By Sandy Morris
Falling is a hazard that occurs due to decreased muscle mass and strength, vertigo, limb injuries, fatigue and a variety of other health issues. Injuries from a fall can be devastating but can be greatly decreased by using an appropriate mobility aid. There are a variety of ambulation aids available including canes, walkers, scooters and wheelchairs.
Canes provide an additional point of support to enhance safety and stability. As a rule of thumb, a cane can support up to 25% of a person’s body weight and are most useful when balance is minimally impaired or when one leg is significantly weaker than the other. They require moderate hand and arm strength and come with either a hook or horizontal grip. The horizontal grip is recommended for people with hand weakness, as it provides for a secure grasp and increased weight-bearing surface for the hand. The tip of the cane can be a single contact point or a quad base consisting of four separate feet. The additional feet provide more stability, and the base is available in a various sizes. A quad cane can stand upright when not in use, but it can be somewhat heavy.
A walker may be the next option when a cane cannot provide sufficient support. Use of a walker also requires moderate hand and arm strength. Depending on the style of walker, the user can support up to 50% of their body weight. A standard design has four fixed legs and has to be lifted and maneuvered to provide support. It is best for someone with significant stability issues. Wheeled walkers, also known as rollators, come with two, three, four and more wheels and are generally easier to maneuver. Some models include locking brakes for added safety or a bench for resting. Most can be folded for easy storage. Rollators are commonly made of lightweight metals such as aluminum and are similar to walking with a shopping cart. These models allow for a more normal gait and the ability to move with less fatigue compared to a standard walker.
A motorized scooter can be helpful for a person who has some arm strength and dexterity, but is unable to walk long distances. Additionally, the user must also be able to sit upright for an extended period of time. Scooters come many different designs including three- or four-wheeled models; those intended for indoor or outdoor use or both; heavy-duty models designed for rugged outdoor terrain and carrying heavy loads; and lightweight travel models.
Indoor scooters typically have three wheels designed not to leave marks on floors and front-wheel drive for greater maneuverability in tight spaces. Rear-wheel drive provides greater traction for outdoor models, which typically feature four wheels for enhanced stability on a variety of terrains. Both types usually have adjustable chassis, armrests and seats, and come in models designed for specific body types such as taller, shorter or large-framed people. They are also available in ultralight materials that can be disassembled or collapsed for easy portability.
Excessive fatigue, unsteadiness, difficulty rising from a chair and occasional falls are indications that a cane or walker may not provide sufficient support. If your loved one is unable to sit upright or lacks the arm strength or dexterity to operate a scooter, a wheelchair might be the best option to help them remain independent and participate in the activities they enjoy without depending on someone else to assist them.
Wheelchairs are available in manual and electric models. Consult with a doctor or physical therapist to determine the type of seating, back support and other features needed, and a prescription will be written for the chair that best meets your loved one’s needs. Selecting a power wheelchair will require familiarity with terms normally associated with a car purchase, such as front-wheel drive and independent suspension. Each type of system has its plusses, and you may need to balance the doctor’s prescription with insurance coverage, budget limitations, and personal preference to determine the best wheelchair for your loved one’s needs.
Fit is essential
Not only is it important to choose the correct type of walking aid, but you should make sure the user is fitted for the device and trained by a professional on how to use it properly. Too often, a well-meaning friend or relative buys a used cane or walker without realizing that one size does not fit all. The result is often someone unnecessarily stooped over their assistive device, distracting from their stability and causing posture-related problems and even pain.
To select the proper length for a cane, have the user stand up straight with shoes on and arms at their sides. The top of the cane should reach the crease on the underside of the wrist. When properly fit, the elbow will be flexed 15-20 degrees holding the cane while standing. An adjustable cane is a good choice to accommodate different styles of shoes.
The correct height of a walker is also measured from the floor to the wrist. The elbow should be flexed in a range of 15-20 degrees. Be sure the walker is large enough to surround the user on three sides, so they can use the walker for both front and side support.
Scooters and wheelchairs can be customized in numerous ways, so achieving a proper fit usually requires a professional's assistance and expertise.