II. 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

III. Indication

  1. Gait disturbance (full weight bearing)
  2. Difficult balance
  3. Bilateral lower extremity weakness

IV. 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)

V. 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)

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Related Studies

Ontology: Walkers (C0043016)

Definition (UMD) Metal structures (i.e., frameworks) designed to help users to stand and walk (i.e., walkers). Walkers are typically a metal (some also include hard plastics) structure that frames the front and sides of users at waist level and that is supported by multiple (two to five are typical) legs; they usually include supports (i.e., grips, platforms) for the hands. Walkers are intended for the permanent assistance of disabled (e.g., infirm) patients and/or for use during rehabilitation therapy. Standard (i.e., rigid, nonwheeled), wheeled, foldable, adjustable, and one-side two-leg walkers are available; some walkers may include seats and/or other detachable accessories (e.g., trays, pouches). Combinations of walkers and integral seats (i.e., walker/chairs) are also available.
Definition (MSH) Walking aids generally having two handgrips and four legs.
Concepts Medical Device (T074)
MSH D014853
SnomedCT 49338004
LNC LA10117-2
English Walkers, WALKER MISC. EACH, WALKER @ @ EACH, WALKER EACH, Walker, device, walker, walker (treatment), WALKER MISCELL EACH, WALKER@@MISCELL@EACH, walkers, walker [device], Walker, Walker, device (physical object)
Swedish Gånghjälpmedel
Czech chodítka
Finnish Kävelytelineet
Russian ORTOPEDICHESKIE PRISPOSOBLENIIA DLIA KHOD'BY, ОРТОПЕДИЧЕСКИЕ ПРИСПОСОБЛЕНИЯ ДЛЯ ХОДЬБЫ
French Cadres de marche, Déambulateurs
Polish Balkoniki ortopedyczne
Norwegian Ganghjelpemidler, Gåstol
Spanish Caminadores, andador (objeto físico), andador, Andadores
German Gehhilfen
Italian Girello
Dutch Looprek
Portuguese Andadores

Ontology: Walking frame (C0438860)

Definition (SPN) A mechanical walker is a four-legged device with a metal frame intended for medical purposes to provide moderate weight support while walking. It is used by disabled persons who lack strength, good balance, or endurance.
Concepts Medical Device (T074)
SnomedCT 151414007, 183145003, 266731002
Spanish dispositivo para andador, dispositivo para andador (objeto físico), dispositivos para andar
English WALKER, MECHANICAL, frames walking, walking frame, Walker, rigid (pickup), adjustable or fixed height, Walking frame, WF - Walking frame, Walking frame (physical object), Walker rigid adjust/fixed ht

Ontology: Rolling Walkers (C1961317)

Concepts Medical Device (T074)
English Rolling Walkers