The OT’s Perspective: What we look for when recommending walking aids
Identifying the correct walking aid for a client is one of the most important things that an OT can do, so with that in mind, I have highlighted a few pointers that should hopefully help anyone selecting or manufacturing walking aids.
Generally speaking, when it comes to walking and movement aids, it usually falls into one of four categories:
- Equipment that provides additional contact with the floor, helping to stabilise the gait i.e. a walking stick
- Equipment that allows some weight bearing i.e. an offset cane
- Equipment that allows substantial weight bearing i.e. a four-leg (quad cane), crutches or Zimmer frame
- Equipment that aids movement for people who can’t bear any weight i.e. a wheelchair or scooter
So, which equipment is right for your client, and how do you decide?
Well first, there’s the “Shop Test”
Walk with the end-user holding onto their hand.
If they can walk ok and need little support, an aid is required for stabilising the gait.
If a bit of pressure is felt, an offset cane or aid required.
If two hands or arm around the waist is required, a quad cane, crutches or Zimmer frame is required.
If they’re unable to stand safely for 10 seconds, the chances are that the individual requires physiotherapy/rehabilitation; a walking aid is not sufficient unless you are looking at a RoWalker 400 from Handicare or similar.
You also need to consider environment…
What environments does the end-user regularly find themselves in? Do they spend a lot of time at home, or in a school or college? Where do they work? What tasks do they need to complete most days? Do they travel to work? What activities/hobbies do they have?
Asking yourself all of those questions and then considering how a walking aid will fit into each of them will help you work out how appropriate each solution is.
Other factors to consider is the weight of an aid – larger aids are more stable, but also heavier to use.
It’s also important to consider the home: for example, a small toilet or bathroom may mean that when home the aid does not fit within the bathroom and alternative solutions will be required.
And then, you need to consider these factors:
What is their level of cognition?
How coordinated are they?
What’s their upper body strength and grip strength like?
What level of physical endurance can they cope with?
You also need to ensure how appropriate the aid is for the duration of its use…
A patient may be fine in the morning but some conditions mean by afternoon, they are exhausted and the aid is not suitable.
In this situation, there is no harm in adding different aids for different situations.
For some conditions – for example, Parkinsonism – the client may be non-weight bearing prior to medication, then up and walking with a walking stick two hours later.
Other key things to consider when choosing walking aids:
- VAT relief is available for disabled clients, terminally ill clients and those with diagnosed long-term conditions
- If choosing a walking cane, the length should be roughly the distance from the ground to the elbow crease
- If the client is using one walking aid, it should be used on the opposite side of the weak or painful leg.
I hope you’ve found this useful! If you’ve got any other questions, feel free to fire them over to firstname.lastname@example.org
Stuart Barrow of Promoting Independence is a member of the Royal College of Occupational Therapists and a recognised expert in the field of home adaptations. His experience is sought by manufacturers and service providers looking for an expert opinion. Stuart also runs the Occupational Therapy Adaptations Conference (OTAC).