Canes, crutches and walkers are assistive devices for patients who have an unsteady gait or weak muscles, and they reduce the burden on their physical frame, owing to age, disability or disease.
The cane is the simplest of all the mobility devices to correct gait disturbances. Gait disorders are known to fall into three types: Balance (sensory and cerebellar), motor (cerebral initiation of walking and muscular strength) and joint or skeletal problems.
According to Robert Lam, MD, MS, FCFP, physician in the Geriatric Rehabilitation Program at the Toronto Rehabilitation Institute in Ontario, Canada, a standard cane "can help stabilize a patient's gait by providing an extra contact point with the ground, therefore, increasing the base of support." If you suffer from arthritis of the hip or knee pain, an offset cane can bear your weight and offer you stability. If you are someone with paralysis, an offset four-legged quad cane could offer substantial weight bearing. According to a 2006 study in American Geriatrics Society, canes can easily support up to 15 percent to 20 percent of a patient's body weight.
What to Look for
First, is the cane meant for you? It depends on whether you need a single hand for assistance to walk, in which case a cane is what should be appropriate. But if you need someone's both hands for walking assistance, you might want to go in for a walker, instead.
Next, make sure the cane is of the right length. For enough elbow movement while walking, you may want to ensure at least 20 to 30 degrees bend in the elbow when holding the cane approximately 15 cm from the lateral border of the toes. Just measure the distance from the ground to your wrist crease with your arm hanging by your side, advises Dr. Lam in the Canadian Family Physician December 2007 issue. Choosing the most suitable walking device depends on several factors, including physical and mental coordination, ability and the walking terrain. For instance, if your home is no bigger than a small room, a large, heavy walker is out of place. A staircase can further complicate the issue. Again, a four-legged cane would require a substantial need or disability on your part.
Common Pitfalls
"Watch out for patients using their standard cane grip backward, as this might signal unsafe and excessive weight bearing," warns Dr. Lam.
According to a 2005 report in the journal Archives of Physical Medicine and Rehabilitation, canes "can also interfere with one's ability to maintain balance in certain situations, and the strength and metabolic demands can be excessive." Incorrectly used, therefore, these assistive devices can lead to falls and broken bones. Consult with a physical therapist, occupational therapist, or rehabilitation nurse, if you need to learn their correct use at home or outdoors.
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