Choosing the Right Walking Aids
Do you feel weak or unsteady on your feet? Did you have a fall recently? Are you afraid to stand or walk without holding onto something or someone?
We lose balance or become immobile because of many reasons and some of which are:
- Back or legs injuries
- infections of the leg bones or muscles
- Weakness resulting from surgery or prolong illness
- Arthritis and other joint pains
- Old age
- Diseases involving the central or peripheral nervous systems such as stroke, peripheral neuropathy, and Parkinson disease.
Walking aids may help to improve your mobility and regain independence. However, it is important to get a suitable device and use it correctly. Otherwise instead of helping you, the device can hinder your movements and jeopardise your safety.
The first consideration is safety
Research found that a fairly large number of elderly falls are related to walking aids. Apparently, a high percentage of walking aids in use may be inappropriate, of incorrect height, or used incorrectly. A study published in the Journal of the American Geriatrics Society1 in 2009 estimated that each year about 47,000 older Americans are treated in the emergency departments with falls associated with walkers and canes.
A more recent study in Belgium2 also warned that using walking aids without proper training possibly increase the risk of falling. It further suggested that seniors should be given adequate training to use a walker or cane safely, including proper gait patterns and ways to avoid falls. The training should also include complicated maneuvers such as opening and closing doors with the aid.
Therefore, before purchasing any walking aid, your needs, your lifestyle and your home environment should be assessed by qualified professionals first. Similar consideration applies if you intend to get a walking aid for a family member or a person you care for. Also bear in mind that it may be more difficult for an elderly to learn or remember how to use a walking aid.
If you are not sure why you are losing balance or dragging your feet, you should consult your doctor to find out the cause and get treatment if necessary. When you are ready for normal activities, the doctor will refer you to a physiotherapist (physical therapist) to get professional help and advice about mobility.
You can also access physiotherapist service directly. In UK and Ireland, physiotherapists are based in hospitals or community health centres, or private practices.
The physiotherapists will carry out an assessment about your gait, balance and strength. Based on what they found, they will make recommendation and advice, and help you choose the most suitable walking aid. They will make sure that the walking stick or walker is of the correct height and weight for your physical condition so that it is safe and you can use it with comfort. Besides, they will also advise you about the footwear, the exercise and the proper technique of using the walking equipment.
Range of walking aids
There are a variety of walking aids with different useful features to take care of different physical disabilities. We can broadly group them into 3 categories:
Walking stick or cane
When used correctly, a walking stick can relieve pressure on sore knees, hips, ankles and feet, as well as improve balance. It tends to be used by elderly and those with moderately reduced balance. You need to have enough strength in your arm to use a walking stick, since your arm must partially support your body’s weight. The main criterion of choosing walking stick is
the height and the type of handle or grip. It is important that the grip fits you well and feels comfortable when walking.
Tripods and quadrupeds
Tripod or quadruped are much like walking stick except that they have three or four rubber-capped feet at the base of the shafts. They are therefore freestanding and give more support and stability than standard walking sticks, though be aware that these are slightly heavier too.
The standard walking or pulpit frames are commonly known as Zimmer frames and are mostly used indoors. They are suitable for those with poor balance and weak legs, and may be used as a rehabilitation aid after prolonged illness. Although it provides a large base support, it prevents a natural walking pattern because the user has to stop and pick up the frame to forward each step. It is therefore not suitable for those who get tired quickly or patients with Parkinson’s disease. Wheeled walking frame is a better option as they do not require lifting for every step.
Rollators are similar to wheeled walkers but in addition to the handlebars, frame and wheels, a seat or shopping basket may be included in its design. If used properly they are good for outdoor activities such as walking and shopping because the users can walk naturally with it, and sit down to rest when the occasion calls for. However, if you need to lean or push against the frame for support, it may run away if the brake was not applied.
Crutches are used after a leg injury or surgery if you only need temporary help with balance and stability. You need strength and good coordination to use crutches properly. Hence, they are not suitable for elderly.
Reducing the risk of falls
To minimise the risk of fall whilst using a walking aid:
- No loose rugs, trailing cables and clutter on the floor. The entrance of all rooms, and the route of movement must be kept clear at all times.
- If you have stairs in your house, it is much safer to keep one walking aid upstairs and one downstairs. You should use the handrails when going up and down the stairs. NEVER use a walking aid on the stairs.
- Do not hold on to a walking frame or stick to get in and out of a chair. They are not stable enough. You should push up with your hands on the arms of the chair and only take hold of the frame or stick once standing. If necessary ask to practise this with a healthcare professional.
- Walking equipment should not be used in wet floor areas. If you need to access a wet room or shower area, ask the advice of an occupational therapist. It is safer to install grab rails in the bathroom.
- Footwears should be well fitted, secure on your feet and supportive as you walk.
- It is vital that your walking aid is kept in good condition. For example, replace the rubber tips at the bottom of the stick or the feet of the tripods if they are worn.
- Stevens, J.A. et al., 2009, ‘Unintentional Fall Injuries Associated with Walkers and Canes in Older Adults Treated in U.S. Emergency Departments’, Journal of the American Geriatrics Society, 57(8), 1464–1469
- Roman de Mettelinge, T. et al., 2015, ‘Understanding the Relationship Between Walking Aids and Falls in Older Adults: A Prospective Cohort Study’, Journal of Geriatric Physical Therapy, 38(3), 127-132