Dataset Information

Are older people putting themselves at risk when using their walking frames?

ABSTRACT:

Background

Walking aids are issued to older adults to prevent falls, however, paradoxically their use has been identified as a risk factor for falling. To prevent falls, walking aids must be used in a stable manner, but it remains unknown to what extent associated clinical guidance is adhered to at home, and whether following guidance facilitates a stable walking pattern. It was the aim of this study to investigate adherence to guidance on walking frame use, and to quantify user stability whilst using walking frames. Additionally, we explored the views of users and healthcare professionals on walking aid use, and regarding the instrumented walking frames ('Smart Walkers') utilized in this study.

Methods

This observational study used Smart Walkers and pressure-sensing insoles to investigate usage patterns of 17 older people in their home environment; corresponding video captured contextual information. Additionally, stability when following, or not, clinical guidance was quantified for a subset of users during walking in an Activities of Daily Living Flat and in a gait laboratory. Two focus groups (users, healthcare professionals) shared their experiences with walking aids and provided feedback on the Smart Walkers.

Results

Incorrect use was observed for 16% of single support periods and for 29% of dual support periods, and was associated with environmental constraints and a specific frame design feature. Incorrect use was associated with reduced stability. Participants and healthcare professionals perceived the Smart Walker technology positively.

Conclusions

Clinical guidance cannot easily be adhered to and self-selected strategies reduce stability, hence are placing the user at risk. Current guidance needs to be improved to address environmental constraints whilst facilitating stable walking. The research is highly relevant considering the rising number of walking aid users, their increased falls-risk, and the costs of falls.

SUBMITTER: Thies SB

PROVIDER: S-EPMC7057469 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Are older people putting themselves at risk when using their walking frames?

Thies Sibylle Brunhilde SB Bates Alex A Costamagna Eleonora E Kenney Laurence L Granat Malcolm M Webb Jo J Howard Dave D Baker Rose R Dawes Helen H

BMC geriatrics 20200304 1

<h4>Background</h4>Walking aids are issued to older adults to prevent falls, however, paradoxically their use has been identified as a risk factor for falling. To prevent falls, walking aids must be used in a stable manner, but it remains unknown to what extent associated clinical guidance is adhered to at home, and whether following guidance facilitates a stable walking pattern. It was the aim of this study to investigate adherence to guidance on walking frame use, and to quantify user stabilit ...[more]

PMID: 32131743

Similar Datasets

Project description:BACKGROUND:The six-minute walking test (6MWT) is a tool that plays a key role in evaluating the functional exercise capacity, prognosis and evaluation of treatment response of patients with various cardiopulmonary diseases. However, standard reference equations are currently unavailable for the six-minute walking distance (6MWD) for people aged 60-85?years in China. The purpose of this study was to 1) measure the 6MWD of healthy Chinese people aged 60-85?years, 2) establish reference equations for predicting the 6MWD, and 3) compare our reference equations with equations reported in previously published studies. METHOD:We obtained informed consent from each participant prior to the test, and the research design was approved by the Ethics Committee of Wenzhou People's Hospital. The demographic and anthropometric data and the 6MWD of healthy Chinese subjects aged 60-85?years old were measured using a standardized protocol. Every subject completed two 6MWTs, and the longest 6MWD further analyzed. RESULTS:Two hundred sixty-six subjects (128 males and 138 females) completed the 6MWT, and the mean walking distance was 518?±?72?m. Males achieved a longer walking distance than females (518?±?72?m vs. 487?±?70?m; p <?0.0001), and active subjects achieved a longer walking distance than nonactive subjects (512?±?76?m vs. 485?±?63?m; p <?0.0001). According to the univariate analysis, the 6MWD was significantly associated with age, height, body mass index (BMI), heart rate and blood pressure after exercise and changes in heart rate before and after exercise. The stepwise multivariate regression analysis identified age, height and BMI as independent predictors of the 6MWD. The reference equations for Caucasians and South Americans tended to overestimate the 6MWD of our subjects, while the equations for Asian and African populations tended to underestimate the 6MWD. CONCLUSIONS:This study is the first to describe the 6MWD of healthy Chinese people aged 60-85?years, and reference prediction equations were proposed. These findings will help to improve the evaluation of Chinese patients with diseases that affect exercise capacity.

Project description:ImportanceThe relationship between self-reported walking limitation, a proxy of muscle function, and fracture risk has not been investigated.ObjectiveTo examine the association between a self-reported walking limitation of 1000 m or less and 5-year risk of fracture.Design, setting, and participantsThis prospective cohort study compared individuals with various degrees of walking ability limitation at 1000 m (a little limitation and a lot of limitation) and those without limitation (no limitation) accounting for age, falls, prior fractures, and weight. Participants from the ongoing population-based Sax Institute 45 and Up Study were followed from recruitment (2005-2008) for 5 years (2010-2013). Data analysis was conducted from July 2020 to September 2023.ExposureSelf-reported walking limitation.Main outcomes and measuresIncident fracture and site-specific fractures (hip, vertebral, and nonhip nonvertebral [NHNV] fractures).ResultsAmong the 266 912 participants enrolled in the 45 and Up Study, 238 969 were included, with 126 015 (53%) women (mean [SD] age, 63 [11] years) and 112 954 (47%) men (mean [SD] age, 61 [11] years). Approximately 20% reported a degree of limitation in walking 1000 m or less at baseline (39 324 women [24%]; 23 191 men [21%]). During a mean (SD) follow-up of 4.1 (0.8) years, 7190 women and 4267 men experienced an incident fracture. Compared with participants who reported no walking limitations, a little limitation and a lot of limitation were associated with higher risk of fracture (a little limitation among women: hazard ratio [HR], 1.32; 95% CI, 1.23-1.41; a little limitation among men: HR, 1.46; 95% CI, 1.34-1.60; a lot of limitation among women: HR, 1.60; 95% CI, 1.49-1.71; a lot of limitation among men: HR, 2.03; 95% CI, 1.86-2.22). Approximately 60% of fractures were attributable to walking limitation. The association was significant for hip, vertebral, and NHNV fracture and ranged between a 21% increase to a greater than 219% increase.Conclusions and relevanceIn this cohort study of 238 969 participants, self-reported walking limitations were associated with increased risk of fracture. These findings suggest that walking ability should be sought by clinicians to identify high-risk candidates for further assessment.

Dataset Information

Are older people putting themselves at risk when using their walking frames?

Background

Methods

Results

Conclusions

Publications

Are older people putting themselves at risk when using their walking frames?

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets