Mobility Aids
This week let’s dive into the world of mobility aids. This includes things all the way from a single-point cane to an electric scooter! Canes have been around for centuries in some form or fashion, a shepherd’s staff is a good example of a mobility aid that had multiple other uses. In fact, when I think of a cane I imagine the curved handle, which was derived from the shepherd’s crook. In the 1600s, canes became an expression of wealth as a fashion accessory, specifically in Europe. Canes, although still fashionable, are much more functional in the 21st century.
Canes come in a few patterns, the most common being single-point and a quad-point. They are best used for an injury to ONE leg, but many older adults will use them for general balance issues, which is fine as long as a different assistive device is not needed. To use a cane, put it in the hand that is OPPOSITE to the injured leg. This seems counterintuitive, but is the proper way to use a cane. Put the cane out in front of you, step with the injured leg while putting weight on the cane, and then step with the good leg! Rinse and repeat until you’ve reached your destination.
Walkers come in many different form factors, and I usually differentiate based on the number of wheels. There is the “base model,” which is a walker frame without wheels. Then there are front-wheel walkers, three-wheel walkers, and four-wheel walkers, which are known as “rollators.” Walkers are more commonly used for balance disorders as well as strength and endurance difficulties. A base walker must be picked up and set down with every couple steps, so it requires quite a bit of coordination and upper extremity strength. A rollator doesn’t need to be picked up, but it does require a person to be able to work the brakes (some come with brakes that are activated by squeezing a handle and others come with brakes that are always activated unless the person is squeezing the handle). Rollators usually have a seat and a basket, which are great for walking a long distance to help with weight distribution (personal items can go in the basket) and with rest (take a break on the seat). They are limited by the wheels and the weight, so stepping up a curb is generally impossible unless someone is willing to help.
Wheelchairs are highly variable, but for older adults we can break them down into manual and electric. Wheelchairs are used for a variety of reasons ranging from balance disorders to strength and endurance difficulty to neurodegenerative disease. Manual wheelchairs are used if a person is able to self-activate, and for many older adults this involves scooting along in the chair by using legs instead of hands. It can be very challenging for an older adult to move their body weight in a wheelchair by using their arms and requires quite a bit of strength, coordination, and endurance. Electric wheelchairs can provide excellent independence and mobility for older adults, but should only be used in appropriate settings and in appropriate situations.
Guidance of our selection of mobility device should come from our therapists. Both physical and occupational therapists are excellent allied health professionals that can help find ways to improve our day to day mobility and independence! Anytime I have a patient experiencing mobility issues, one of the first things I do is refer them to a therapist for assistance. As a geriatrician, I get to work with multiple other health disciplines and every time I speak with a physical or occupational therapist I learn something new!
Key Points:
Mobility devices have been around since humans have been on two feet
If you need a mobility device, a therapist should help guide you to the correct one
