Abstract

BackgroundIn an increasing aging society, reduced mobility is one of the most important factors limiting activities of daily living and overall quality of life. The ability to walk independently contributes to the mobility, but is increasingly restricted by numerous diseases that impair gait and balance. The aim of this cross-sectional observation study was to examine whether spatio-temporal gait parameters derived from mobile instrumented gait analysis can be used to measure the gait stabilizing effects of a wheeled walker (WW) and whether these gait parameters may serve as surrogate marker in hospitalized patients with multifactorial gait and balance impairment.MethodsOne hundred six patients (ages 68–95) wearing inertial sensor equipped shoes passed an instrumented walkway with and without gait support from a WW. The walkway assessed the risk of falling associated gait parameters velocity, swing time, stride length, stride time- and double support time variability. Inertial sensor-equipped shoes measured heel strike and toe off angles, and foot clearance.ResultsThe use of a WW improved the risk of spatio-temporal parameters velocity, swing time, stride length and the sagittal plane associated parameters heel strike and toe off angles in all patients. First-time users (FTUs) showed similar gait parameter improvement patterns as frequent WW users (FUs). However, FUs with higher levels of gait impairment improved more in velocity, stride length and toe off angle compared to the FTUs.ConclusionThe impact of a WW can be quantified objectively by instrumented gait assessment. Thus, objective gait parameters may serve as surrogate markers for the use of walking aids in patients with gait and balance impairments.

Highlights

  • In an increasing aging society, reduced mobility is one of the most important factors limiting activities of daily living and overall quality of life

  • Functional mobility assessment battery revealed stronger signs of impairment in patients that were used to a wheeled walker (WW) (FUs) compared the First time users (FTU) in several parameters

  • Fear of falling assessed by the Falls Efficacy Scale International questionnaire (FES-I) questionnaire revealed an overall increased fear of falling level, which was even more pronounced in the Frequent users (FU) compared to the FTUs

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Summary

Introduction

In an increasing aging society, reduced mobility is one of the most important factors limiting activities of daily living and overall quality of life. The ability to walk independently contributes to the mobility, but is increasingly restricted by numerous diseases that impair gait and balance. The ability to walk independently is crucial for the individual mobility, but is increasingly restricted by numerous diseases that impair gait and balance in elderly people [2, 3]. Schülein et al Journal of NeuroEngineering and Rehabilitation (2017) 14:18 and mobility of affected patients [15,16,17,18] Walking aids such as crutches, canes, or 4-wheeled walkers (WW) are suitable to reduce the dependency on care-givers and to decrease the burden of care allowing the patient to remain functionally independent and mobile. Even though the benefit of walking aids such as WW is generally well accepted [15, 21,22,23], only little is known about the impact of these devices on gait parameters as objective measures in geriatric patients with gait and balance disorders

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