Canes
Indicated for the patient with one-sided weakness or injury, occasional loss of balance, or increased joint pressure, a cane provides balance and support for walking and reduces fatigue and strain on weight-bearing joints. Available in various sizes, the cane should extend from the greater trochanter to the floor and have a rubber tip to prevent slipping. Canes are contraindicated for the patient with bilateral weakness; such a patient should use crutches or a walker.
Equipment
Rubber-tipped cane ▪ Optional: walking belt.
Although wooden canes are available, three types of aluminum canes are used most frequently. The standard aluminum cane (used by the patient who needs only slight assistance with walking) provides the least support. The T-handle cane (used by the patient with hand weakness) has a straight-shaped handle with grips and a bent shaft. It provides greater stability than the standard cane. Three- or four-pronged (quad) canes are used by the patient with poor balance or one-sided weakness and an inability to hold onto a walker with both hands. The base of these types of canes splits into three or four short, splayed legs and provides greater stability than a standard cane but considerably less than a walker.
Preparation of Equipment
Ask the patient to hold the cane on the uninvolved side 6″ (15 cm) from the base of the little toe. Adjust the aluminum cane’s height by pushing in the metal button on the shaft and raising or lowering the shaft; if it’s wood, the rubber tip can be removed and excess length sawed off. The handle of the cane should be level with the greater trochanter to allow approximately 30-degree flexion at the elbow. If the cane is too short, the patient will have to drop his shoulder to lean on it; if it’s too long, he’ll have to raise his shoulder and will have difficulty supporting his weight.
Implementation
Confirm the patient’s identity using at least two patient identifiers according to your facility’s policy.4
Tell the patient to hold the cane on the uninvolved side to promote a reciprocal gait pattern and to distribute weight away from the involved side.
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