Crutches, in general, are medical devices that assist people ambulate from one place to another when they are unable to walk due to an illness or injury. They act as an assistive device by helping support the person's body weight in hopes the patient can be more mobile. Lofstrand crutches, more commonly known as forearm, elbow or Canadian crutches, consist of cuffs that partly or fully encompass the forearms along with having grips or handles for the patient to hold and rest his/her hands; the cuffs and hand rests act together to help support the patient's body weight. The full cuff forearm crutch has a narrow opening allowing the quick release of the crutches making it easy to take off the crutches when wanted or to relieve the forearms from damage if a fall occurs.
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Forearm crutches are the preferred crutch design in Europe, along with much of the rest of the world, while axillary (or underarm) crutches are still more commonly used in the United States. One reason behind the lack of usage of forearm crutches in the United States could stem from the permanent connotation associated with forearm crutches in comparison to the indicated temporary usage of axillary crutches. Indeed, forearm crutches are a better solution for long-term usage patients as well as shorter term users with unimpaired upper body strength. Several studies have shown that forearm crutches are less harmful to one's body.
History
"Evidence from an Egyptian carving dating back to 2830 BC suggests that crutches have been used at least since the pharaohs ruled Egypt 5,000 years ago." In 1917, Emile Schlick patented the first commercially produced crutch; the design consisted of a walking stick with an upper arm support. Later, A.R. Lofstrand, Jr. developed the first crutches with a height-adjustable feature making the crutches customizable. Through time, the design of crutches haven't changed much such that the classic design still is most commonly used. However, some modern inventor's have worked to develop innovative designs of this ancient assistive device in hopes to better address different types of patients. In 1997, forearm crutches got a boost when President Bill Clinton started wearing them after tearing his right quadriceps tendon. He called the forearm crutches his "Stealth" crutches. In a news conference, Clinton said, "I think they were developed as an offshoot of B-2 technology... I like them quite a lot."
Advantages of Forearm Crutches
In comparison to axillary crutches, forearm crutches have many advantages. Prescribed to both younger patients as well as adults, they spread the burden of the weight across the entire forearm rather than concentrating it in the wrist, which is beneficial for those with weak wrists or arthritis. Forearm crutches have a greater initial learning curve but they also allow for greater control of movement. "They also allow for a greater variety of walking styles and gaits, and are more stable on rough or uneven terrain." Forearm crutches also encourage good posture in users in comparison to axillary crutches. Forearm crutches require more upper body strength than typical axillary crutches; they are a great prescription for patients who will need an assistive device for a long-term period due to the upper body strength needed. Therefore, as the patient uses the forearm crutches, upper body strength is continually strengthened. They are also more convenient than other types of crutches due to the smaller size.
Fitting Forearm Crutches
It is extremely vital that the crutches are properly fitted to each individual user. If improperly fitted, the patient can experience muscle pains and end up having abrasions along with possible nerve damage. The patient should be able to stand upright in a comfortable position with the hands resting on the handles. When doing so, the elbows should be bent at 15-30 degrees of flexion.
Here are some tips to properly use Lofstrand Crutches:
- Adjust your crutches properly. Have a friend or family member help you for this step. Wear the shoes you plan to wear for most of your recovery and stand normally. To adjust the overall crutch height, flex your elbow so the crease of your wrist is level with your hips at a thirty degree angle. Measure from the largest part of your forearm to the floor, and adjust your crutch accordingly. The handle of the crutch should be level with your wrist.
- Put the crutch on so the open end of the cuff faces away from your body. Position the cuff one to two inches below your elbow, around the thickest part of your forearm. Grip the handles firmly.
- Place the crutch tips one step in front of you while standing on your uninjured foot.
- Let your forearms and crutches take your weight as you swing your body forward. Always keep your injured foot raised.
- Lift your uninjured foot and swing forward, carefully maintaining balance on the crutches. Place your foot one step ahead of the crutches and let your body's weight carry through.
- Repeat! With practice you will develop a smooth and even gait that allows you to move quickly in spite of your injury. You can also consult with a physical therapist for alternative gaits and rhythms.
Manufacturers
Most Lofstrand crutches are made from heavy-wall, high-strength aluminum tubing and vinyl-coated, tapered, contoured arm cuffs.
- Walk Easy
- Guardian
- Medline
- Drive Medical
- Patterson Medical
- Sammons and Preston
- Kinsman Enterprises