Postural and metabolic benefits of using a forearm support walker in older adults with impairments

Publication date: Available online 24 October 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Chandrasekaran Jayaraman, Chaitanya Krishna Mummididetty, Alexandra Loesch, Sandi Kaur, Shenan Hoppe-Ludwig, Manfred Staat, Arun Jayaraman

Abstract

Objective

To investigate the postural and metabolic benefits a walker with adjustable elbow support (LifeWalker (LW)) can provide for ambulation in population with impairment. The clinical outcomes from the elbow support walker will be compared with standard rollator (SR) and participants predicate device (PD).

Design

Case-crossover study design

Setting

Clinical laboratory

Participants

Individuals aged between 18 and 85 years using a rollator walker as primary mode of assistance and certified as medically stable by their primary physician. 30 participants (80% female (n=24)) recruited from a convenient sample provided voluntary consent and completed the study.

Intervention

Not applicable

Main outcome Measure(s)

The trunk anterior posterior sway (during the 10 m walk test), oxygen consumption (during the 6 minute walk test), the mean forearm load off loaded to the elbow support as percentage of body weight and mean peak hand grip load (during the 25 m walk) were measured.

Results

Ambulating with a LifeWalker led to, (i) reduced trunk sway in the anterior-posterior direction [(Z_{LW Vs. PD} = -2.34, p = .018); (Z_{LW Vs. SR} = -3.461, p = .001)], (ii) reduced erector spinae muscle activation at the left lumbar L3 level [(Z_{LW Vs. PD} = -2.71, P = .007); (Z_{LW Vs. SR} = -1.71, P = .09)], and (iii) improved gait efficiency [(Z_{LW Vs. PD} = -2.66, P = .008) _O2-cost; (Z_{LW Vs. SR} = -2.66, P = .008) _O2-cost]. Participants offloaded between 39%-46% of their body weight through the elbow support armrest while ambulating with the LifeWalker. Irrespective of the walker used, participants exerted ∼5% to 6% of their body weight in gripping the walker handles during walking.

Conclusions

Using the forearm support-based LifeWalker led to, upright body posture, offloaded portions of body weight from the lower extremity and improved gait efficiency during ambulation in comparison to the Standard Rollator and the participants own predicate Device. Further studies focusing on population specific benefits is recommended.

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