Walking aids are issued to older adults to prevent falls, however, paradoxically their use has been identified as a risk factor for falling. To prevent falls, walking aids must be used in a stable manner, but it remains unknown to what extent associated clinical guidance is adhered to at home, and whether following guidance facilitates a stable walking pattern. It was the aim of this study to investigate adherence to guidance on walking frame use, and to quantify user stability whilst using walking frames. Additionally, we explored the views of users and healthcare professionals on walking aid use, and regarding the instrumented walking frames (‘Smart Walkers’) utilized in this study. This observational study used Smart Walkers and pressure-sensing insoles to investigate usage patterns of 17 older people in their home environment; corresponding video captured contextual information. Additionally, stability when following, or not, clinical guidance was quantified for a subset of users during walking in an Activities of Daily Living Flat and in a gait laboratory. Two focus groups (users, healthcare professionals) shared their experiences with walking aids and provided feedback on the Smart Walkers. Incorrect use was observed for 16% of single support periods and for 29% of dual support periods, and was associated with environmental constraints and a specific frame design feature. Incorrect use was associated with reduced stability. Participants and healthcare professionals perceived the Smart Walker technology positively. Clinical guidance cannot easily be adhered to and self-selected strategies reduce stability, hence are placing the user at risk. Current guidance needs to be improved to address environmental constraints whilst facilitating stable walking. The research is highly relevant considering the rising number of walking aid users, their increased falls-risk, and the costs of falls.

中文翻译：

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老年人在使用步行架时是否处于危险之中？

向老年人发放助行器以防止摔倒，然而，自相矛盾的是，使用助行器被认为是跌倒的危险因素。为了防止跌倒，必须以稳定的方式使用助行器，但是尚不清楚在家中遵守相关临床指导的程度以及遵循指导是否有助于稳定的步行方式。这项研究的目的是调查对步行框架使用指导的遵守情况，并量化使用步行框架时用户的稳定性。此外，我们探讨了用户和医疗保健专业人员对助行器使用的看法，以及本研究中使用的器械式助步架（“智能助行器”）的观点。这项观察性研究使用Smart Walkers和压力感应鞋垫调查了17位老年人在家庭环境中的使用模式。相应的视频捕获的上下文信息。另外，在日常活动公寓和步态实验室中行走时，对一部分或部分使用者的临床指导进行了稳定性评估。两个焦点小组（用户，医疗保健专业人员）分享了使用助行器的经验，并提供了有关智能助行器的反馈。在16％的单支撑期和29％的双支撑期中发现使用不正确，这与环境限制和特定的框架设计特征有关。错误使用会降低稳定性。参与者和医疗保健专业人员对Smart Walker技术持积极态度。临床指南不能轻易遵循，自我选择的策略会降低稳定性，因此使用户处于危险之中。需要改进当前指南以解决环境限制，同时促进稳定的行走。考虑到助行器使用者数量的增加，跌倒风险的增加以及跌倒的成本，该研究具有高度相关性。