Crutch
Encyclopedia
Crutches are mobility aids
used to counter a mobility impairment or an injury that limits walking ability.
Forearm : Forearm crutches are crutches with a cuff at the top to go around the forearm, and are also known as the Lofstrand crutch. They have been the type most commonly used in Europe
; in the United States
and Canada, they have been almost exclusively used by people with permanent or lifelong disabilities. However, American orthopaedic surgeons are now beginning to prescribe forearm crutches for patients with shorter-term needs. Forearm crutches are used by slipping the arm into a cuff and holding the grip. The cuff, typically made of plastic or metal, can be a half-circle or a full circle with a V-type opening in the front allowing the forearm to slip out in case of a fall.
Underarm : In the United States underarm crutches are used most often by people with temporary disability
or injury
. These are used by placing the pads against the ribcage beneath the armpits and holding the grip, which is below and parallel to the pad. These are sometimes known as axillary crutches.
Strutters : These are a variation on underarm crutches, incorporating large soles which remain flat on the floor or ground while the user walks. They allow for an improved walking gait, and distribute body weight to reduce the risk of nerve damage caused by underarm crutches.
Platform : These are less common and used by those with poor hand grip due to arthritis
, cerebral palsy
, or other condition. The arm rests on a horizontal platform and is strapped in place. The hand rests on a grip which, if properly designed, can be angled appropriately depending on the user's disability.
Leg Support : These non-traditional crutches are useful for users with an injury or disability affecting one lower leg only. They function by strapping the affected leg into a support frame that simultaneously holds the lower leg clear of the ground while transferring the load from the ground to the user's knee or thigh. This style of crutch has the advantage of not using the hands or arms while walking. A claimed benefit is that upper thigh atrophy
is also reduced because the affected leg remains in use. Unlike other crutch designs these designs are unusable for pelvic, hip or thigh injuries and in some cases for knee injuries also.
With underarm crutches, sometimes a towel or some kind of soft cover is needed to prevent or reduce under arm injury. A condition known as crutch paralysis, or crutch palsy can arise from pressure on nerves in the armpit, or axilla. Specifically, "the brachial plexus
in the axilla is often damaged from the pressure of a crutch...In these cases the radial
is the nerve most frequently implicated; the ulnar nerve
suffers next in frequency".
and the wheelchair
are possible alternatives for patients who cannot use or do not like crutches. These wheeled devices introduce an additional limitation, however, since they cannot negotiate stairs.
Different variations of walking and mobility devices have appeared on the market, notably one called the Strongarm Forearm Crutch, which is a combination between a traditional walking cane and forearm crutch. The inventor of the Strongarm Forearm Crutch, Michael E. Adams of patented this device
Mobility aids
Mobility aids are devices designed to assist walking or otherwise improve the mobility of people with a mobility impairment.There are various walking aids which can help with impaired ability to walk and wheelchairs or mobility scooters for more severe disability or longer journeys which would...
used to counter a mobility impairment or an injury that limits walking ability.
Types
There are several different types of crutches:Forearm : Forearm crutches are crutches with a cuff at the top to go around the forearm, and are also known as the Lofstrand crutch. They have been the type most commonly used in Europe
Europe
Europe is, by convention, one of the world's seven continents. Comprising the westernmost peninsula of Eurasia, Europe is generally 'divided' from Asia to its east by the watershed divides of the Ural and Caucasus Mountains, the Ural River, the Caspian and Black Seas, and the waterways connecting...
; in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
and Canada, they have been almost exclusively used by people with permanent or lifelong disabilities. However, American orthopaedic surgeons are now beginning to prescribe forearm crutches for patients with shorter-term needs. Forearm crutches are used by slipping the arm into a cuff and holding the grip. The cuff, typically made of plastic or metal, can be a half-circle or a full circle with a V-type opening in the front allowing the forearm to slip out in case of a fall.
Underarm : In the United States underarm crutches are used most often by people with temporary disability
Disability
A disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
or injury
Injury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...
. These are used by placing the pads against the ribcage beneath the armpits and holding the grip, which is below and parallel to the pad. These are sometimes known as axillary crutches.
Strutters : These are a variation on underarm crutches, incorporating large soles which remain flat on the floor or ground while the user walks. They allow for an improved walking gait, and distribute body weight to reduce the risk of nerve damage caused by underarm crutches.
Platform : These are less common and used by those with poor hand grip due to arthritis
Arthritis
Arthritis is a form of joint disorder that involves inflammation of one or more joints....
, cerebral palsy
Cerebral palsy
Cerebral palsy is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement....
, or other condition. The arm rests on a horizontal platform and is strapped in place. The hand rests on a grip which, if properly designed, can be angled appropriately depending on the user's disability.
Leg Support : These non-traditional crutches are useful for users with an injury or disability affecting one lower leg only. They function by strapping the affected leg into a support frame that simultaneously holds the lower leg clear of the ground while transferring the load from the ground to the user's knee or thigh. This style of crutch has the advantage of not using the hands or arms while walking. A claimed benefit is that upper thigh atrophy
Atrophy
Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations , poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, disuse or lack of exercise or disease intrinsic to the tissue itself...
is also reduced because the affected leg remains in use. Unlike other crutch designs these designs are unusable for pelvic, hip or thigh injuries and in some cases for knee injuries also.
Walking sticks (canes)
Walking sticks or canes serve an identical purpose to crutches, but are held only in the hand and have a limited load bearing capability because of this.Information on use
Several different gait patterns are possible, and the user chooses which one to use depending on the reason the crutches are needed. For example, a person with a non-weight bearing injury generally performs a "swing-to" gait: lifting the affected leg, the user places both crutches in front of himself, and then swings his uninjured leg to meet the crutches. Other gaits are used when both legs are equally affected by some disability, or when the injured leg is partially weight bearing.With underarm crutches, sometimes a towel or some kind of soft cover is needed to prevent or reduce under arm injury. A condition known as crutch paralysis, or crutch palsy can arise from pressure on nerves in the armpit, or axilla. Specifically, "the brachial plexus
Brachial plexus
The brachial plexus is a network of nerve fibers, running from the spine, formed by the ventral rami of the lower four cervical and first thoracic nerve roots...
in the axilla is often damaged from the pressure of a crutch...In these cases the radial
Radial nerve
The radial nerve is a nerve in the human body that supplies the upper limb. It supplies the medial and lateral heads of the triceps brachii muscle of the arm, as well as all 12 muscles in the posterior osteofascial compartment of the forearm and the associated joints and overlying skin.It...
is the nerve most frequently implicated; the ulnar nerve
Ulnar nerve
In human anatomy, the ulnar nerve is a nerve which runs near the ulna bone. The ulnar collateral ligament of elbow joint is in relation with the ulnar nerve. The nerve is the largest unprotected nerve in the human body , so injury is common...
suffers next in frequency".
Alternative devices
The knee scooterKnee scooter
A knee scooter or knee walker is a three or four-wheeled alternative to crutches or a traditional walker as an ambulation aid. It is known by many other names, such as a knee walker, knee cruiser, knee caddy, orthopaedic scooter, or leg walker....
and the wheelchair
Wheelchair
A wheelchair is a chair with wheels, designed to be a replacement for walking. The device comes in variations where it is 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...
are possible alternatives for patients who cannot use or do not like crutches. These wheeled devices introduce an additional limitation, however, since they cannot negotiate stairs.
Materials
- WoodWoodWood is a hard, fibrous tissue found in many trees. It has been used for hundreds of thousands of years for both fuel and as a construction material. It is an organic material, a natural composite of cellulose fibers embedded in a matrix of lignin which resists compression...
- Metal alloyAlloyAn alloy is a mixture or metallic solid solution composed of two or more elements. Complete solid solution alloys give single solid phase microstructure, while partial solutions give two or more phases that may or may not be homogeneous in distribution, depending on thermal history...
s (most often SteelSteelSteel is an alloy that consists mostly of iron and has a carbon content between 0.2% and 2.1% by weight, depending on the grade. Carbon is the most common alloying material for iron, but various other alloying elements are used, such as manganese, chromium, vanadium, and tungsten...
, Aluminium alloyAluminium alloyAluminium alloys are alloys in which aluminium is the predominant metal. The typical alloying elements are copper, magnesium, manganese, silicon and zinc. There are two principal classifications, namely casting alloys and wrought alloys, both of which are further subdivided into the categories...
s, Titanium alloyTitanium alloyTitanium alloys are metallic materials which contain a mixture of titanium and other chemical elements. Such alloys have very high tensile strength and toughness , light weight, extraordinary corrosion resistance, and ability to withstand extreme temperatures...
s) - Carbon or glass fiber reinforced compositesComposite materialComposite materials, often shortened to composites or called composition materials, are engineered or naturally occurring materials made from two or more constituent materials with significantly different physical or chemical properties which remain separate and distinct at the macroscopic or...
- thermoplasticThermoplasticThermoplastic, also known as a thermosoftening plastic, is a polymer that turns to a liquid when heated and freezes to a very glassy state when cooled sufficiently...
- carbon fiber reinforced polymer
Patents and inventions
Emile Schlick, a French mechanical engineer, patented a walking stick that provided an oblique support at the upper end for resting the forearm. This invention was first patented in Nancy (France) on May 7, 1915. Philipp Cederstom patented a similar-looking cane crutch. Finally, the invention of A. R. Lofstrand, Jr., who filed a patent in 1945, consists of an adjustable-length crutch. In the US, forearm crutches are also sometimes referred to as Lofstrands, Canadian crutches (since they are commonly used in Canada), elbow crutches or even Walk Easies (Walk Easy is a brand name).Different variations of walking and mobility devices have appeared on the market, notably one called the Strongarm Forearm Crutch, which is a combination between a traditional walking cane and forearm crutch. The inventor of the Strongarm Forearm Crutch, Michael E. Adams of patented this device