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. Participants (N=30; 80% women [n=24]) recruited from a convenient sample provided voluntary consent and completed the study. INTERVENTION Not applicable. MAIN OUTCOME MEASURES The trunk anterior-posterior (AP) sway (during the 10-meter walk test), oxygen consumption (during the 6-minute walk test), the mean forearm load offloaded to the elbow support as percentage of body weight, and mean peak hand grip load (during the 25-meter walk test) were measured. RESULTS Ambulating with a LW led to (1) reduced trunk sway in the AP direction [(ZLW vs PD= -2.34, P=.018); (ZLW vs SR= -3.461, P=.001)]; (2) reduced erector spinae muscle activation at the left lumbar L3 level [(ZLW vs PD= -2.71, P=.007); (ZLW vs SR= -1.71, P=.09)]; and (3) improved gait efficiency [(ZLW vs PD= -2.66, P=.008) Oxygen cost; (ZLW Vs. SR= -2.66, P=.008) Oxygen cost]. Participants offloaded between 39% and 46% of their body weight through the elbow support armrest while ambulating with the LW. Irrespective of the walker used, participants exerted ∼5%-6% of their body weight in gripping the walker handles during walking. CONCLUSIONS Using the forearm support-based LW led to upright body posture, offloaded portions of body weight from the lower extremity, and improved gait efficiency during ambulation in comparison to the SR and the participants' own PD. Further studies focusing on population-specific benefits are recommended.

中文翻译：

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在有障碍的老年人中使用前臂支撑助行器的姿势和代谢益处

目的 调查具有可调节肘部支撑的助行器 (LifeWalker [LW]) 可为残疾人群提供步行的姿势和代谢益处。肘部支撑助行器的临床结果将与标准助行器 (SR) 和参与者谓词装置 (PD) 进行比较。设计 案例交叉研究设计。设置 临床实验室。参与者 年龄在 18 至 85 岁之间、使用助行车作为主要辅助方式并经其主治医师证明病情稳定的个人。从方便的样本中招募的参与者（N=30；80% 的女性 [n=24]）自愿同意并完成了研究。干预 不适用。主要观察指标躯干前后（AP）摇摆（10米步行测试期间），耗氧量（6分钟步行测试期间），测量了以体重百分比形式卸载到肘部支撑的平均前臂负荷，以及平均峰值握力负荷（在 25 米步行测试期间）。结果 使用 LW 走动导致 (1) 减少了 AP 方向的躯干摇摆 [(ZLW vs PD= -2.34, P=.018); （ZLW 与 SR= -3.461，P=.001）]；(2) 左侧腰椎 L3 水平竖脊肌激活减少 [(ZLW vs PD= -2.71, P=.007); （ZLW 与 SR= -1.71，P=.09）]；(3) 提高步态效率 [(ZLW vs PD= -2.66, P=.008) 氧气成本；（ZLW 与 SR= -2.66，P=.008）氧气成本]。参与者在使用 LW 走动时通过肘部支撑扶手卸载了他们体重的 39% 到 46%。无论使用哪种助行器，参与者在步行过程中握住助行器手柄时都施加了其体重的 5%-6%。结论 与 SR 和参与者自己的 PD 相比，使用基于前臂支撑的 LW 导致直立的身体姿势，从下肢卸载部分体重，并提高步行期间的步态效率。建议进一步研究侧重于特定人群的益处。