As we get older we can become weaker and become more unsteady on our feet, this makes getting around difficult both physically and mentally – being unsteady is scary!!
Mobility aids aim to help people with walking and other daily activities, reducing the risk of fall, increasing confidence, and increasing their autonomy and independence.
They are a vital bit of kit for many – but we often see people using the wrong type of mobility aid, or the right one that is set up incorrectly for them.
Common Mobility Problems
There are usually many factors that contribute to somebody having mobility issues, including muscle weakness, pain, joint issues, disease, and cognitive factors, such as a fear of falling.
Whilst physiotherapy can aid to improve many of these factors, appropriate mobility aids are vital to the rehabilitation process and assist in normal daily living.
Ultimately, we must avoid people with mobility issues from falling.
- 1 in 3 people over the age of 65 will fall every year – up to half of these will not be able to get up
- 1 in 2 people over the age of 80, who live in the community, will have a fall this year
- Half of people who fall will fall again in the next 12 months
- Injury due to falls is the leading cause of mortality in people aged over 75, with recurrent falls leading to increased hospitalisation and increased rates of long-term care.
Common Mobility Aids
Walking Sticks
Walking sticks are the simplest type of mobility aids, ranging from a simple wooden stick, to adjustable lightweight aluminium sticks to ornate canes. Regardless of the style, walking sticks aid people who require the least assistance with their mobility. Often they just need assistance when mobilising uneven surfaces and steps, and a safety net when the feel tired or unsteady. People often just use them to increase confidence when walking in public or busy spaces. Walking sticks do this by increasing your base of support, making you more steady and by distributing your body weight, taking pressure off of weak or painful joints and muscles.
Quad or Tri sticks feature a wider base, with a bigger number of feet, giving greater balance and weight distribution than a standard walking stick. This increases stability and gives better opportunity to use upper body strength. However, they are slightly heavier therefore slightly more cumbersome than a standard walking stick.
Crutches
Crutches are a very versatile walking aid, they can be used individually or in pairs. They can also allow you to mobilise without putting any weight through a limb (non-weightbearing), allow you to adjust how much weight you put through a limb (partial-weightbearing), or to put all you weight through a limb (fully-weightbearing). This can be very helpful when you are recovering from an injury or operation that may temporarily reduce your mobility, such as; a knee replacement, hip replacement, ankle sprain or even post fall.
However, they do require a good level of upper body strength and so may not be the best option for some older people.
When set up correctly, crutches are fantastic for enabling you to walk with a good gait (walking) pattern, they can help you to maintain a good upright posture. Crutches can be a great way to maintain independence, with more stability than a walking stick but are less cumbersome than a frame or rollator.
Walking Frames – Zimmer Frames & Rollators
Both Zimmer Frames and Rollators offer much more stability than sticks or crutches. The terminology for these frames can be a little confusing, with people often using different words to mean the same thing.
We talk about:
Zimmer Frame – a frame with four fixed feet. Generally, Zimmer frames are great for short distance or for use around the home. They are very stable, but require the user to have enough strength to lift them up.
Wheeled Zimmer Frame – a frame with two fixed feet at the back and two wheels at the front, like a zimmer frame these are great for use around the home or short distances. The wheels make them a little less stable than a zimmer frame, with the user pushing them forward rather than lifting. This reduces reliance on upper body strength and makes them slightly easier to manoeuvre.
Rollator – a frame where all of the corners are wheeled – these can come in three or four wheel varieties. They may have a seat and or storage. A rollator with seats gives the user a chance to have a rest when needed. Storage is very handy, it also means that hands are free to use the aid whilst walking, reducing the risk of falls.
Physiotherapy Assistance with Walking Aids
Walking aids can be a vital aid in reducing your risk of falls, increasing your mobility and regaining independence.
BUT, and it’s a big but, a recent study “Understanding the Relationship Between Walking Aids and Falls in Older Adults: A Prospective Cohort Study”, suggests that a walking aid that is the wrong type, that is fitted incorrectly, not properly maintained, or that the user is not trained to use can actually increase risk of falls. Approximately 30% of walking aids purchased are not used as they are a poor fit for their user and their environment.
Therefore, if you are looking at getting a mobility aid for yourself or a loved one, it is important that you pick the correct type and have it fitted correctly. Booking in with one of our Community Physiotherapists should be the first port of call. We are able to assess your needs, and advise on the appropriate aid that meets your individual requirements. The advantage of Home Visits Physiotherapy is that we are able to see how your home is set up, look at number of stairs, how you access the house, ect. It may well be that a combination of aids will be appropriate.
Our initial assessment will ask about current issues, past medical history, current medical history, any medications that you’re taking and the home set up. We will then look at your walking, balance and strength. We may use special tests to look at your balance and strength in closer detail to try to pinpoint where physiotherapy will be able to help. We will then give you your own personalised exercise programme, tailored to your individual needs and advice on appropriate mobility aids. After you have received your mobility aid, we can ensure that it is set up correctly to ensure you get the maximum stability and ease of use from it. We can then teach you how to use it safely and effectively.
We provide education and training on how to use the walking aid, the benefits (as mentioned above), proper prescription and fitting the aid to suit your needs.
Case study
Here is an example of how our Community Physiotherapy Team have worked alongside a client to aid recovery, utilising the right walking aids at the appropriate time. This approach took our client from being practically incapacitated to mobilising independently – a feat that John did not think was going to be possible at the beginning.
John (not real name), is a 94 year old gentleman who was very active in life. Unfortunately, he fell whilst out shopping and fractured his hip. John underwent a total hip replacement, and after 3 weeks in hospital, John was able to return home with a wheeled zimmer frame to help him to move around. The wheeled zimmer frame enabled John to move around his house but meant he wasn’t able to help as much with household chores, carry anything or take part in his regular social life.
At this point, we came into picture to work with John. After a few weeks of physiotherapy sessions with us, John became increasingly confident with the wheeled zimmer frame and wanted to be able to go out into the garden. The zimmer frame was not ideal for this as it isn’t designed for outside and doesn’t manage well on uneven surfaces.
John worked really hard, both during physiotherapy sessions and with his home exercises (helped out by his family). This enabled us to progress John onto 2 crutches which allowed him to walk around his beloved garden. Within a few weeks of using 2 crutches we were able to progress John further onto 1 crutch which in turn meant he was able to walk and carry items around the house and up and down stairs.
John did so well with his physiotherapy that he finally progressed to where he was comfortable which was using 1 walking stick to walk outside, meaning he was able to attend all his weekly social activities.
Using the right walking aid at the right time, being led by professionals, meant that John was able to progress well and return to his way of life and regain his independence.
Should you like to book an appointment then please call us on 01293 365011 or email info@sbphysiotherapy.co.uk
Our Community Team cover Horley, Crawley, Redhill, Reigate, East Grinstead, Lingfield, Copthorne and surrounding areas. We may be able to visit areas outside of this at request.
For further information on our Community Physiotherapy Team – please visit their page here