Sports Medicine Book

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Canes

Aka: Canes, Standard Cane, Single Prong Cane, Offset Cane, Offset Handle Cane, Pedestal Base Cane, Multi-Leg Cane, Multiple Leg Cane, Quadripod Caneb, Quad Cane, Walk Cane, Hemi-Walker
  1. See Also
    1. Mobility Device
    2. Assistive Technology
    3. Crutches
    4. Walkers
    5. Wheelchair
  2. Indication
    1. Gait disturbance
    2. Weight redistribution (~10% off loading) from painful lower limb
    3. Stability when balance is impaired
  3. Contraindications
    1. Insufficient balance, dexterity or upper body strength with one handed support on cane
  4. Types: Cane (in order of weight bearing support)
    1. Standard Cane (Stright cane)
      1. For balance only (not for weight bearing)
        1. For Ataxia, Vertigo or Decreased Visual Acuity
      2. Materials
        1. Wood (light and inexpensive)
        2. Aluminum (light and adjustable length, higher cost)
      3. Advantages
        1. Least expensive canes ($10-20 in 2021)
      4. Disadvantages
        1. Risk of Carpal Tunnel Syndrome from holding the curved handle
        2. Less supportive with the curved handle and weight bearing line behind the cane shaft
          1. Corrected with use of an Offset Cane
    2. Offset Cane (Crook or offset below handle)
      1. Aluminum cane with adjustable length
      2. Distributes patient's weight over cane shaft
        1. Contrast with Standard Cane which has a weight bearing line behind the cane shaft
      3. Allows for one-handed partial weight bearing
        1. For moderate hip or Knee Osteoarthritis
    3. Multiple Leg Cane (Quadripod cane, Quad Cane, Pedestal Base Cane)
      1. Cane with 4 legs at base
      2. Indications
        1. Severe hip or Knee Osteoarthritis
        2. Hemiplegia (allows use of hands - not encumbered by always holding cane)
      3. Advantages
        1. Allows for greater weight bearing than Offset Cane
        2. Stands upright even when not being held
      4. Disadvantages
        1. All 4 legs must be in contact with floor (use may be awkward)
        2. Heavier than other canes
        3. Adjust cane base size for gait speed
          1. Fast paced gait: Smaller cane base
          2. Slow paced gait: Larger cane base
            1. Also needed for greater weight bearing
    4. Walk Cane (Hemi-Walker, one handed, four legged walker)
      1. For severe leg weakness (e.g. post-CVA Hemiparesis)
      2. Allows for greater weight bearing than Quad Cane
      3. Uses only 1 hand (contrast with Standard Walker)
  5. Technique: Cane use
    1. Cane should support 15-20% of patient's body weight
    2. Curved handle should face backwards
    3. Cane held by hand opposite deficient leg
      1. Weak right leg: Hold cane in left hand
      2. Weak left leg: Hold cane in right hand
    4. Advance cane while advancing deficient leg
      1. Resembles tripod with 3 points in contact with floor
      2. Weak right leg advances with left arm and cane
      3. Weak left leg advances with right arm and cane
  6. Preparation
    1. Fitting
      1. Patient stands upright with arm relaxed at side
      2. Keep elbow flexed at side to 15 to 30 degrees when cane held vertically on ground
      3. Cane length
        1. Wrist crease (with arm hanging at side) or
        2. Hip Greater trochanter to floor (with shoes)
    2. Handles
      1. Umbrella handle
        1. Typical handle on a Standard Cane
        2. Risk of Carpal Tunnel due to pressure on palm
      2. Shotgun handle
        1. Flat handle similar in shape to a shotgun butt
        2. Distributes pressure across entire hand (not just palm)
        3. Less risk of secondary Carpal Tunnel
      3. Finger and thumb groove handle
        1. Forces use of the correct hand to hold the cane
  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]

CANE, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR FIXED, WITH TIP (C0006856)

Definition (UMD) Assistive devices using a single shaft designed to aid the user while walking by providing additional support. These devices usually consist of a straight shaft including a handle at the proximal end and a rubber tip at the distal end. Canes are typically made of sturdy materials such as wood (e.g., walnut), light metals (e.g., aluminum), plastics (e.g., acrylics), fiberglass, or a combination of these. Most patients use only a single cane but a few may use two canes while walking; dedicated canes with a variety of handles and/or special characteristics (e.g., spring-loaded tips) are also available. Pedestal-base canes have several (e.g., three or four) distal tips to improve floor contact. Also available are canes dedicated for the visually impaired. Frequently having a white shaft and/or red tips, these canes are intended to guide visually impaired users and alert others to that impairment.
Definition (SPN) A cane is a device intended for medical purposes that is used to provide minimal weight support while walking. Examples of canes include the following: A standard cane, a forearm cane, and a cane with a tripod, quad, or retractable stud on the ground end.
Definition (SPN) A cane is a device intended for medical purposes that is used to provide minimal weight support while walking. Examples of canes include the following: A standard cane, a forearm cane, and a cane with a tripod, quad, or retractable stud on the ground end.
Definition (MSH) Sticks used as walking aids. The canes may have three or four prongs at the end of the shaft.
Concepts Medical Device (T074)
MSH D002183
SnomedCT 87405001, 360006004
LNC LA15197-9
English Canes, Stick, Walking, Sticks, Walking, Walking Stick, Walking Sticks, CANE, CANE, INCLUDES CANES OF ALL MATERIALS, ADJUSTABLE OR FIXED, WITH TIP, CANE, SAFETY WALK, CANE MISC. EACH, CANE @ @ EACH, CANE EACH, Cane, device, Walking Canes, canes (treatment), canes, CANE@@MISCELL@EACH, CANE MISCELL EACH, cane, walking stick, caned, stick walking, walking sticks, Cane, includes canes of all materials, adjustable or fixed, with tip, Cane, Cane, device (physical object), Walking stick (physical object), Walking stick, Cane adjust/fixed with tip
Swedish Käppar
Czech hole
Finnish Kävelykepit
Italian Bastoni da passeggio, Bastoni
Russian TROSTI, PALKI DLIA KHOD'BY, ПАЛКИ ДЛЯ ХОДЬБЫ, ТРОСТИ
Spanish Báculo, báculo (objeto físico), bastón, dispositivo (objeto físico), bastón, dispositivo, báculo, bastón (objeto físico), bastón, Bastones
French Cannes
Croatian ŠTAPOVI
Polish Laski
Japanese ステッキ, 杖, つえ
Norwegian Spaserstokker
German Gehstöcke, Wanderstöcke
Dutch Kruk, Krukken, Wandelstok
Portuguese Bastões para Marcha, Bengala
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Canes, Adjustable-Length, Offset-Handle (C0179550)

Definition (UMD) Canes using a single adjustable-length shaft and an off-set handle designed to provide additional support to the user while walking. These canes usually consist of a straight shaft divided in several sections with holes and pins to adjust the desired height, an offset handle at the proximal end, and a rubber tip at the distal end. The offset handle provides comfort and additional balance assistance (i.e., the hand rests directly over the shaft of the cane) and may also include an easy-to-turn button/knob at its base with a mechanism that is activated to adjust the length of the cane. They are typically made of sturdy materials such as light metals (e.g., aluminum), plastics (e.g., acrylics), fiberglass, or a combination of these. Offset-handle adjustable-length canes are mainly designed to help provide balance for patients with mobility disabilities.
Concepts Medical Device (T074)
English Canes, Adjustable-Length, Offset-Handle
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Canes, Pedestal Base (C0179553)

Definition (UMD) Canes with a single fixed-length shaft and a supporting (pedestal) base designed to provide additional support and maximum stability to the user while walking. These canes usually consist of a one-piece straight shaft including a handle at the proximal end, and a pedestal base with metal/rubber pods at the distal end. The tips of the pods make the cane self-standing in order to provide maximum stability (e.g., tripod, quadripod). They are typically made of sturdy materials such as light metals (e.g., aluminum), plastics (e.g., acrylics), fiberglass, or a combination of these. Pedestal-base canes are available as fixed-length or adjustable-length. They are mainly designed to provide the user with support, balance, and stability and to reduce the stress of impact on the user's hand.
Concepts Medical Device (T074)
English Canes, Pedestal Base, Pedestal Base Canes
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Canes, Quad Base (C0179554)

Concepts Medical Device (T074)
English Canes, Quad Base
Sources
Derived from the NIH UMLS (Unified Medical Language System)


single prong cane (C2006241)

Concepts Medical Device (T074)
English single prong cane (treatment), single prong cane
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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