CRUTCH HANDLE DESIGN - EFFECT ON PALMAR LOADS DURING AMBULATION

Objective: To compare loads, load distributions, pressures, and areas of weight-bearing on the palm for forearm crutches with cylindrical an d wide handles during ambulation to determine if one handle type produ ced greater loads on the car-pal tunnel region. Design: Single-group r epeated measures of normal adults; descriptive study of patients who w ere long-term crutch users. Data were collected from six palmar region s using an F-Scan system. Setting: Center for neuromuscular disorders in a hospital. Participants: Thirty normal volunteers and 6 patients. Main Outcome Measure: Differences in loads for the palmer regions betw een the two handles, particularly the carpal tunnel region, Results: F or the normal adults, significantly greater loads were found in two di stal regions for the cylindrical handle and in one proximal legion for the wide handle. Distribution of weight-bearing loads showed a simila r pattern for both handles with the palm's proximal and distal radial sides having the greatest loads and the carpal tunnel region having th e third highest load. The area of weight-bearing was significantly gre ater for the wide handle than for the cylindrical. Conclusions: Cylind rical and wide crutch handles have similar load distributions, making it impossible to recommend one type over the other to reduce the occur rence of carpal tunnel syndrome. The wide handle distributes the loads over a greater surface area, producing less focal pressure. (C) 1998 by the American Congress of Rehabilitation Medicine ann the American A cademy of Physical Medicine and Rehabilitation.