Background

Walking aids are designed for structural support during walking, however, surprisingly self-reported use of a walking aid (“Yes, I use one.”) has been identified as a risk factor for falling. Adjustment and design of walking aids may affect their usefulness in facilitating a stable walking pattern. We previously identified that increased body weight transfer onto a walking frame (‘device loading’) is associated with increased user stability.

Research question

We asked: “Could adjustment of walking frame height to a lower height than clinically recommended serve as a mechanism to facilitate device loading and thereby increase stability? And: “Do ultra-narrow frames have an adverse effect on stability as compared to standard-width frames?

Methods

Ten older adults that were users of front-wheeled walking frames walked with walking frames of 1) ‘standard width, standard height’, 2)‘standard width, low height’, 3)‘narrow width, standard height’. Smart Walker technology was used to record forces acting on the walking frame and inside the user’s shoes, and cameras recorded relative position of the user’s feet in relation to the frame’s feet. Stability of the user-frame system and device loading (percent body weight transferred onto the frame) were calculated. A general linear mixed effects model was used for statistical analysis.

Results

A lower height setting did not increase device loading and stability, therefore adjusting the height to a lower setting proved to be an unsuccessful mechanism to increase stability. However, device loading was positively correlated with stability for all frame conditions (p < 0.05). Finally, stability was reduced when walking with the ultra-narrow, as compared to standard-width, frame (p = 0.002).

Significance

To increase stability in fall-prone users, active encouragement to transfer body weight onto the walking frame is needed. Considering the adverse effects of ultra-narrow frames on stability, such frames should be prescribed and used with caution.

中文翻译：

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步行架的高度和宽度对步行稳定性的影响研究

背景

助行器专为步行过程中的结构支撑而设计，但是，令人惊讶地自我报告称使用助行器（“是，我用一个。”）是跌倒的危险因素。助行器的调整和设计可能会影响其在促进稳定步行方式方面的作用。我们之前发现，增加体重转移到行走框架上（“设备负荷”）与增加用户稳定性有关。

研究问题

我们问：“将步行架的高度调整到比临床建议的高度低的高度，是否可以作为一种有助于装置装载并因此增加稳定性的机制？并且：“与标准宽度的框架相比，超窄框架是否会对稳定性产生不利影响？

方法

十名使用前轮步行镜的老年人走路时行走着以下镜架：1）“标准宽度，标准高度”，2）“标准宽度，低身高度”，3）“窄宽度，标准身高”。Smart Walker技术用于记录作用在步行框架上和使用者鞋子内的力，而摄像机则记录使用者的脚相对于框架脚的相对位置。计算了用户框架系统的稳定性和设备负载（转移到框架上的体重百分比）。通用线性混合效应模型用于统计分析。

结果

较低的高度设置不会增加设备的负载和稳定性，因此，将高度调整到较低的设置被证明是提高稳定性的不成功机制。但是，在所有帧条件下，设备负载与稳定性呈正相关（p <0.05）。最后，与标准宽度的车架相比，超窄行走时的稳定性降低了（p = 0.002）。

意义

为了增加容易跌倒的使用者的稳定性，需要积极鼓励将体重转移到行走框架上。考虑到超窄框架对稳定性的不利影响，应规定此类框架并谨慎使用。