Ambulation Aids: Patient Teaching

Assess the patient's mobility needs, cognitive status, and...

  1. physical ability.
  2. Assess the patient's home environment by asking the patient about stairs, the availability of a bathroom and bedroom on the main level, etc.
  3. Measure and adjust the ambulation aid.
  4. Ensure that the patient is wearing shoes with nonslip soles. Free the area of potential hazards (equipment or furniture in the path or a wet floor surface).
  5. Assess the patient for strength, mobility, range of motion, visual acuity, perceptual difficulties, and balance.

Three-Point Pattern (Two Crutches or a Walker)

  1. Advance the walker or crutches and the injured leg , then step up to the walker or slightly ahead of the crutches with the uninjured leg.

Modified Three-Point Pattern (Two Crutches or a Walker)

  1. Advance the walker or crutches simultaneously with the partial-weight bearing leg.
  2. Advance full-weight-bearing leg.

Modified Two-Point Pattern (One Cane or Crutch)

  1. Hold the ambulation aid in the arm opposite to the leg that requires protection or support.
  2. The ambulation aid comes forward simultaneously with the leg to be protected.
  3. The ambulation aid and protected leg maintain position while the unaffected leg steps forward.

Four-Point Pattern (Two Crutches or Canes)

  1. The right crutch or cane comes forward, then the left leg.
  2. The left crutch or cane comes forward, then the right leg.

Sitting Down or Standing Up From a Chair

To sit down in a chair:

  1. Hold both crutches in one hand on the same side as the affected leg.
  2. Place the unaffected leg close to the chair edge.
  3. Put the free hand on the seat bottom and lower to chair using crutches, the unaffected leg, and the free hand for balance and support.

To stand:

  1. Hold both crutches in one hand on the same side as the affected leg.
  2. Push up using the free hand, the unaffected leg, and the hand that is holding the crutches.

Ascending and Descending Stairs

  1. Step up with good leg, followed by injured leg.

With a Handrail
To go up stairs with a handrail:

  • Hold both crutches in the hand opposite the handrail.
  • Push down on the crutches and the handrail while stepping up with the good leg.
  • Straighten the back, and lift the crutches and injured leg up to the same step.

To go down stairs with a handrail:

  • Hold both crutches in the hand opposite the handrail.
  • Bend the good leg, and lower both crutches and the injured leg one step.
  • Leaning on the crutches and the handrail, step down to the same step with the good leg.

Without a Handrail
To go up stairs without a handrail:

  • Use the three-point gait pattern.
  • Advance the crutches and good leg, then step up.
  • Extend the hip and flex the knee on the injured side to 90 degrees to clear the stair with the injured leg.

To go down stairs without a handrail:

  • Bend the good leg (to assist with balance), and lower both of the crutches and the injured leg to the step.
  • Lean on the crutches, and step down with the good leg.

Post Procedure

  1. Ensure that patient is able to return demonstration of mobility device in a safe, effective manner.
  2. Perform hand hygiene.
  3. Document the procedure in the patient's record.
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