How to Choose the Best Assistive Device for Walking
The correct walking aid, when fitted and used properly, can increase independence and physical activity in people with chronic gait disorders and other mobility issues. But in order to achieve this, one has to know how to choose an assistive device for walking.
When a child or adult has a new disability, illness, or gait disorder, the first stop should always be a doctor or physical therapist to ensure a thorough evaluation of the user's physical and cognitive abilities. Our more generalized tips can be considered together with the medical professional’s evaluation to help you choose the right walking aid.
5 Steps to Choosing an Assistive Device
According to a practice guide by Dr. Robert Lam, there are five key factors that must be considered when choosing a walking aid:
Cognitive function
Coordination
Upper-body and grip strength
Physical endurance
Walking environment
Looking at these factors one by one will shed some important insights into device selection.
1. Cognitive Function
An individual's ability to concentrate and plan their movements beforehand affects the walking aids that that person can use safely.
Walking canes. Canes can be helpful for individuals with mild visual, sensory, or balance issues, or they can provide support in cases of mild arthritis or joint pain. To use a walking cane safely, the person needs to have sound cognitive function to prevent trips and falls.
Walkers. Walkers provide a higher level of stability than canes but require more attention from the user. Front-wheel walkers can be especially helpful for people with Parkinson's disease as they don’t increase gait freezing, a problem that often occurs with regular walkers.
Rollators and knee scooters. Rollators, like the ones we stock in our Denver, CO showroom, are ideal for individuals who have a high level of cognitive function and will remember to apply the brakes before sitting down. Likewise, knee scooters roll on wheels and should be used by people of sound mind.
Crutches. Crutches require a high level of motor planning, especially when moving up and down stairs. This makes them more suited to people with full cognitive function who are recovering from a lower-body injury.
For someone with significant cognitive decline, the best walking aid is generally a front-wheeled walker used under supervision or a transport chair when a walker is not enough. Before use, the patient and caregiver should always be trained in the safe use of each device and the device adjusted to the correct height.
2. Coordination
Individuals who have suffered a stroke or have a neurodegenerative disease often struggle with coordination, balance, and reaction time. When looking at assistive devices for people with coordination problems, prioritize stability and ease of use.
Canes. Walking canes provide straightforward support in the case of mild balance issues because they provide a third point of contact with the ground. A quad cane provides more support than a single-tip cane.
Walkers and rollators. Walkers and rollators support the user on both sides of the body, making them suitable for people with poor balance or lower-body weakness. Rollators allow for a faster walking speed than traditional walkers because they don’t need to be picked up and placed back on the ground for each step.
3. Upper-Body and Grip Strength
When devices are used to relieve some of the weight on the individual's lower body, upper-body and grip strength become important considerations.
Offset cane. An offset cane allows the user to bear weight by distributing that weight through the angled shaft of the cane. Offset canes can bear around 25% of the user's body weight (which can be especially helpful for moderate hip or knee arthritis) and are easier and more ergonomic to grip than canes with an umbrella-style handle.
Standard walkers. Standard walkers can bear up to 50% of the user's body weight but need to be picked up and put down again for every step, which requires at least moderate upper-body strength. Individuals with little upper-body strength might consider a front-wheel cane or rollator, both of which are rolled forward rather than needing to be picked up.
Crutches. Crutches can bear 100% of the user's weight, allowing the individual to be completely non-weight-bearing on one side. Crutches require significant upper-body strength and coordination to use.
Knee scooters. Knee scooters put the weight on the knee of the bad leg rather than on the upper body. This makes them a better option than crutches for users with low to moderate upper-body strength.
4. Physical Endurance
Mobility aids like canes and walkers assist with stability in individuals who still have the energy to get around independently. However, for people with respiratory or cardiovascular diseases, chronic illnesses, or frailty due to age, consider a walking aid that allows the user to rest.
Rollators. Rollators have a padded seat that the user can sit on when he or she needs to take a break. Before sitting down, make sure that the brakes are on and that the rollator is rolled up against a wall or other hard surface.
Manual wheelchairs. Individuals who have upper-body strength but tire easily can benefit from using a manual wheelchair. To rest, the user simply puts on the brakes and uses the chair as a seat.
Transport chairs. Transport chairs can help a lot with day trips and outings that could prove tiring for older adults and people with chronic illnesses. These lightweight chairs can simply be carried and then folded out for use when the person needs to rest.
5. Walking Environment
Finally, it's essential to factor in the person's home, outdoor environment, and how often the assistive walking device is intended to be used.
Stairs. Walking canes and crutches can safely be used on stairs. If neither of these is a suitable option, consider buying or renting a stairlift and installing a wheelchair ramp outside.
Smooth vs rough surfaces. Front-wheeled walkers, rollators, and knee scooters are ideal for use on smooth surfaces like concrete, laminate, tiles, thin carpets, and wooden floors. For rough surfaces like grass, plush carpets, and gravel, consider a walking cane, standard walker, crutches, manual wheelchair, or transport chair.
Infrequent vs constant use. For infrequent use, individuals can consider walking aids that provide less support, such as single-tip walking canes and crutches. For all-day support, consider something more heavy-duty like a quad cane, rollator, or manual wheelchair.
Don't Guess When It Comes to Choosing a Walking Aid - Seek Professional Advice
All things considered, the best way to choose the right walking aid is to be evaluated by a professional, measured for the proper fit, and trained in the proper use of the device.
Once you know which walking aid would be most appropriate, you or your loved one can then go to a mobility aid store, select the preferred color and model, and have the device adjusted for fit before taking it home.