crutches image

The World Health Organization’s (WHO) recent global assistive technology guide contains important information for assistive technology manufacturers to help design high-quality devices.

The guide includes specifications for 26 prioritised assistive products, covering mobility, hearing, vision, communication, cognition and self-care. Products range from rollators, hearing aids and portable ramps through to wheelchair seat cushions, walking frames and shower chairs.

Each product listed describes the functional and performance requirements that can be used as a model to guide manufacturing and procurement.

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The main aim of WHO’s guide is to ensure countries get supply of good quality and affordable assistive products for all who need them.

Below, THIIS has summarised the key information from the guide about manufacturing different types of crutches for end-users.  This can then be used to form the basis of a tender announcement, which suppliers use to formulate bids and the procurement team uses to evaluate bids received.

For specific ISO reference points and tests, read the guide here.

Description and intended use

The guide provides the following description of crutches: “Crutches are walking aids with elbow, underarm or forearm support and a single shaft fitted with a tip (ferrule). A single crutch or pair of crutches is intended for use by children and adults to support balance or weightbearing through the leg(s).”

A crutch has a straight or offset handle with an ergonomically shaped handgrip and a height-adjustable shaft fitted with a tip.

Elbow, axilla and forearm crutches are included in this definition. Walking sticks with or without seats, multi-tip walking sticks (e.g. tripods, quadripods), and lateral support frames are separate assistive technology categories, though, WHO underlines.

General design requirements

The guide says that crutches manufacturers should ensure the following when designing these daily living aids:

  • That they are easily adjustable, strong and durable
  • Have a low deformation risk and high abrasion resistance
  • Be made from a lightweight material
  • The tips of the crutch should be durable, non-slip and replaceable
  • Parts must be replaceable and made from materials that withstand the environment of use

Size and weight

Suppliers should also provide the following information to procurement teams or as part of a bid regarding the size and weight of crutches:

  • overall length
  • height-adjustment range(s)
  • maximum user weight
  • unit weight
  • handle height (axilla and elbow crutches)
  • length of forearm support (forearm crutches)
  • underarm pad (axilla crutches) or cuff (elbow crutches) to handle length

Environment of use and lifespan

Crutches should be appropriate for local terrain and conditions such as sand, rocky terrain, rain, ice and snow, the guide advises. WHO says that each crutch should last for at least for five years, provided they are properly looked after in line with product instructions.

Accessories and spare parts

Manufacturers should also provide tips for different environmental conditions, height adjustment mechanisms, and individual components as spare parts with each crutch. Additionally, manufacturers can also supply padded handgrip covers and cuff protectors as optional accessories.

­­­Functional requirements

Elbow crutches

Elbow
Credit: WHO’s assistive technology guide

Typical user

Elbow crutches are designed for short- or long-term use. Children or adults use elbow crutches if they need support to balance or bear weight through their legs.

Specific characteristics

This type of crutch specifically features cuffs, shafts and height-adjustment mechanisms, WHO says. Cuffs should be closed/semi-circles, have a hinged/fixed attachment and an ergonomically moulded handgrip.

Shafts should be height-adjustable and fitted with a tip, while the height adjustment mechanism should be quick-release. There should be a single height adjustment for the shaft only or a double height adjustment for the cuff and shaft.

Requirements for standard configuration

Elbow crutches should come in three to four different sizes to suit paediatric and adult users, such as sizes for children, teenagers and adults. There should also be a dedicated bariatric range for individuals over 120kg.

These aids to daily living should also come completely assembled with an appropriate tip for the environment. Tips are to be securely fitted and made from durable rubber, the guide recommends.

Axilla crutches

Axilla crutches image
Credit: WHO’s assistive technology guide

Typical user

Designed for short-term use only, axilla crutches are aimed at children or adults who need support to balance or bear weight through their legs.

Specific characteristics

Axilla crutches should come with cushioned underarm supports and ergonomically moulded handgrips. WHO says that the shaft should be height-adjustable and fitted with a tip. These crutches should feature a height adjustment mechanism that facilitates double height adjustment (handgrip and shaft).

Requirements for standard configuration

As with elbow crutches, axilla crutches should also come in three to four different sizes to suit paediatric and adult users, as well as have a plus-size range for individuals over 120kg.

Each crutch should come completely assembled with an appropriate tip for the environment, with tips securely fitted and made from durable rubber.

WHO advises that the shaft should have an adjustable height and be made from aluminium or wood. The height adjustment of the handgrip should be independent of the shaft’s adjustment, the guide underlines, with the handgrip commonly made from plastic.

Forearm crutches

Forearm crutches image
Credit: WHO’s assistive technology guide

Typical user

Children or adults can use forearm crutches for short- or long-term use. They are designed for individuals who need support to balance or bear weight through their legs and are unable to use standard handgrip due to hand or arm impairment.

Specific characteristics

The forearm supports should offer horizontal support and be moulded and cushioned. They should come with a hook-and-loop fastener.

Handgrips should come with a telescopic handle that rotates through 360 °, the guide advises. The shaft should be height-adjustable and fitted with a tip.

Additionally, the height adjustment mechanism should be quick-release and the shaft should feature a single height adjustment.

Requirements for standard configuration

Like elbow and axilla crutches, forearm crutches should also come in three to four different sizes to suit paediatric and adult users, as well as have a bariatric range for individuals over 120kg.

The daily living aids should come fully assembled with an appropriate tip for the environment, with tips securely fitted and made from durable rubber.

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