a genetic condition, developed condition, surgery, injury…etc. ADs may help you regain some independence and give you the ability to move around again

WHERE do I get an assistive device?

  • Contact your Doctor or physical therapist for more information on where to obtain an appropriate assistive device, as they have more information and connections to ensure you get the proper equipment.
  • Contact your insurance company, as some companies may cover the cost of your assistive device if you utilize a resource they recommend.
  • Online sites sell assistive devices, but be sure to look at the reviews to ensure you are getting the correct device, as well as good equipment.

HOW do I use my assistive device?

  • Canes
    • Ensure the cane fits YOU properly!
      • The cane should go on the opposite side of your injury or weaker side
      • The grip of the cane should align with the crease of your wrist when you are standing upright
      • There should be a slight bend in your elbow
    • How to move using your cane!
      • Keep the cane slightly in front of and to the side of your body
      • As you move your injured or weak leg, move the cane with it as well
      • As you move your strong leg, put weight through the cane to take some of the load off your injured or weaker leg. The cane should remain on the ground at all times when putting weight through it!
  • Walker
    • Ensure the walker is the proper device for you and fits YOU properly!
      • The handles of the walker should align with the crease of your wrists when you are standing upright
      • There should be a slight bend in your elbows
    • How to use your walker!
      • DO NOT USE YOUR WALKER TO STAND UP, PUSH OFF THE CHAIR, SOFA…ETC TO STAND UP AS THE WALKER CAN TIP AND CAUSE YOU TO FALL
      • Make sure to stand upright, do not lean forwards or backwards to avoid falling
      • Remain inside the base of your walker, do not move the walker too far in front of you when walking
      • Make sure all 4 legs of the walker are on the ground at all times
      • When walking, move the walker slightly forward, use your arms to take the load off the weaker or injured leg and step fully back into the walker
  • Wheelchair
    • Ensure the wheelchair fits you properly!
      • When sitting in the chair, your hips and knees should form 90/90 angles. Your knees should not align above your hips.
      • There should be space between the back of your knees and the wheelchair cushion to avoid rubbing
      • Ensure there is about a 2 inch space between the edge of your legs and the arm rests of the chair
      • Ensure the back rest is not too high or too low. Too high will hinder your ability to propel the wheelchair forwards, and too low will not provide enough trunk support.
    • How to use your wheelchair!
      • When you are not moving, or plan to get out of the wheelchair,  make sure to lock both brakes.
      • To go straight forwards, push both arms forwards, to go straight backwards, pull both arms back
      • To turn left, hold the left wheel so it does not move and push the right wheel forwards. To turn right, hold the right wheel so it does not move and push the left wheel forwards.
  • Crutches
    • Ensure the crutches fit YOU properly!
      • Make sure the crutches are not jammed up into the armpit, this can injure the nerves that reside there. Ensure there is about 2 inches of space between the crease of your armpit and the top of the crutch, which can be placed on the side of your chest.
      • The handles of the crutch should align with the crease of your wrists when standing upright
      • The bottom of the crutches should be slightly wider than your shoulder width
    • How to use your crutches!
      • Check to see if you have any precautions, such as weight bearing as tolerated (WBAT) or non-weight bearing (NWB) given to you by your doctor or surgeon.
      • WBAT
        • Weight should be dispersed through both lower extremities and arms
        • Crutches should both be moved forward as your non injured leg takes on the majority of the weight and the injured leg takes as much weight as tolerated.
        • One crutches have been moved, allowing your arms to take on the majority of the weight and move lower extremities forwards by stepping and putting weight through them.
      • NWB
        • Put all your weight through your arms and non affected leg (if applicable)
        • Crutches should both be moved forward as your non injured leg takes on the weight.
        • One crutches have been moved, allow your arms to take on the weight and move lower extremities forwards

Preventing Falls

  1. Check your medications with a health care provider. Bring a list of your medications with you to your
    appointment. Your health care provider can go over the medication side effects for side effects and
    interactions that can increase your risk for falls.
  2. Make sure you have adequate lighting inside and outside of your home to prevent the risk of falls.
  3. If you have had a fall, write down the date and time of the fall. Please be prepared to discuss how the
    fall happened, where the fall occurred, and if you received medical follow up. Also, be prepared to
    discuss any almost falls, where you caught yourself or someone else prevented your falls. Please be
    prepared to discuss how many falls and almost falls occurred within the last year.
  4. Please be prepared to discuss any health conditions that may result in dizziness and falls. For example,
    do you have eye or ear disorders?
  5. Please remove throw rugs from your home. If you want to keep throw rugs, please make sure that the
    rugs have a non-slip backing or tack down the rug.
  6. See a physical therapist that can set up an exercise and walking program to keep you moving for fall
    prevention. The more active you are the less likely you will have a fall.
  7. Wear sensible shoes. High heels, floppy shoes and slippers can lead to falls. Shoes with slick soles and
    stocking feet can lead to falls.
  8. Remove objects, i.e., boxes, electrical cords, phone cords, and papers from the pathways.
  9. Move plant stands and coffee tables from high traffic areas.
  10. Use bathmats with non-slip surface in the shower.
  11. Install handrails for both sides of the stairs.
  12. If needed grab bars in the shower as well as a shower chair
  13. If you are using an assistive device please walk with the device at all times.
  14. Place night lights or adequate lighting in all rooms, including the stairs.
  15. Store flashlights in an easy accessible place in case the power goes out.

Do You Have Shin Pain?

You may be suffering from Medial Tibial Stress Syndrome (Shin Splints).

Physiology: Repetitive stress and force on lower extremity from activities such as running and jumping can cause inflammation in tissues, muscles and tendons within the lower extremity that pulls on shin bone, causing achy or sharp pain on medial, lateral or both aspects of shin.

Who's affected: Commonly runners, dancers, athletes, military personnel are affected by shin splints, but anyone who increases physical activity levels significantly can be affected.

Causes: Repetitive overloading of the lower extremity muscles, insufficient arch (flat feet), muscular imbalances and improper footwear.

Prevention: Proper warm up before exercises (heel raises, toe raises, ankle circles..etc), ramp up to target activity (if you are accustomed to running 1 mile, do not immediately jump up to 3 miles, instead progress to 1.25 miles and slowly work up to 3 miles).

Treatment: REST! Allow your muscles and tissues to heal before resuming activity, Cross training (stretching and strengthening of lower extremities and feet), Soft tissue and trigger point release, ice and antiinflammatories to control pain and inflammation.

If you are unable to treat yourself, our amazing therapist's can put together a treatment plan that will help you get back on your feet and doing what you love!