Walking assistance using crutches: A state of the art review

Crutches are one of the most common ambulatory assistive devices. Using crutches encourages more physical activity than many other assistive devices, which has long-term health benefits. Recent advances have led to improvements in performance, but using crutches remains slower than normal walking, are energetically inefficient, cause additional strain on upper extremities, and often result in abrasions on the skin. Further improvements to address these deficiencies are needed but require an understanding of the crutch users' disabilities, different crutch gait patterns, associated biomechanics, and how the crutch design interacts with the user. It is important that research studies and designs take into account parameters from multiple ways of measuring performance in order for impaired users to achieve effective crutch walking. Many existing studies of crutches only analyze a subset of quantitative variables, so the overall impact of a design or modification is not fully assessed or comparable to other designs. Another important aspect is the user; each crutch type has specific characteristics that need to match the user's ability, physical fitness, and gait pattern. Pain and injuries on upper extremities should also be considered as an important factor in long-term users. A search was done to find research papers and related patents focusing on crutch design and usage. Papers that studied one or more of the following topics were included: effects of crutches on the gait parameter, types of crutch walking patterns, improving walking efficiency through crutch design, and identifying the important components when studying a gait. This review paper summarizes the effects of existing crutch types and gives guidelines for how future studies should comprehensively evaluate design changes. This paper includes an overview of crutch gait walking patterns, users, the components and measurements of crutch studies, and advancements of crutch designs.