Towards safer use of walking frames

Walking aids such as frames are generally given to older people to improve their mobility and stability, however, paradoxically, previous research has shown that their general use is associated with an increased risk of falls. 

In part this is likely due to users being frail, but notably the effectiveness of walking aids also depends on how appropriately they are being used. However, little guidance is offered to users and how stable they are in real-life situations was until recently entirely unknown.

A study from the University of Salford showed that the effectiveness of walking aids depends largely on how appropriately they are being used. For instance, lifting them in order to turn corners or navigate around obstacles can make them unstable. However, little guidance is offered to users, a problem that the university is now seeking to tackle by providing online training resources.

Researchers at the university developed the ‘Smart Walker’ approach, a novel way of measuring stability of walking aid users, and used it in a number of studies. This method can help researchers to study how, for example, the way someone uses a walking aid, or the design of walking aids, might affect their stability. The Salford Smart Walker system has been used in a series of projects funded by the Dunhill Medical Trust and Dowager Countess Eleanor Peel Trust.

Each Smart Walker is fitted with force sensors and is used in combination with motion analysis cameras and pressure-sensing insoles inside the user’s shoes. The system monitors how stable the user is with their frame, how they transfer their body weight onto the frame, and how the frame moves in relation to the user’s own foot movements. 

The latest study looked at how people used their frame in their own homes and also in the university’s Activities of Daily Living flat, a facility designed to look like a real-world flat. Video footage showed that, for example, when turning, users would sometimes completely lift the frame off the ground and then step to turn. This meant that they were not only unsupported, but also carrying the weight of the frame during the manoeuvre. 

Researcher Dr Sibylle Thies (pictured) said: “Analysis with our Smart Walker system showed that during complex tasks such as turning, people displayed usage patterns that reduced their stability. Compared to a wide hospital corridor where prescription and initial training may take place, peoples’ homes were generally more cluttered and tighter for space, and users are provided with little training as to how best to walk with their frame around these obstacles.”

Informed by their research studies, and supported by feedback from a group of healthcare professionals, the team has now put together new guidance leaflets and videos that demonstrate how to do complex tasks with a front-wheeled walking frame, as a first step towards safer frame use. They plan to continue their work to look at other frame models and to see if improvements in design may facilitate more stable and potentially safer use of walking frames at home. 

Sibylle explained: “Figures show that 40% of older adults living at home fall at least once every year, with associated costs estimated at £2.3 billion, and falls often resulting in significant impact on the life of the individual and their family. Walking aids are used indoors by about 22% of UK older adults, and outdoors by about 44%.

“With the ongoing coronavirus pandemic, it is more important than ever that users can access help and guidance online to support them in using their walking aids safely, to prevent falls wherever possible.”