adjustable cuffs for elbow crutches
A comfortable fit is an important part of using (elbow) crutches. The existing cuffs, which only come in one “universal” size consist of a flexible metallic material (probably aluminium) coated with plastic and have plenty of scope for enlargement -essential for when slipping the arm down into it . The standard cuff with internal diameter:10cms (circumference 31.4cm) is suitable for a typical adult arm of ~ 30cm circumference . Unless the user has a very thin arm , it is unlikely to be too large but the converse for large arms is not the case. Our client was a large man who had worked manually all his life and had gained additional weight on retiring on medical grounds. He now weighed 20stone (126kg) and the circumference of his arms were 48cms, which is large and not uncommon! Used with only a shirt covering his arms the cuffs were an uncomfortable tight fit and he certainly was not able to use them outside when wearing additional clothing. Although the cuffs could be stretched to accommodate his arms (and sprung back afterwards) what was needed was a means of holding the cuffs “open” to the required size and could be easily adjusted further for outdoor use. His mobility was already limited by his condition and difficulty utilising his crutches outside resulted in fewer social interactions and predictably had an adverse effect on his mental health.
Unfortunately “over size” cuffs are no longer available commercially which seems short sighted considering the common occurrence of poor mobility (frequently requiring walking aids) with obesity. In a previous case I had used stainless steel strips to hold open a pair of cuff crutches for a client to use for his daily walks whilst wearing an overcoat. He also had a pair of unmodified crutches for in door use. The stainless steel was stiff and did not lend itself to easy adjustment.
In this case thin aluminium sheet : 1.5mm thick was used as it was more flexible and easier to work. Each cuff was fitted with a strip 30mm wide x 30cms long and secured on each side by M5 12mm c/s S/S bolt + nyloc nut. It was important that the strip was spaced out from the back of the cuff so that it did not impede the hingeing movement of the cuff on its mounting. This adaption can be done at the clients home in 30minutes. This arrangements allows a wide range of expansion- easily to accommodate a “large” arm , even when wearing a coat, which can easily be squeezed back to its original size afterwards ie fully reversible.
Inevitably this will eventually lead to metal fatigue in the long run when the strip can equally easily be quickly replaced at minimum cost.
Our client can now use his crutches around his home without his arms feeling “pinched” and more importantly he can go out more & socially mix (within the current restrictions) which will help his social isolation & ease his mental health symptoms.
NB: Bariatric size crutches are designed for users >25st (160kg) with an an enlarged cuff size :12cms diameter -circumference 37cms so in retrospect our client needed the “bariatric” enlarged cuff size but not the heavy duty crutch itself with its additional cost.