Using Crutches
The video provided by our professor about different crutch walking gaits was thorough
and each type of crutch walking gaits were demonstrated clearly. The video also provided
rationale for each step for us to know what are the logical basis of the course of action of the
particular step or gait. The video showed the tripod crutch, swing to crutch, swing through
crutch, four-point crutch, two-point crutch, and three-point crutch gaits; then going up and down
of the stairs; and lastly sitting down and standing up. In the video axillary crutches was used it is
to provide support and assists patients who need aid in walking. Crutches are used to assist
patients who cannot bear any weight on one or both legs and it is also to prevent injury to client
who has difficulty in ambulation. When the patient will use crutches for the first time, it should
be adjusted first to the patient’s height it is to provide broad base of support for the client, the
space between the crutch pad and axilla prevents pressure to the radial nerves and the flexion of
the elbows provides space between the crutch pad and axilla.
When the patient is starting to learn to use crutches, the nurse should apply a gait belt to
the patient foe safety. For each type of gait, the first step is always assuming the proper standing
position will assist in preventing the client to experience orthostatic hypotension. And when the
patient is ready to start ambulating with crutches, they will start in the tripod crutch gait it is for
patients who are learning to do swing to gait pattern and to gain balanced standing. Tripod crutch
gait is the initial pattern for patients with paraplegia and with moderate balance and coordination
impairment. The pattern for tripod crutch gait is “right crutch - left crutch – both feet to crutch”.
Swing to crutch gait is also for patients with paraplegia or weakness of both legs but
partially weight bearing, moderate balance and coordination impairment and moderate weakness
of upper extremities. The patient will move both crutches forward and then swing both legs
forward to the same point as the crutches to provide faster ambulation.
Swing through crutch gait is for patients with paraplegia but partially weight bearing,
with good balance and coordination and strong upper extremities. The patient will move both
crutches forward and then swing both legs forward, past the crutches to have the fastest gait
pattern.
Four-point crutch gait is for patients with weakness of both legs but partially weight
bearing, with moderate balance and coordination impairment and moderate strength of upper
extremities. this type of gait is similar to the two-point gait but the crutch and leg move
separately rather than at the same time. The pattern is “right crutch – left foot – left crutch – right
foot” to provide greater stability, weight bearing is on three points at all times. The client must
be able to bear weight with both legs.
Two-point crutch gait is for patients with mild weakness of both legs and partially weight
bearing, mild balance and coordination impairment and moderate strength to the upper
extremities. The patient will move the injured side’s crutch at the same time as the non-injured
leg and then the patient will move the non-injured side’s crutch at the same time as the injured
leg. The pattern is “right crutch and left foot – left crutch and right foot” to provide a strong base
of support. The client must be able to bear on both legs. This gait is faster than four-point gait.
Three-point crutch gait is for patients with injury on one leg and is non-weight bearing,
good balance and coordination and strong upper extremities. The patient will not let the injured
leg touch the ground; therefore, the patient will move both crutches and the injured leg forward
together and then move the non-injured leg. The pattern will be “both crutch and injured foot –
good foot” it to provide a strong base of support. This gait can be used if the client has a weak or
non-weight-bearing leg and it eliminates all weight bearing on the affected leg.
Going up the stairs is for patients with injury on one leg and is non-weight bearing, good
balance and coordination and strong upper extremities. The patient should establish balance first
and step up the good leg first the both crutches together with the bad leg follows to prevent
weight bearing on the weaker leg.
Going down the stairs is for patients with injury on one leg and is non-weight bearing,
good balance and coordination and strong upper extremities. The patient should establish balance
first and step down with the injured leg both crutches together then good leg follows to prevent
weight bearing on the weaker leg.
Sitting down stairs is for patients with injury on one leg and is non-weight bearing, good
balance and coordination and strong upper extremities. The patient will back up to the chair until
they feel the chair with the back of their non-injured leg. The patient will then move both
crutches on to the injured side and grip the hand grips of the crutches for support. The patient
will keep the injured leg extended out and slightly bend the non-injured leg. Then the patient will
feel for the chair’s seat with the non-injured side and sit down, all while keeping the injured leg
extended out.
Standing up stairs is for patients with injury on one leg and is non-weight bearing, good
balance and coordination and strong upper extremities. The patient will keep the injured leg
extended out forward and put both crutches on the injured side and grip the hand grips of the
crutches. Then the patient will lean forward and push up with the arm of the non-injured site on
the chair’s seat and by using the hand grips on the crutches, which is on the injured side. Once
standing, the patient will bring the crutches into the tripod position.
