Journal
DISABILITY AND REHABILITATION-ASSISTIVE TECHNOLOGY
Volume 10, Issue 5, Pages 407-414Publisher
TAYLOR & FRANCIS INC
DOI: 10.3109/17483107.2014.908243
Keywords
Ambulation aids; falling; gait stability; quiet standing; stroke; traumatic brain injury; wheeled walker
Categories
Funding
- Canadian Institutes of Health Research
- Natural Sciences and Engineering Research Council of Canada
- Toronto Rehabilitation Institute
- Ministry of Health and Long Term Care in Ontario
- National Institute on Disability and Rehabilitation Research (NIDRR) through Rehabilitation Engineering Research Center on Universal Design and the Built Environment [H133E050004-08A]
- Centre for Inclusive Design and Environmental Access (IDEA)
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Purpose: Despite the common use of rollators (four-wheeled walkers), understanding their effects on gait and balance is limited to laboratory testing rather than everyday use. This study evaluated the utility of an ambulatory assessment approach to examine balance and mobility in everyday conditions compared to a laboratory assessment. Methods: Standing and walking with a rollator was assessed in three neurological rehabilitation in-patients under two conditions: (1) in laboratory (i.e. forceplate, GaitRite), and (2) while performing a natural walking course within and outside of the institution. An instrumented rollator (iWalker) was used to measure variables related to the balance control (e.g. upper limb kinetics), destabilizing events (e.g. stumbling), and environmental context. Results: Two of three patients demonstrated greater reliance on the rollator for standing balance (2.3-5.9 times higher vertical loading, 72-206% increase in COP excursion) and 29-42% faster gait during the walking course compared to the laboratory. Importantly, destabilizing events (collisions, stumbling) were recorded during the walking course. Such events were not observed in the laboratory. Conclusion: This study illustrated a greater reliance on the rollator during challenges in everyday use compared to laboratory assessment and provided evidence of specific circumstances associated with destabilizing events that may precipitate falls in non-laboratory settings.
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