The fitting process and the use of standard canes and quad canes are very similar. The choice of which type cane you should use depends on how much support and added stability is needed. The quad tipped cane provides much greater stability because of its multiple points on the ground and has the advantage of being free standing. One disadvantage of a quad cane is that it is heavier.
The choice of the handgrip will depend largely on the size of your hand. You may also want to consider one of the canes with a curve in the shaft. This design locates the handgrip directly over the cane tip, eliminating uncomfortable offsetting leverage and instability. This feature provides better balance, added confidence, and less fatigue to the hand and wrist.
In addition to the choice of handgrips and shaft design, quad canes are available in either a narrow base or a wide base version. The wide base models are used by individuals needing substantial support and who do not have to negotiate stairs. The wide base will not safely fit onto a step.
The narrow base quad cane provides somewhat less support but can be used on stairs. Even with the narrow base the cane should be turned sideways on steps to provide greater safety.
You should not attempt to negotiate stairs with any type of cane without the approval of your physician or therapist
HEIGHT ADJUSTMENT
The correct height adjustment is one that provides a 20 to 30 degree bend in the elbow. This can be easily achieved by having the user stand erect, look straight ahead with shoulders squared and arms hanging relaxed at the sides. The height of the cane is then adjusted to place the hand just above the waist.
After making any height adjustment, check carefully that the adjustment mechanisms locked securely.
INSTRUCTIONS FOR USE
All canes should always be used in the hand on the opposite side from the affected or weaker leg. For example, if the right leg is injured, the cane should be used in the left hand. This procedure should be followed regardless of whether you are right or left handed. The cane and the affected leg should be moved forward simultaneously while bearing weight on the stronger leg. Then, leaning on the cane to reduce weight on the involved leg, the stronger leg should be brought forward. This procedure may seem awkward at first and may require some patience and practice, but it will provide much safer and more stable walking. After a little practice it will seem quite natural.
For those who are just beginning to use a cane for the first time, it may be helpful to break the movement of the cane and the weak limb into two steps. Move the cane forward first, followed by the affected limb. Then, bearing weight on the cane, bring the strong leg forward.
Always take short steps. Over striding tends to cause loss of balance.
If you are using a quad cane, the position of the base is an important safety factor. The bases of most quad canes are flat on one side. The two legs on the flat side are approximately parallel to the shaft while the two legs on the opposite side extend outward for greater stability. It is very important that the cane be used with the flat side in toward the user so as to prevent tripping.
On some model quad canes it may be necessary to rotate the base 180 degrees (1/2 turn) on the shaft to place the flat side toward the user. This is accomplished by using the same mechanism used to adjust the height of the cane. After making any adjustment of the height or the base position always check to confirm that this adjustment mechanism is securely locked.
To sit down in a chair while using a cane or quad cane simply back up to the chair until both legs are touching the seat; then, reaching downward for the armrests, slowly lower your body into the chair. The cane may be placed to the side or back of the chair during this procedure. When rising, pick up the cane and place it in the hand on the strong side. Then, with both feet squarely on the floor in front of you, reverse the process by pushing up on the armrests.
The rubber tips on your cane or quad cane should be inspected regularly. Worn or damaged tips should be replaced immediately. The security off the handgrip should also be checked frequently. A handgrip that could slip off or rotate during weight bearing can cause a fall.
If your Physician's or Therapist's instruction differ in any way from those given here, follow there instructions explicitly.