The purpose of using a cane and other walking aids is to increase the area of support for individuals who have difficulty maintaining the centre of gravity safely over their support area. A variety of walking aids is accessible for the individual needs of the person. Walking aids such as canes improve balance, extend and redistribute the weight-bearing area, decrease lower leg pain, offer small propulsive forces, and give sensory feedback. Along with other walking aids, canes are considered as extensions of the upper limb. Therefore, it is essential to have enough arm strength and coordination. An exercise program designed for the arms is beneficial and may complement walking with aids to increase stability and endurance.
The type of walking aid needed depends on how much balance and weight-bearing assistance is required. The transmission of the body weight for a unilateral cane opposite the affected leg is 20% to 25%. It is 40% to 50% with the use of a forearm or arm cane.
Using the Cane Correctly
The first step in using the cane is to ensure the right measurement. Measure the tip of the cane to the level of the greater trochanter or the bone you can feel at the mid-level of the lateral side of the hip. The patient must be in an upright position. The elbow must be bent approximately 20 degrees, which is a desirable position of the elbow for all walking aids.
Canes are made of wood or aluminium, the aluminium one has flexible notches so that one cane fits all.There are three common types of canes. The "C" cane is the one most commonly used. It is also called the crook top cane. A functional grip cane provides the patient a grip that may be more comfortable compared to the "C" cane. A quad cane gives an increased area of support compared with other canes. Quad canes likewise come in a wide- and narrow-based forms for different ranges of support. The lateral two legs are directed away from the body.
A cane is used on the side opposite the supporting leg and is advanced with the opposite leg. The cane is usually held on the side of the unaffected leg. This is done to reduce the force exerted on a hip or knee with a pathological condition. The load is increased by four times the body weight on the stance side while walking, owing to the gravitational forces and the forces exerted by the gluteus medius-minimus (muscles on the buttocks) across the side of the hip that bears the weight. The cane helps to reduce the force produced across the affected hip by lessening the work of the muscles in the buttocks. This happens when the arms exert a force on the cane to help minimize pelvic drop on the side opposite the weight-bearing lower leg.
In ascending and descending stairs, the mnemonics "good goes to heaven and bad goes to hell" or "up with the good and down with the bad" serve as easy reminders. This means that the patient always have the good leg assume the first full weight-bearing step while going upstairs, and the diseased leg first while going downstairs.