Mobility aids are assistive devices that improves a person’s level of functioning, primarily with regard to movement but also has an impact on many aspects of daily life both in terms of physical and mental functioning. The simplest of the mobility aids are walking sticks which assists with balance and stability. A step above are the medical walkers which are mainly for lower body weakness or paralysis. These devices can be used temporarily for gait training in a person undergoing physical rehabilitation but are also a lifeline for a person who is unable to balance and support themselves unassisted even for short periods of time.
Although cumbersome and restrictive for a more able bodied person with mild imbalance, medical walkers offers less mobile patients the option to stand and move independently and therefore carry out various daily functions on their own. It is not a device solely for the elderly – infact medical walkers are more correctly indicated for the person of any age with conditions like hemiplegia and ataxia. Of the different types of mobility aids, medical walkers provide maximum support for the user but should be reserved for the user who fails with other assistive devices.
There are several different types of medical walkers which can be broadly defined as fixed, wheeled or jointed. Each type has its own distinct advantages and disadvantages and the choice of a walker should be made by the patient in conjunction with the guidance of a doctor and physical therapist. The hemi-walker by definition is a walking cane and not a walker, but is discussed under walkers for the convenience of the lay reader.
Walkers are always operated with two hands when moving, with the exception of the hemi-walker. However, a patient may not need to use only one hand when standing. With more able bodied users, there may be no need to hold onto a walker when standing although it should be close to the person to allow for instant support when needed. The medical walkers of today are very lightweight and durable, mainly due to the use of aluminum in its construction, and some are also adjustable.
The hemi-walker is a walking cane that can be used for one-sided weakness that is moderate or severe or for paralysis. With the light weight of walkers these days, the hemi-walker is more frequently used for those with very poor balance where other canes are not sufficient rather than just for muscle weakness.
These types of walkers include :
The standard pick-up walker is among the more widely used medical walker. It is lightweight and adjustable for patients of different heights. It is used for severe instability associated with muscle weakness or paralysis of both legs. Forearm support walkers are heavier devices for patients with upper arm deformity, weakness or pain. Stair-climbing walkers, as the name suggests, improves stability for a person to climb up stairs. It should be used by younger persons with very good upper body strength and balance who are only impaired by lower extremity weakness.
There are two types of wheeled walkers – the front-wheeled and heavy-wheeled. A front-wheeled (roller) medical walker increases mobility without the need for picking up the walker with each step. While the same degree of upper body strength is not needed, the main disadvantage of the roller walker is that there is some instability with the front wheels. Heavy-wheeled walkers are solely for indoor institutional use but are heavy, cumbersome and can be unsafe.
These types of medical walkers have swivel joints. It is known as reciprocal walkers because one side moves in alternation to the other side. It is ideally suited for the user who wants to move around quicker and in the less awkard gait associated with using fixed walkers.
Although medical walkers offer maximum support amongst the different mobility aids, there are some disadvantages that need to be noted. Walkers offer complete stability for lower body weakness but due to its rigidity, it can cause an awkward and slow gait. These characteristics also promote a bad posture and affects normal walking habits. Therefore it should only be used temporarily by those undergoing rehabilitation. A medical walker is not indicated for outdoor use unless walking on flat and level surfaces like properly maintained sidewalks. It may also create a level of dependence and reduce the users confidence.
A physical therapist should instruct a person on how to use a walker. The user must be capable to manage moving around with a walker before being allowed to do so independently. Without this level of capability to safely operate a medical walker, the user may be prone to falls and serious injuries which can ultimately complicate the overall health status. Family members need to be informed accordingly and should not leave a very unstable person entirely unattended when moving around.