We all know it and we all love to hate the idea of needing it. The reality is – many have no choice. Here's a perspective on this staple piece of medical equipment; the good, the not so good and where we need to improve.
The walker came about in the early 1950s, originally patented in the US in 1953. Revolutionary at the time, it enabled mobility where it once wasn’t. It continues to be used so widely in healthcare because it is a low cost, compact and stable walking aid – a combination of benefits that lends well to a variety of use case scenarios.
Today it’s highly commoditized as a standard in all care settings, reimbursed by insurance and a default recommendation from most providers. Other walker-type devices haven’t supplanted it because they don’t provide the same combination of benefits (and presumably nor are they trying).
For those who require them it can enable mobility and mitigate falls risk compared to without. We also have evidence that device use may moderate severity of injury in the event of a fall compared to without the device.
A 2017 study by The Gerontologist found an important correlation in a survey of 162 device users who had sustained falls - rates of head trauma, fractures, hospitalization and surgery were all significantly higher in the group that fell when they weren’t using their device (either cane or walker) compared to those who fell while using their device. 100% of the respondents who required surgery as a result of their fall were not using their device at the time of the fall.
Innovations in technology have left walker users behind. While it is often the best and only option for patients, the inadequacies of the device lead to greater falls risks, longer recovery times and more reliance on family, caregivers and supplemental equipment. They have their place but right now we ask much of them, casting them in a wide net of scenarios out of necessity. Users often have no choice but to use the walker as their best option - that doesn't mean it's meeting their needs.
The walker’s list of inadequacies are known in the healthcare world with existing research done on the subject but much left to be figured out. A 2009 CDC study tracking ER visits over a 6 year period found that 87% of walking aid related falls involved walkers. The 2017 The Gerontologist study determined “New strategies are needed to improve device acceptability and accessibility.” In understanding where they fall short in acceptability we can perhaps inform innovation.
Designed specifically as a walking aid, the device isn’t meant to support other areas of mobility. There’s an important catch-22 here as the more necessary a walking aid is for a person, the more difficulty they likely have getting out of bed, standing from a chair, reaching a hand to the sink to wash their hands or open the fridge, etc. Difficulty walking and other areas of mobility aren’t mutually exclusive, quite the opposite. People who require walkers have a wide range of needs and circumstances, often meaning they own more than one assistive device, have supplemental equipment and/or require physical assistance from a caregiver. Yet still, many struggle.
Assistive devices are necessary as much now as ever to support an aging population seeing skyrocketing falls rates and increases in frequency of chronic conditions.
A well-focused strength and balance program, particular compensation or piece of equipment - it's the subtleties that often really make the difference in what mobility goals walker users are able to achieve and on what timeline. Being able to put an optimal device in front of someone who needs it is vital for both the user and any caregiver, whether during recovery from injury or in chronic debility.
Innovation will likely lie in an improved understanding of how user’s interact with assistive devices from the perspectives of:
SmartStep Mobility is looking closely at these areas of improvement. Please follow us!