Measurement and Fit
General Guidelines
- Parallel bars should be 2" wider than greater trochanters
- ambulation aid grip/handle should line up with greater trochanter or ulnar styloid process (wrist crease) when the patient is in static standing
- a range of 20 to 30 degrees of elbow flexion is optimal
- measure from the greater trochanter to the patient's heel to determine grip/handle height if the patient needs to remain supine
- forearm crutch cuff should be 1-1.5 inches distal to elbow crease
- allow approximately 2 inches from the axilla to the axillary rest during standing/gait activities to minimize risk for neurovascular compression
Specific guidelines for each ambulation aid are provided in Procedure 9-2 in Therapeutic Exercises (pg. 225)
Common Errors
- measurements are not adjusted for postural imbalances in upright positions
- measurements do not account for footwear
- measurements are not confirmed in standing
- optimal resting standing position is not maintained during measurements
- crutches/cane - positioned too far or too close (ant/posterior/lateral) to lower extremities
- walker - feet are too far anterior/posterior of rear legs
Effects of Poor Fit
- decreased stability
- increased energy expenditure
- decreased function
- decreased safety
