WordNet

a wooden or metal staff that fits under the armpit and reaches to the ground; used by disabled person while walking
anything that serves as an expedient; "he uses drugs as a psychological crutch"

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松葉づえ / 支えになるもの

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/06/13 22:09:09」(JST)

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For other uses, see Crutch (disambiguation).

Using underarm crutches

A typical forearm crutch

A crutch is a mobility aid that transfers weight from the legs to the upper body. It is often used for people who cannot use their legs to support their weight, for reasons ranging from short-term injuries to life-long disabilities.

Types [edit]

There are several types of crutches:

Forearm: a type of crutch with a cuff at the top to go around the forearm, also known as the Lofstrand crutch. It has been the type most commonly used in Europe.^{[citation needed]} Forearm crutch is used by inserting the arm into a cuff and holding the grip. The cuff, typically made of plastic or metal, can be a half-circle or a full circle with a V-type opening in the front allowing the forearm to slip out in case of a fall.
Underarm: or axilla crutch. It is used by placing the pad against the ribcage beneath the armpit and holding the grip, which is below and parallel to the pad.
Platform: These are less common and used by those with poor hand grip due to arthritis, cerebral palsy, or other conditions. The arm rests on a horizontal platform and is strapped in place. The hand rests on a grip which, if properly designed, can be angled appropriately depending on the user's disability.
Leg Support: These non-traditional crutches are useful for users with an injury or disability affecting one lower leg only. They function by strapping the affected leg into a support frame that simultaneously holds the lower leg clear of the ground while transferring the load from the ground to the user's knee or thigh. This style of crutch has the advantage of not using the hands or arms while walking. A claimed benefit is that upper thigh atrophy is also reduced because the affected leg remains in use. Unlike other crutch designs these designs are unusable for pelvic, hip or thigh injuries and in some cases for knee injuries also.

Walking sticks or canes serve an identical purpose to crutches, but are held only in the hand and have a limited load bearing capability because of this.

Information on use [edit]

Several different gait patterns are possible, and the user chooses which one to use depending on the reason the crutches are needed. For example, a person with a non-weight bearing injury generally performs a "swing-to" gait: lifting the affected leg, the user places both crutches in front of himself, and then swings his uninjured leg to meet the crutches. Other gaits are used when both legs are equally affected by some disability, or when the injured leg is partially weight bearing.^[1]

With underarm crutches, sometimes a towel or some kind of soft cover is needed to prevent or reduce under arm injury. A condition known as crutch paralysis, or crutch palsy can arise from pressure on nerves in the armpit, or axilla.^[2]^[3] Specifically, "the brachial plexus in the axilla is often damaged from the pressure of a crutch...In these cases the radial is the nerve most frequently implicated; the ulnar nerve suffers next in frequency".^[3]

Alternative devices [edit]

The knee scooter and the wheelchair are possible alternatives for patients who cannot use or do not like crutches. These wheeled devices introduce an additional limitation, however, since they cannot negotiate stairs.

Materials [edit]

Wood
Metal alloys (most often Steel, Aluminium alloys, Titanium alloys)
Carbon or glass fiber reinforced composites
thermoplastic
carbon fiber reinforced polymer

References [edit]

Wikimedia Commons has media related to: Crutches

^ Walk Easy > Interact > Crutch Gait. Retrieved on March 22, 2007.
^ Glanze, W.D., Anderson, K.N., & Anderson, L.E, ed. (1990). Mosby's Medical, Nursing, and Allied Health Dictionary (3rd ed.). St. Louis, Missouri: The C.V. Mosby Co. ISBN 0-8016-3227-7. p.324
^ ^a ^b Warwick, R., & Williams, P.L, ed. (1973). Gray’s Anatomy (35th ed.). London: Longman. p.1046

UpToDate Contents

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English Journal

Kinematic and electromyographic studies on unaided, unilateral and bilateral crutch walking in adolescents with spastic diplegia.

Yeung EH, Chow DH, Su IY.Author information Tuen Mun Hospital, Hong Kong, Hong Kong.AbstractBACKGROUND: Back pain and ambulation deterioration among ambulatory individuals with cerebral palsy (CP) are common as they grow older and walking aids are often prescribed to improve stability and promote maximal weight-bear on lower limbs during gait.
Prosthetics and orthotics international.Prosthet Orthot Int.2012 Mar;36(1):63-70. doi: 10.1177/0309364611429722. Epub 2011 Nov 30.
BACKGROUND: Back pain and ambulation deterioration among ambulatory individuals with cerebral palsy (CP) are common as they grow older and walking aids are often prescribed to improve stability and promote maximal weight-bear on lower limbs during gait.OBJECTIVE: To investigate the effects of walkin
PMID 22130909

An upper extremity inverse dynamics model for pediatric Lofstrand crutch-assisted gait.

Slavens BA, Bhagchandani N, Wang M, Smith PA, Harris GF.Author information Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201-0413, USA. slavens@uwm.eduAbstractThe objective of this study was to develop an instrumented Lofstrand crutch system, which quantifies three-dimensional (3-D) upper extremity (UE) kinematics and kinetics using an inverse dynamics model. The model describes the dynamics of the shoulders, elbows, wrists, and crutches and is compliant with the International Society of Biomechanics (ISB) recommended standards. A custom designed Lofstrand crutch system with four, six-degree-of-freedom force transducers was implemented with the inverse dynamics model to obtain triaxial UE joint reaction forces and moments. The crutch system was validated statically and dynamically for accuracy of computing joint reaction forces and moments during gait. The root mean square (RMS) error of the system ranged from 0.84 to 5.20%. The system was demonstrated in children with diplegic cerebral palsy (CP), incomplete spinal cord injury (SCI), and type I osteogenesis imperfecta (OI). The greatest joint reaction forces were observed in the posterior direction of the wrist, while shoulder flexion moments were the greatest joint reaction moments. The subject with CP showed the highest forces and the subject with SCI demonstrated the highest moments. Dynamic quantification may help to elucidate UE joint demands in regard to pain and pathology in long-term assistive device users.
Journal of biomechanics.J Biomech.2011 Jul 28;44(11):2162-7. doi: 10.1016/j.jbiomech.2011.05.012. Epub 2011 Jun 8.
The objective of this study was to develop an instrumented Lofstrand crutch system, which quantifies three-dimensional (3-D) upper extremity (UE) kinematics and kinetics using an inverse dynamics model. The model describes the dynamics of the shoulders, elbows, wrists, and crutches and is compliant
PMID 21652035

Upper extremity inverse dynamics model for crutch-assisted gait assessment.

Slavens BA, Sturm PF, Harris GF.Author information Department of Biomedical Engineering, Marquette University, 1515W. Wisconsin Ave, Milwaukee, WI 53233, USA. brooke.slavens@mu.eduAbstractCurrent inverse dynamics models of the upper extremity (UE) are limited for the measurement of Lofstrand crutch-assisted gait. The objective of this study is to develop, validate, and demonstrate a three-dimensional (3-D) UE motion assessment system to quantify crutch-assisted gait in children. We propose a novel 3-D dynamic model of the UEs and crutches for quantification of joint motions, forces, and moments during Lofstrand crutch-assisted gait. The model is composed of the upper body (i.e., thorax, upper arms, forearms, and hands) and Lofstrand crutches to determine joint dynamics of the thorax, shoulders, elbows, wrists, and crutches. The model was evaluated and applied to a pediatric subject with myelomeningocele (MM) to demonstrate its effectiveness in the characterization of crutch gait during multiple walking patterns. The model quantified UE dynamics during reciprocal and swing-through crutch-assisted gait patterns. Joint motions and forces were greater during swing-through gait than reciprocal gait. The model is suitable for further application to pediatric crutch-user populations. This study has potential for improving the understanding of the biomechanics of crutch-assisted gait and may impact clinical intervention strategies and therapeutic planning of ambulation.
Journal of biomechanics.J Biomech.2010 Jul 20;43(10):2026-31. doi: 10.1016/j.jbiomech.2010.03.026. Epub 2010 Apr 18.
Current inverse dynamics models of the upper extremity (UE) are limited for the measurement of Lofstrand crutch-assisted gait. The objective of this study is to develop, validate, and demonstrate a three-dimensional (3-D) UE motion assessment system to quantify crutch-assisted gait in children. We p
PMID 20403602

Japanese Journal

Development of a Standing Style Transfer System ABLE with Novel Crutches for a Person with Disabled Lower Limbs

MORI Yoshikazu,TANIGUCHI Toshiya,INOUE Kousuke,FUKUOKA Yasuhiro,SHIROMA Naoji
Journal of System Design and Dynamics 5(1), 83-93, 2011
… The ABLE system comprises three modules: a pair of telescopic Lofstrand crutches, a powered lower extremity orthosis, and a pair of mobile platforms. … In this paper, the telescopic Lofstrand crutch is mainly discussed. … This crutch has no actuator, and its length is switched between two levels; …
NAID 130000431813

215 下肢障害者のための直立移動補助システムの開発 : ロフストランドクラッチを用いた場合の検討(ライフサポートにおける工学技術)

前嶋兼,森善一
茨城講演会講演論文集 : Ibaraki district conference 2006, 57-58, 2006-09-14
… The previous telescopic crutch realizes continuous telescopic motions and the power assist. … In this paper we propose a novel type of telescopic crutch based on a Lofstrand crutch. … This telescopic Lofstrand crutch has no actuators, and its length can be switched in two states easily according to the situations. …
NAID 110006675929

杖使用歩行時における杖にかかる最大荷重と肩および肘関節負担度

相馬俊雄,大西秀明,百瀬公人,大山峰生,山本澄子,黒川幸雄
新潟医療福祉学会誌 3(1), 69-76, 2003-03
本研究の目的は一側上肢で杖を用いた歩行の際に、杖にかかる最大荷重率および杖使用側の肩・肘関節にかかる負担度を4種類の杖で比較検討することである。健常成人を対象として、T字杖(T杖)、四点杖(Q杖)、ロフストランド杖(L杖)および松葉杖(A杖)に最大荷重をさせた平地歩行を行った。動作解析には三次元動作解析装着(VICON512)および床反力計(AMTI)を使用した。負担度は動作中の関節モーメントの値 …
NAID 110004323121