Ambulatory Assistive Device

Aka: Ambulatory Assistive Device, Ambulatory Device, Mobility Device, Mobility Aid, Walking Aid, Ambulation Device

1. See Also
   1. Assistive Technology
   2. Canes
   3. Crutches
   4. Walkers
   5. Wheelchair
2. Epidemiology
   1. More than 25% of those over age 65 years use an Ambulatory Assistive Device either at home or out of the home
3. Background
   1. Mobility Assistive Devices are Durable Medical Equipment
      1. Up to 80% of cost is covered under Medicare Part B (after deductible)
      2. Medically necessary as prescribed by a physician for use within the home
   2. Proper fit and use is important
      1. Consult physical therapy, occupational therapy or Orthotics
4. Indications
   1. Gait disturbance
   2. Deconditioning and generalized weakness
   3. Weak, painful or immobilized leg
   4. Fall Prevention
   5. Maintain Activities of Daily Living
   6. Aid independence and less need for Caregiver assistance
5. Types: Available Mobility Devices
   1. Canes
      1. Standard Cane
      2. Offset Cane
      3. Multi-Leg Cane (Quad Cane)
      4. Walk Cane (Hemi-Walker)
   2. Crutches
      1. Axillary Crutches
      2. Forearm Crutches
   3. Walkers
      1. Standard Walker
      2. Front Wheeled Walker
      3. Four Wheeled Walker (Rollator)
   4. Wheelchair
      1. Manual Wheelchair
      2. Scooter
      3. Power Wheelchair
6. Management: Mobility Device selection in elderly
   1. Patient needs only 1 hand on Ambulatory Device to maintain weight bearing and balance
      1. Patient needs weight bearing assistance
         1. Occasional or Intermittent use: Offset Cane
         2. Frequent use: Quadripod Cane (Quad Cane)
         3. Continuous use: Hemi-Walker
      2. Patient needs device only for balance
         1. Standard Cane
   2. Patient needs 2 hands on Ambulatory Device to maintain weight bearing and balance
      1. Patient needs weight bearing assistance
         1. Intermittent or Occasional use
            1. Two Wheeled Walker (Front-Wheeled Walker)
            2. Standard Walker
         2. Frequent use
            1. Two Wheeled Walker (Front-Wheeled Walker)
            2. Forearm Crutches
         3. Continuous use
            1. Two Wheeled Walker (Front-Wheeled Walker)
            2. Standard Walker
      2. Patient needs device only for balance
         1. Four-Wheeled Walker (Rollator)
   3. Patient unable to use an Ambulatory Device (e.g. cane, walker)
      1. Adequate upper body strength to power a Manual Wheelchair
         1. Manual Wheelchair
      2. Strength and postural balance to use a scooter
         1. Scooter
      3. Unable to manually power a Wheelchair or to use a scooter
         1. Power Wheelchair
7. References
   1. Bradley (2011) Am Fam Physician 84(4): 405-11 [PubMed]
   2. Sehgal (2021) Am Fam Physician 103(12): 737-44 [PubMed]
   3. Van Hook (2003) Am Fam Physician 67(8):1717-24 [PubMed]