Walkers

Aka: Walkers, Standard Walker, Walking Frame, Front-Wheeled Walker, Front Wheeled Walker, Two Wheeled Walker, Two-Wheeled Walker, Four-Wheeled Walker, Four Wheeled Walker, Rolling Walker, Rollator

1. See Also
   1. Mobility Device
   2. Assistive Technology
   3. Canes
   4. Crutches
   5. Wheelchair
2. Background
   1. Walkers provide broadest base of support of the Ambulatory Devices (compared with Crutches, canes)
   2. Decreased maneuverability compared with other Ambulatory Devices
   3. Requires upper body strength and partial weight bearing
3. Indication
   1. Gait disturbance (full weight bearing)
   2. Difficult balance
   3. Bilateral lower extremity weakness
4. Types (in order of most stable to most mobile)
   1. Standard Walker
      1. Four 4 Rubber-tipped legs and no wheels
      2. For Ataxia (offers full weight bearing support)
      3. Advantages
         1. Most stable device of the Walkers
      4. Disadvantages
         1. Need strength and balance to fully lift walker with each step
         2. Requires slow deliberate gait pattern
         3. Needs most attention of any Ambulatory Device
   2. Front-Wheeled Walker or Two Wheeled Walker
      1. Two Rubber tipped back legs and two front wheels
      2. Rubber tipped back legs help prevent the walker from sliding away from patient
      3. For Movement Disorder (e.g. Parkinson's) or Ataxia
      4. Allows those with poor upper body strength to move walker without lifting
      5. Allows for normal gait and faster pace than Standard Walker
      6. Less stable for weight bearing than Standard Walker
   3. Four-Wheeled Walker (Rollator)
      1. Four wheeled freely mobile device
      2. Least stable of the Walkers, with risk of sliding out from under the patient
         1. May come equipped with hand brake to prevent unwanted movement
      3. Advanced models include a seat and basket allowing for rest breaks
         1. Consider in patients with cardiopulmonary disease with limited walk distance
      4. For mild Movement Disorder or Ataxia
      5. Intended for relatively high functioning patients who do not need support of weight bearing
      6. Do not use for weight bearing support (fall risk)
5. Fitting
   1. Keep elbow flexed at side to 15 to 30 degrees
   2. Cane length: greater trochanter to floor (with shoes)
   3. Technique is important
      1. Do not lean over the walker (poor spine mechanics)
6. References
   1. Sehgal (2021) Am Fam Physician 103(12): 737-44 [PubMed]
   2. Van Hook (2003) Am Fam Physician 67(8):1717-24 [PubMed]