Prepared by: GROUP 2

Oblimar, EarlOliveros, OliverOlivo, LenjenOmpoc, kin

Indication: The person walks with the frame surrounding their front and sides and their hands provide additional support by holding on to the top of the sides of the frame. Traditionally, a walker is picked up and placed a short distance ahead of the user. The user then walks to it and repeats the process. With the use of wheels and glides, the user may push the walker ahead as opposed to picking it up. This makes for easier use of the walker, as it does not require the user to use their arms to lift the walker. This is beneficial for those with little arm strength. A walker is a good tool for those who are recuperating from leg or back injuries. It is also commonly used by persons having problems with walking or with mild balance problems. Also related is a hemi-walker, a walker about half the size of a traditional walker which is intended for use by persons whose dexterity is limited or non-existent in one hand or arm. These walkers are more stable than a quad cane (a cane with four points that touch the ground, as opposed to one), but are not recommended as highly as a traditional walker for those who can use it.

A cane (or walking stick) is a simple crutch used as a mobility aid by an injured or disabled person. A cane can serve several different functions as appropriate to the needs of the individual user; it can aid balance, it can support a weakened or painful limb or joint, and it can aid in sensing the environment. Users may use either a single cane, usually in the hand opposite the affected limb, or may use one in each hand where greater support is needed or both legs are affected.

Parts of medical canes:

Handle -The handle of a cane is extremely important to the user. Many different styles exist, the most common traditional designs are the Tourist, or crook handle, the Fritz Handle and the Derby Handle. Ergonomically shaped handles have become increasingly common for canes intended for medical use, both increasing the comfort of the grip for the user (particularly important for those users with disabilities which also affect their hands or wrists), and better transmitting the load from the user's hand and arm into the shaft.

Collar- The collar of a cane may be only a decorative addition made for stylistic reasons, or may form the structural interface between shaft and handle.

Shaft  -The shaft of the cane transmits the load from the handle to the ferrule and may be constructed from carbon fiber polymer, metal, composites, or traditional wood.

Ferrule  -The tip of a cane provides traction and added support when the cane is used at an angle. Many kinds of ferrules exist, but most common is a simple, ridged rubber stopper. Users can easily replace a ferrule with one that better suits their individual needs.

Aglet -The end of a cane

How to Choose and Use a Cane Care GuideA cane is a stick used to give you support and balance when walking. Most canes are made of metal, wood, or plastic.Why do I need to use a cane?You may need to use a cane if you are weak on one side of your body. If you have balance problems you may also need to use a cane. The cane may decrease your pain when walking because it takes weight off your leg and joints. Using a cane may help you to feel less tired.What kind of cane should I use?There are many kinds of canes. A cane can be made longer or shorter to fit your height. Your caregiver will help choose the cane that is right for you. The ends of the canes usually have nonskid rubber tips to prevent them from slipping. You can buy canes at drug stores and medical supply stores. The following are 3 kinds of canes:

•Standard canes: This type of cane is usually made of wood or metal. The cane may be 34 to 42 inches (86 to 107 cm) long and may have a rounded crook handle. This cane is easy to use and is usually not very expensive. Try to get a cane that has a wooden or plastic handle instead of metal. A metal handle may slip from your hand if your hand sweats. In cold weather the metal handle may get too cold for you to touch.

•Straight-handled canes: This cane may also be called a "T-handle cane" and is usually made of wood, plastic, or metal. You may need this type of cane if your hand is weak. Using a T-handle cane may help you be more steady when you walk. It is important that the height of the cane is correct for you.

•Broad-based canes: This is a lightweight metal cane with 3 or 4 short legs. These legs give you a lot of support. The legs also allow the cane to stand-up when not in use. You may need this type of cane because it is hard for you to keep your balance.

How do we use the cane?Your caregiver will teach you how to use your cane. The following steps may also help you learn to get in and out of a chair and to walk using a cane.•Using your cane to get into a chair:

Stand with the back of your legs against the chair seat.Rest the cane against the chair.Reach back with both hands to grip the chair arms.Put your weaker leg slightly off the floor.Put all your weight on your stronger leg.Slowly sit down and slide backwards into the chair.

•Using your cane to get out of a chair:Hold your cane with your stronger hand.Grasp the arms of the chair.Put your stronger foot a little forward.

Lean a little forward and push on the arms of the chair to raise yourself.Stand with your cane about 4 inches (10 cm) to the side of your stronger foot.Wait a few seconds to get used to standing before you start walking.

•Using your cane to walk on flat floors:Put the cane about 4 inches (10 cm) to the side of your stronger leg.Put weight on your stronger side.Move the cane about 4 inches (10 cm) in front of your stronger leg, bringing your weaker leg forward at the same time.

You may find it helpful to use a cane if you have a small problem with balance or instability, some weakness in your leg or trunk, an injury, or pain. If you are elderly, a single point cane may also help you to keep living independently. Proper Positioning The top of your cane should reach to the crease in your wrist when you stand up straight. Your elbow should bend a bit when you hold your cane. Hold the cane in the hand opposite the side that needs support. Walking When you walk, the cane and your injured leg swing and strike the ground at the same time. To start, position your cane about one small stride ahead and step off on your injured leg. Finish the step with your normal leg. Stairs To climb stairs, grasp the handrail (if possible) and step up on your good leg first, with your cane in the hand opposite the injured leg. Then step up on the injured leg. To come down stairs, put your cane on the step first, then your injured leg, and finally the good leg, which carries your body weight.

Tips for using your cane safely:Wear shoes with rubber soles, such as tennis shoes. Slippers should not be worn because they can slide off your feet and cause a fall. Do not wear shoes with leather heels or soles that may slide and cause you to fall.Check the floor to be sure it is safe for using the cane. The floor must be clean, dry, and well lit. Remove throw rugs to prevent falls. Tape or nail down loose carpet edges. Keep the traffic areas and the floor free of clutter.Stand a few seconds before you start moving with your cane. This will get your body used to standing. Do not start walking if you are dizzy.Look straight ahead when you are walking. You may run into or trip over something if you are looking at your feet.To carry light things while using your cane, use a backpack or carry a bag. Do not try to carry heavy things.

Crutches:A wooden or metal vertical prop that helps support a disabled person while

he or she is walking. Crutches extend from the walking surface to either the armpit or the arm. A typical hardwood armpit crutch has a 20-inch length of 1"x1" wood at the bottom to which are attached 2 other lengths of about 4 feet or longer that taper upward and outward, like the letter "Y," to a maximum width of about 5 inches at the top. Across the top is a padded or unpadded horizontal piece 6 to 8 inches wide that fits under the armpit to support the body. In the middle of the crutch, between the tapering shafts, is a crosspiece used as a handgrip. Holes, bolts and wing nuts in the sides of the bottom shaft and the two tapering top shafts allow the user to adjust the length of the crutch and the position of the handgrip. A typical aluminum armpit crutch has a similar design and may have push buttons to allow for easy adjustment. Arm crutches typically are metal and have a single shaft with a projecting handgrip and a cuff that closes around the arm. Crutches usually have a nonskid rubber tip on the bottom. "Crutch" is often used figuratively to refer to an inadvisable measure a person uses to bear up under stress, anxiety or depression. Crutches of this kind include alcohol, drugs and tobacco."Crutch" is derived from the Middle English words "crutche" and "crucche.“

Why use crutches?If used correctly, crutches can accelerate the healing of certain

injuries by reducing potentially detrimental weight bearing forces during walking or standing. This allows healing to take place in

the absence of further tissue damage, thereby accelerating recovery. Crutches may also improve mobility and walking

technique. In addition, patients who use crutches correctly may be less likely to develop other injuries due to compensatory

walking strategies (i.e. limping).

When should crutches be used?As a general rule, if walking is painful and causing you to limp due to your injury, crutches are most likely to be useful. The suitability of crutches can be confirmed by a physiotherapist.

Crutches are also indicated for conditions including: most surgical procedures or fractures of the lower limb

most moderate to severe sprains of the ankle, knee or hip moderate to severe muscle strains of the lower limb

All patients using crutches should see their physiotherapist to ensure their crutches are fitted and used correctly and that it is

appropriate to use them.

How much weight should I be placing through my injury when using crutches?

The degree to which crutches should be used to reduce weight bearing forces varies from injury to injury. In some conditions, no weight should be placed through the affected region for a period

of time. In these instances, full body weight should be placed through the crutches. This should be guided by your

physiotherapist and is generally reserved for fractures or during the first few days following severe sprains and strains of the

lower limb. In most injuries, however, some weight bearing force placed through the affected region is beneficial, with the

remaining bodyweight placed through the crutches. As a general rule, when using crutches, weight should be taken off the affected limb so walking is pain-free and does not cause you to limp. If you experience pain with rest after walking with crutches, or the following morning after walking with crutches,

then you have been putting too much weight through your injured leg. In these instances, it is advisable to place more

weight through the crutches to prevent soreness with rest or the following morning.

Crutch pad distance from armpits – the crutch pad (top of the crutches) should be 1.5” to

2” below the armpits, with shoulder relaxed.

Handgrip – place it so your elbow is flexed about 15 to 30 degrees – enough so you can

fully extend your elbow when you take a step.

Crutch length (top to bottom) – the total crutch length should equal the distance from your

armpit to about 6” in front of a shoe.

Using crutches when going up and down on stairs

Going up:Step up with the strong leg and weight should be on the hand grip. The weak/ operated leg follows. Put no weight on the weak legThe crutches are brought up last. If presence of cast be sure your toes clear the steps before proceeding the next step.

Going down:

Place both crutches on the stairs belowStep down with the weak leg Push down on the handgrip and step down the stronger leg.Place the crutches down again and proceed.

Different ways to use crutches ti assist with ambulation or walking.

Four- point gait:Indicated for weakness in both legsAdvance the right crutch followed by the left foot; then the left crutch followedBy the right foot.

Right crutch↓

Left foot↓

Left crutch↓

right foot

Two point gait:Indicated with weakness but good coordination and arm strength Advance the right crutch and left foot together then the left crutch and right foot together.

Right crutch and left foot↓

Left crutch and right footThree point gait

Three point gait:Indicated for inability to bear weight on one leg (fractures, pain, amputation)Advance both crutches and weak leg together followed by the strong leg.

Both crutches and weak leg↓

Strong leg

Swing through gait:Indicated to fully bear weight on both legsAdvance both crutches, swing the body so that the feet will be past the level of crutches

Swing to gait:Indicated with patients have weakness of both lower extremities. Advance both crutches, swing the body so that the feet will be to the level of the crutches

Important rules for safety and comfort:

Don’t look down. Look straight ahead as you normally do when you walkDon’t use crutches if you feel dizzy or drowsyDon’t walk on slippery surfaceDon’t put any weight in your foot if your doctor has so advised.Make sure your crutches have rubber tipsDo wear well fitting low heel shoesDo position handgrips correctly do keel pads below your armpit.Watch out for and remove loose items on the floor such as rugs, electrical cords, toys or anything else that you could trip over. Simplify your household to keep the items you need handy. Put everything else out of the way. Carry a backpack or sling-type messenger bag so you have a place to put things that are easy to reach and out of the way. Take short steps and rest often. Keep most of your weight on your hands rather than on your armpits.

Wheelchair:

A wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it's propelled by motors or by the seated occupant turning the rear wheels by hand. Often there are handles behind the seat for someone else to do the pushing. Wheelchairs are used by people for whom walking is difficult or impossible due to illness (physiological or physical), injury, or disability. People with both sitting and walking disability often need to use a wheelbench.

The earliest record of wheelchairs dates back to the 6th century, as an inscription found on a stone slate in China. Later dates relate to Europeans using this technology during the German Renaissance. Harry Jennings and his disabled friend Herbert Everest, both mechanical engineers, invented the first lightweight, steel, collapsible wheelchair in 1933. Mr Everest had broken his back in a mining accident. The two saw the business potential of the invention and went on to become the first mass-manufacturers of wheelchairs: Everest and Jennings. Their "x-brace" design is still in common use, albeit with updated materials and other improvements

Types of wheelchair:

Basic manual wheelchair incorporates a seat, foot rests, handles at the back and four wheels: two castor wheels at the front and two large wheels at the back.

electric wheelchair shown on the right is fitted with Mecanum wheels (sometimes known as Ilon wheels) which give it complete freedom of movement. It can be driven forwards, backwards, sideways, and diagonally, and also turned round on the spot or turned around while moving, all operated from a simple joystick.Manual or self-propelled wheelchairs are propelled by the occupant, usually by turning the large rear wheels, from 20-26 inches in average diameter, and resembling bicycle wheels. The user moves the chair by pushing on the handrims, which are made of circular tubing attached to the outside of the large wheels.transport wheelchairs are usually light, folding chairs with four small wheels. These chairs are designed to be pushed by a caregiver to provide mobility for patients outside the home or more common medical settings

Attendant-propelled chairs are designed to be propelled by an attendant using the handles, and thus the back wheels are rimless and often smaller. These chairs are often used as 'transfer chairs' to move a patient when a better alternative is unavailable, possibly within a hospital, as a temporary option, or in areas where a user's standard chair is unavailable. These chairs are commonly seen in airports. Special airplane transfer chairs are available on most airlines, designed to fit narrow airplane aisles and transfer wheelchair-using passengers to and from their seats on the plane.Wheelbase chairs are wheeled platforms with specially-molded seating systems interfaced with them for users with a more complicatedposture. A molded seating system involves taking a cast of a person's best achievable seated position and the either carving the shape from memory foam or forming a plastic mesh around it. This seat is then covered, framed, and attached to a wheelbase.Electric-powered wheelchair is a wheelchair that is moved via the means of an electric motor and navigational controls rather than manual power.Bariatric wheelchair is one designed to support larger weights; most standard chairs are designed to support no more than 250 lbs. on average.Pediatric wheelchairs are another available subset of wheelchairs. Hemi wheelchairs have lower seats which are designed for easy foot propulsion. The decreased seat height also allows them to be used by children and shorter individuals.

Sports variants

Disabled athletes use sport wheelchairs for disabled sports that require speed and agility, such as basketball, rugby, tennis and racing.

Powerchair Football/Power SoccerA new sport has been developed for powerchair users called powerchair

football or power soccer. It is the only competitive team sport for powerchair users. The Federation Internationale de Powerchair Football Associations

(FIPFA) governs the sport and is located in Paris, France with country

affiliates around the world.

A wheelchair-swing on a playground in New Zealand.

An antique wheelchair

Wheelchair fitted with Mecanum wheels, taken at an exhibition in the early 1980s.Electric wheelchair