A Cornell University study showed a considerable gap between many of today’s walkers and what seniors actually want and need in an assistive device.
“Reimagining Assistive Walkers: An Exploration of Challenges and Preferences in Older Adults,” published this spring, used data from questionnaires completed by 24 older adults, 30 caregivers, and 27 health care professionals. Study authors noted that more than half of the caregivers and health care professionals “displayed good knowledge, positive attitudes and effective practices regarding walkers.”
Many of the seniors surveyed reported vision impairments (79%) and/or hearing impairments (58%), demonstrating that many people with mobility difficulties also have other conditions that impact efficient ambulation.
Arthritis and knee/hip conditions (42% each) were the most commonly reported issues impacting participants’ mobility. Additionally, 8% of participants reported having Parkinson’s disease or paralysis, and 8% said they’d had a stroke. And 5% reported having osteoporosis. The mean age of participants was 88 years.
Although researchers noted that mobility devices “have been shown to boost independence, foster social participation and improve the quality of life in older adults,” using a walker “presents its own set of challenges,” the authors said. “Despite some studies suggesting that walking aids may prevent falls in older individuals, the association remains poorly understood. This is because walking aids can alter gait patterns by preventing normal arm swing, changing posture, decreasing gait speed and increasing standing time. Difficulty in navigating stairs, destabilizing biomechanical effects, upper-limb pain and an increased risk of falling are among the potential drawbacks.”
Mobility needs and current technology don’t always align
“Moreover, assistive walkers frequently fail to satisfy the needs of older adults, and this misalignment between their needs and the adoption of these technologies stymies their capacity to achieve independence,” the study added.
Wheeled walkers “may fall short in providing adequate support during essential sit-to-stand transfers that are crucial for daily activities,” the study said as one example.
Seniors in the study strongly agreed that their current walkers were helpful in maintaining daily routines. But researchers pointed out that 21% of seniors were unsure about walker safety and 25% reported experiencing discomfort from using their walkers.
Among health care professionals who completed the survey, researchers noted “some uncertainty around safety precautions and prescribing.” But 50% of those health care professionals reported “neutral” agreement with the statements “I think assistive walkers serve as a sign of weakness and frailty” and “I think conventional assistive walkers (CAW) used in hospital settings can cause frustration among users.”
Half of the surveyed health care professionals also felt neutral about the statements “I have a procedure for evaluating patients requiring a CAW” and “I perform regular follow-up on mobility improvements with patients who use a CAW.”
Half of participating caregivers were neutral “on whether older adults avoid CAWs due to usage factors or design,” while 37% perceived walkers as fall risks due to stability issues.
Changes that could help
Of the seniors surveyed, 96% identified a lack of navigation systems for walkers, and 42% reported that the physical effort required to use a walker effectively was a concern, “pointing to the need for ergonomic improvements to enhance safety and ease of use,” study authors said.
More than half of the surveyed seniors, caregivers and health care professionals recommended innovative improvements for walkers, including navigation systems and ergonomic designs. More than half of the caregivers and health care professionals also said walkers would benefit from safety and convenience additions such as alarm buttons, user-friendly brakes, and fall-detection systems.
Study authors noted that older adults and their caregivers were more likely to blame falls on the walker itself, such as problems with wheels or brakes. But health care professionals were more likely to correlate falls with patients’ poor balance and cognitive impairments, which “implies there would be benefit in incorporating cognitive assistance features into these walkers to facilitate smoother transfers.”
Health care professionals also advocated for lighter-weight walkers, as today’s walkers tended “to be heavy, requiring so much strength and effort, further exacerbating the issues and increasing the risk of falling.”
And caregivers reported that noise from walkers’ brakes and wheels “could cause discomfort, stress and agitation, leading to reluctance to use the walkers.”
“Integrating noise reduction features, such as noise-absorbing materials in wheels and brakes, could dampen vibrations and improve user experience,” researchers suggested.
Study authors also noted that seniors’ comments were sometimes inconsistent, “such as differing views on navigation systems,” which “highlight the diverse needs of assistive walker users. Our study aimed to capture a broad spectrum of experiences; however, these discrepancies suggest that additional segmentation or subgroup analysis may be beneficial in future research.”
