How do we identify to select an assistive device for a patient rehabilitating from TBI, SCI, etc.? There are lots of options that we can take it like cane, axillary crutch, and walker. How do I distinguish between them?

There are 2 very important factors among others to consider when selecting an assistive device for patient rehabilitation. The first factor is patient safety and the second factor is the patients functional ability. Safety considerations prevent  additional injuries, such as falls or palsies, to the patient. Therefore, in consideration of patient’s safety, assistive devices which require a high degree of coordination are not selected for patients with neurological deficits. Devices that have a narrow base of support are not selected for patients with balance issues (in these instances walkers are preferred to crutches or canes) and lastly, devices such as crutches and canes are calibrated to match, for instance, a patient’s height to avoid exposing the patient to unintended injury (e.g. axillary crutches that are too long causing radial nerve palsy).

On the other hand, a TBI or SCI patient’s functional limitations or in some instances, functional abilities present will determine which type of assistive devices (such as wheelchairs) that will be selected.

In conclusion, the selection of assistive devices is quite a wide area in Physical Therapy practice. I would recommend that you review the chapters that covers the selection of assistive devices in any of the recommended texts or review books for more information.