Assistive devices for the adult patient with orthopaedic dysfunction. Why physical therapists choose what they do.

The more common types of assistive devices seen in the orthopaedic setting are described. Also included are descriptions of patient factors that guide the physical therapist in deciding which of these devices to try for which patients. Examples of typical patient problems are also included to help the nurse understand the decisions that therapists make. A simple decision tree contained in this article helps further this understanding.

Heart rate evaluation of axillary and elbow crutches.

The aim of this study was to compare the possible effect on heart rate in patients with a walking disability using 11 different crutch designs. Eighteen patients, over the age of 18 years, who had used crutches for a minimum of 2 weeks before the study were divided into two groups: elbow and axillary crutch users respectively. The former tested six different designs of elbow crutches and the latter five different pairs of axillary crutches. Heart rate was recorded, using a portable digital pulse monitor during a 5-min walk on the level at self-selected velocities. Walking heart rates increased between 28.6 and 58.8% compared with the resting phase. No differences were found in either heart rate or walking speed between elbow crutches. However, a significant difference (p less than 0.001) in heart rate was noted between elbow crutch users who were non-weight bearing on their injured leg compared with those who were partial-weight bearing. The Canadian axillary crutch showed the lowest increase in heart rate at comparable walking speeds compared with other axillary crutches. Prescribers should be aware that the reduced energy requirements of the Canadian crutch would benefit patients with reduced cardiorespiratory function.