CRUTCH WALKING ortho theory notes (2025)

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April 17, 2018Exam Articles,

CRUTCH WALKING

  • function to prevent weight bearing – eventally to walk unaided

  • muscles required for using crutches are

    • flexors of fingers and thumb to hold the hand grip firmly

    • dorsiflexion of wrist and stabilize the wrist in dorsiflexion

    • extensors of elbow to stabilize elbow in slight flexion – to take the body wt through upper limb

    • flexion of shoulder to move the walking aid forward

    • depression of shoulder girdle to support the body wt

CRUTCH WALKING ortho theory notes (1)

CRUTCH WALKING ortho theory notes (2)

  • ability to use crutches efficiently depends on

  • Crutch stance for the axillary crutch

    • patient against wall – crutches placed under each arm

    • correct stance – head up – back straight – pelvis over feet – shoulder depressed – axillary pads of crutches gripped between the lateral wall of chest and medial aspect of arm , 2 inches below the anterior axillary fold – crutch tips 6 inches forward and 6 inches out from tip of toes – palms of hands on hand grips of crutches – elbows in 300flexion – body wt taken mainly on hands

  • Gait patterns

    • swinging crutch gait

      • swing to crutch gait

      • swing through crutch gait

    • four point crutch gait

    • two point crutch gait

    • three point crutch gait

    • selection of gait depends on

      • ability of the patient to step forward with either one or two feet

      • ability to bear weight and keep balance on one or both feet

      • ability to push body forward by presssing down both crutches

      • ability to maintain body errect

      • ability to control the crutches

    • all assisted gaits need more energy

      • 2 and 3 point partial weight bearing gaits need 33% more energy than normal gait

      • 3 point non weight bearing and swing through gait need 78% more energy

  • Swinging Crutch gait

    • body wt can be taken through both lower limbs together

    • but uncapable of moving his lower limbs due to paralysis

    • calipers are used to stabilize the limbs – limbs are moved by the muscles acting on pelvis

    • stable position is of tripod – triangular base – apex on shoulder

      • crutches form two anterior legs

      • trunk and lower limbs form the posterior leg

    • paralytic is stable in this position – except no FFD of hip, knee, ankle

    • knees braced in extension – centre of gravity falls in front of the hip joint

    • swinging to crutch – advances the crutch – swings the body to crutches

    • swinging through crutch – body swings through beyond the crutches

  • Four point crutch gait

    • when all/ part of body wt can be taken on each foot – but patient is unsteady and needs wide based gait

    • as condition improves – moves to two point gait

    • right crutch – left foot (body wt on right hand) – left crutch – right foot ( body wt on left hand)

  • Two point crutch gait

    • to reduce the amount of body wt taken on both foot – some body wt can be taken by both l/l – good balance – both lowerlimbs painful/ weak

    • right crutch and left foot simoultanously ( taking part of body wt on left foot) - left crutch and right foot simultanously (taking part of body wt on right foot)

  • Three point crutch gait

    • when one limb can support the whole body wt and other cant

    • both crutches support the weak limb – stronger limb takes the whole body wt without support of crutches

    • both crutches and weak limb together – stronger lower limb

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