Unlike the walking stick, which usually is a straight shaft, perhaps topped by an ornamental knob, the cane used in rehabilitation has a handle. A broad array of manufactured handles is available. The basic crook handle enables the person to hang the cane over the forearm or the back of a chair. One ergonomically shaped handle (available at www.CanesCanada.com) is designed to contact more of the hand, thus contributing to the user’s comfort. The handle is made for right and left hand use. The Right-Grip (available at www.fetterman-crutches.com) has a contoured handle designed to keep the wrist in neutral posture rather than in dorsiflexion.
The base of the cane usually is the distal end of the shaft and terminates in a rubber tip. A spring-loaded tip absorbs shock at initial contact. The AbleTripod (available at www.abletripodcane.com) has a flexible triangular tip that maintains floor contact at a wide range of shaft angles; the tip also absorbs shock. Retractable metal tips or spikes increase stability when the user walks on ice or snow.
Other base designs include the standard or wide-based quadruped (quad), which features a distal rectangle supporting four tips intended to increase the base of support.59 Patients with hemiplegia may not find the four-footed cane any more advantageous than a standard cane with a single tip.84 The Pilot rolling cane (available at www.FullLifeProducts.com) has an L-shaped base fitted with three casters that provide the user with the support of a quad cane without the need to lift the cane with each step. The cane also has a brake control in the handle for maximum stability. The Pilot step-up cane has a broad base with a flip-up platform that allows patients to maneuver over curbs and stairs without losing cane support. The user pushes a button on the handle to flip open the hinged platform; this enable the patient to step half the distance of the conventional 8-inch step. With the step retracted, the cane functions as a standard quad cane. The cane also has a second handle part way down the shaft that facilitates rising from toilets and other seats. The side walker/cane (available at www.tfihealthcare.com) has four widely spaced rubber tips that increase stability, especially when used unilaterally by a patient with hemiplegia.
The marketplace also has several novel cane-like designs intended for adults with lower-limb amputation. They enable the user to ambulate without a prosthesis. The Ed Walker (available at www.theedwalker.com) has a bicycle seat mounted on top of a vertical shaft. Jutting laterally is a second curved shaft, which has a platform for the amputation limb and terminates in a cane handle.28 The iWalkFree (available at www.fetterman-crutches.com) has a platform on a vertical shaft that supports the transtibial amputation limb or an injured lower leg. The wearer supports weight through the thigh and knee. Both devices have a stationary base. The Roll-A-Bout (available at www.roll-a-bout.com) terminates in four 8-inch wheels. This folding device has a cushioned platform for the lower leg and a handle that the user holds while propelling with the opposite foot.
A major class of canes is long canes with the lower portion of the shaft colored red. These canes are used by people with visual impairment.58,85,99,109 The shaft transmits to the user vibratory impulses regarding the terrain, while the red tip signals passersby not to impede the user.
