Characterising safe walking aid use
Research type
Research Study
Full title
A clinical assessment tool for safe walking frame use to improve fall prevention by informing frame selection, training and monitoring.
IRAS ID
196275
Contact name
Sibylle Thies
Contact email
Sponsor organisation
University of Salford
Clinicaltrials.gov Identifier
NA, NA
Duration of Study in the UK
3 years, 11 months, 31 days
Research summary
Studies suggest that up to 26% of those aged 75 and over are prescribed walking frames (WF) to assist balance and mobility. Nevertheless, their use has been associated with increased falls-risk, although the reasons for this are, to date, entirely unknown. This could be due to the fact that walking frame use is still very poorly understood and that there is a lack of objective stability measures for assisted walking.
This exploratory work will establish proof-of-concept of a sensor system that has the potential to assist clinical staff with walking aid selection, user training and monitoring. Longer-term, the work is expected to contribute to improved fall prevention and assistive device design. This will be achieved either through biomechanical analysis of human movement in the School’s gait laboratories, the School’s Activity of Daily Living Flat (ADL flat: a flat comprised of bedroom, bathroom, kitchen, and lounge), and also in the participants’ home environments. In fact, as the real world is likely to be more challenging to walking frame users than any lab or hospital corridor, due to the presence of narrow corridors, steps and/or transition trims, obstacles, and different flooring, we consider assessing them in a home environment to be an essential step to gain a better understanding of walking aid use.
Specifically, movement for assisted walking will be recorded with optoelectronic cameras, and with inertial sensors and force sensors. The resulting data of the walking aid and the user’s musculoskeletal system will be analysed with custom-made software, programmed in Matlab. At this time, for establishing proof-of-concept of the sensor system, we plan to collect pilot data for actual users of walking frames that are community or care-home dwelling.In addition to the above, there is little guidance on how to set walking frames to the optimal height for the user. Currently healthcare professionals do not have an evidence-based assessment method to optimally match and adjust a given device to a person. The recommendations simply state “when standing holding the hand grips, the elbows should be slightly bent. When standing with hands at the side of the body, the handgrips should reach just above the wrist joint.”, however, whether this recommended adjustment facilitates stable use of the walking frame is unknown. Walking frame models vary in width, with some “slim/ultra-narrow” frames being marketed as a desirable and easier to use in constrained spaces. However, to date research has not investigated how the design and/or adjustment of walking frames affect stability.
We therefore will investigate the effects of frame height and width settings on upright posture, body weight loading onto the frame, and stability during standing and walking in a group of older adults walking frame users. The work is of relevance as it is the first to question recommended height adjustment and design features; this is important because to date both lack an objective evidence base. If we find that frame height settings affect device loading and stability, this could inform follow-on work concerned with increasing stability of users. If we find that a slim/narrow frame compromises stability, this insight would inform prescription since a trade-off should then be considered between ease-of-use and walking stability.
REC name
London - Dulwich Research Ethics Committee
REC reference
16/LO/0986
Date of REC Opinion
19 May 2016
REC opinion
Favourable Opinion