Introduction[edit | edit source] Show
A walker is a walking aid that has four points of contact with the ground. It usually has three sides with the side closest to the patient being open. It provides a wider base of support than a walking stick, so it is used more to stabilise patients with poor balance and mobility or lower extremity impairment.[1][2] Having a caregiver and being unable to walk more than one metre per second has been significantly associated with walking frame use.[3] Paradoxically, walker or frame use has been associated with an increased risk of falls in both community-dwellers and those who live in residential care.[4][5] Despite the positive correlation between device use and falls, caregivers report mobility aids promote independent mobility in people with disability,[6] and users report that mobility aids increase opportunities for social interactions.[7] Using a walker can also increase metabolic and musculoskeletal demands, so prescription and education are key to helping the user maintain their balance, minimise their falls risk and optimise their activity levels.[2][8] People may be resistant to use walkers due to social stigma and peer pressure, particularly in minority groups.[9] Having positive peers models, greater physician input, more visually pleasing walkers, lower cost walkers and user-friendly walkers would aid in greater acceptance.[10] In 2009 in Australia, the percentage of people with disabilities using aids was 15% [6.6% using walking frames, 6.7% walking sticks].[11] A study in the USA, found that 11.6% of those aged over 65 used walking frames. It was also found that the use of walking aids had jumped up by 50% in the 10 years prior to 2015.[12] In a Canadian study which used data from 2012, 4.1% of the population aged 15 years and older used a walking frame, stick or crutch. Approximately 50% of these used a walker. Since 2004, there was a 2% increase in walking aid use in the community.[13] Types of Walkers [edit | edit source]Many walkers exist on the market, but physiotherapists are well placed to help select the correct walker based on the differing needs of users. [14] 4 Wheeled Walker[edit | edit source]
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Variations on 4 Wheel Walkers[edit | edit source]
[18] Prescription[edit | edit source]There is no one walker that is more desirable than another.[19] Walker choice is dependent on:
There is recent, preliminary evidence to suggest that the stability of a user and their walker can be measured "as one". The methodology considered a combined (user plus walker) centre of pressure and combined base of support (again created by user and walker, not two separate bases of support).[20] This may not be so practical for physiotherapists, particularly those assessing users in their homes, but the physics behind the methodology is useful to consider. Walkers should be adjustable in height, which is measured the same way as one would measure for a walking stick.[19] Shoes should be taken into account during prescription as shoe height can significantly affect walker use.[19] Factors to take into account when prescribing a walking frame[19]:
Assessing the user with a walking aid should be done using an appropriate outcome measure such as the 10 Metre Walk Test or Timed Up and Go. Walkers can result in decreased arm swing and poor back balance.[1] Usage[edit | edit source]Users should have a smooth gait pattern that is unimpeded by the frame. There should be adequate space for step placement. Users should never attempt to use a frame, by pulling on it, to help them sit or stand. Four Point Walker / Zimmer Frame[edit | edit source]A four point walker, often called a zimmer frame, is a frame with four legs and a wide base. It is used in the following way if weight bearing on both legs. The user should:
4 Wheeled Walker[edit | edit source]
Maintenance[edit | edit source]
References[edit | edit source]
What are 4 types of walkers?Talk to your doctor or physical therapist about the options, including:. Standard walker. This walker has four nonskid, rubber-tipped legs to provide stability. ... . Two-wheel walker. ... . Three-wheel walker. ... . Four-wheel walker. ... . Knee walker.. |