HOW TO MEASURE CRUTCHES

“Crutches” as walking aids :

  • Are used to improve balance and to relieve weight bearing fully or partially.
  • Are used typically bilaterally and function to increase the base of support.
  • Improve the lateral stability and allow upper extremity to transfer weight to the floor.

A Physiotherapist may assist in choosing a perfect walking aid which should suit the person’s abilities and requirements.

TYPES OF CRUTCHES :

1. AXILLARY CRUTCHES:

    • These are light weight and can be made of wood or metal.
    • Axillary crutches consist of an axillary bar, hand piece, double uprights joined distally by a single leg covered with a rubber suction tip.
    • The single leg allows height variations, by alterations of screws and wing bolts in predrilled holes known as telescopic arrangements.
    • Hand grip variations can be done either by screws or push button mechanism.
    • These help to improve balance and lateral stability.
    • Provide functional ambulation and lateral stability.
    • Can be used for stair ascending and descending.

MEASUREMENT OF LENGTH :

A. IN LYING :

        • WITH SHOES OFF :
          • (most reliable method) measurement is with the help of inch tape from apex of axilla till the lower margin of medial malleolus.
        • WITH SHOES ON :
          • 5cm vertically down from apex of axilla till 20 cm lateral to the heel of the shoes.
        • Measurement from axillary pad to hand grip :
          • Elbow is flexed 15 degrees, mark a point 5 cm below the apex of axilla and measure till the ulnar styloid process.

B. IN STANDING :

          • 2” below the axilla to a point 2” lateral and 6” anterior to the foot.
          • With shoulder relaxed, the hand piece should be adjusted to provide 20-30 degress of elbow flexion.

2. ELBOW OR FOREARM CRUTCHES :

    • Usually made of aluminum.
    • The elbow crutch consists of a single upright, a forearm cuff, handgrip, and a rubber ferrule.
    • Can be adjusted both proximally to alter the position of the forearm cuff and distally to alter the height of the crutch.
    • Can come with push button mechanism.
    • Forearm cuffs allow use of hands without disengaging the crutch.
    • These are easily adjustable and allow functional stair climbing activity.
    • More cosmetic than other crutches.

DISADVANTAGES :

          • Provide less lateral support due to absence of axillary pad.
          • Cuffs may be difficult to remove.
          • These can be expensive.

MEASUREMENT OF CRUTCH LENGTH :

A. IN LYING : (shoes on)

          • Elbow is flexed to 15 degrees; measurement is taken from the ulnar styloid process to a point 20 cm lateral to the heel of the shoe.

B. IN STANDING :

          • 2” laterally and 6” anteriorly to the foot.
          • Height should be adjusted with relaxed shoulders to provide 20-30 degrees of elbow flexion.

Correct Arm Cuff Location :

      • The higher up on the forearm your arm cuff is the greater the mechanical advantage you get. However if it is too high up, the cuff will bite into your upper arm when you stoop over to pick something up from the ground.
      • Measurement should be at proximal third of the forearm i.e. 1-1.5 inches below the elbow.

DISTANCE “X” :

      • To measure the distance of the bar which attaches the cuff to the hand grip, take the distance from the cuff girth till the ulnar styloid process on the forearm.

DISTANCE “Y” :

      • To take the y measurement hook the end of the tape on the bottom of the crutch tip and measure to the top surface of the hand grip. Standing tall with your back against the wall and shoulders back, allow your hands to hang loosely against your side so that the elbows are flexed approximately at 15 degrees. Measure from the floor up to the deep crease between the palm of your hand and your wrist. It is recommended to take that measurement and add one inch to determine the Y measurement.

This measurement also can be taken in lying position by palpating the greater trochanter and taking the distance from this point till the end of lateral malleolus. (Less reliable method).

3. GUTTER CRUTCHES :

    • Made of metal, with padded forearm support and strap, has an adjustable hand piece and rubber ferrule.
    • Used for patients who require support but cannot take weight through hands, elbows and forearms due to pain and deformities.

MEASUREMENT :

A. IN LYING :

      • With shoes on: measure from the point of fixed elbow till 20 cm lateral to the heel.

Crutches are an important mobility aid. The knee scooter and the wheelchair are possible alternatives for patients who cannot use or do not like crutches.