Effect of uphill and downhill walking on walking performance in geriatric patients using awheeled walker.

Abstract

Wheeled walkers are recommended to improve walking performance in older persons and to encourage and assist participation in daily life. Nevertheless, using awheeled walker can cause serious problems in the natural environment. This study aimed to compare uphill and downhill walking with walking level in geriatric patients using awheeled walker. Furthermore, we investigated the effect of using awheeled walker with respect to dual tasking when walking level. A total of 20 geriatric patients (median age 84.5years) walked 10m at their habitual pace along alevel surface, uphill and downhill, with and without astandard wheeled walker. Gait speed, stride length and cadence were assessed by wearable sensors and the walk ratio was calculated. When using awheeled walker while walking level the walk ratio improved (0.58 m/[steps/min] versus 0.57 m/[steps/min], p= 0.023) but gait speed decreased (1.07 m/s versus 1.12 m/s, p= 0.020) when compared to not using awheeled walker. With respect to the walk ratio, uphill and downhill walking with awheeled walker decreased walking performance when compared to level walking (0.54 m/[steps/min] versus 0.58 m/[steps/min], p= 0.023 and 0.55 m/[steps/min] versus 0.58 m/[steps/min], p= 0.001, respectively). At the same time, gait speed decreased (0.079 m/s versus 1.07 m/s, p< 0.0001) or was unaffected. The use of awheeled walker improved the quality of level walking but the performance of uphill and downhill walking was worse compared to walking level when using awheeled walker.