Six Key Mobility Aids To Get From A to B

Sally Madeley-Carr, OT
06 Jan 2020

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This is an introduction to the main categories of mobility aids designed to help someone walk without assistance. Living with certain medical conditions make it hard moving just short distances around the home, and even more so when you're out and about. Many of these conditions are associated with old age, like arthritis and diabetes.

Obesity, diminished physical strength or a general loss of balance may all play a part as we get older. Any of these can lead to a sense of vulnerability when walking, making it more tricky to do unaided. In these circumstances, your doctor or occupational therapist may advise you to consider a walking aid. If you have ongoing difficulty in walking because of a chronic health problem or if you're recovering from an operation, using specialist equipment may make a big difference.

General benefits of walking aids

• Improve balance and decrease the chances of a fall
• Maintain independence for daily tasks
• Maintain an upright posture
• Maintain physical exercise

1. Crutches

It is important to take direct advice from a medical profession before using a crutch or crutches. They significantly alter how weight is distributed through the body, so using them incorrectly can cause problems.

To use them safely, they need to be of the correct size and the user needs to have a certain amount of body strength. Your GP or occupational therapist will be able to advise you on suitability.

Essentially, crutches take weight off your lower body, transferring it to your upper body. They are often prescribed after injury to a hip or leg, for example.

The most common types of crutches in the UK are Axilla and forearm versions. The latter is probably the most popular and is often prescribed in the UK.

Forearm crutches channel much of the user's body weight through the forearms. They have a grip handle and a forearm cuff. Most models are adjustable so the shafts can be set to the correct length. Double-adjustable versions mean the forearm shaft can be adjusted in length as well as the main vertical one.

This type of crutch is available with standard plastic or 'ergonomic', wide handles. These have a contoured surface which spreads the user's weight through the grip, reducing pressure. Long-term users often prefer this type of handle.

'Axillary' or 'Axilla' crutches have a soft pad which fits under the armpit. They have a second pad for the hands further down. The distance between the hand-hold is usually adjustable, as is the over height of the crutches.

It is important that the user uses their hands and arms to take their weight, rather than slumping so that weight transfers through the armpit itself. Pressure in this area can restrict blood-flow and cause secondary injury.

Both types of crutches are typically made from aluminium. This is because of its relatively light weight and rigidity. Some models for bariatric patients are reinforced with steel, adding to their strength - and there weight.

All crutches require a rubber or plastic 'foot' at the bottom. This ensures they do not slip on hard surfaces. 'Ferrules' as they are known, are available in various sizes and you will certainly be able to find the ones you need at Essential Aids.

2. Walking sticks and canes

The simple stick is probably the oldest walking aid around. Providing a leaning point to take weight and help balance, it is still the most commonly used piece of walking equipment in the UK. They provide a way of improving stability, are lightweight and easy to transport.

While most people use a single stick, some find two walking sticks provides them with the support they need to stay mobile.

While many sticks are made of wood, aluminium is now just as common. In the same way as its rigidity and strength make it great for crutches, the same properties also lend themselves to walking sticks. Another benefit is that it does not readily corrode.

Like crutches, walking sticks are available with standard quite narrow handles, but also with wider ergonomic grips. Sometimes called 'Fischer' grips, as with crutches, these spread the user's weight through the palms and fingers, reducing the tendency of the handles to dig-in to the hand.

Also similar to crutches, it is important to fit a ferrule to the end of your stick to make sure it doesn't slip. In the winter, you might want to fit a jagged metal tip which prevents the stick slipping on mud, snow or ice.

Wooden walking sticks can be cut down to a suitable height, will most aluminium ones are adjustable with a pin-clip mechanism.

Folding walking sticks are made of metal and have sections which fold down for storage in a bag. They usually work using a sturdy piece of elastic which runs through the centre of the tubes. The tubular sections lock together when in use and are easy to pull apart to fold-up the stick.

A strap which prevents the stick falling to the floor is a great accessory.

3. Walking sticks with three or four legs

For extra stability, tripod and quadrupod walking sticks come into their own. While heavier than a conventional stick, they stand upright without support, providing some unique benefits.

One is that they do not easily fall to the ground. For people with mobility issues, the process of picking up objects from the floor is no easy feat. Thus using a walking aid which stays upright even when they're not holding it is welcome.

Various styles are available, with the wider based models offering the most stability, and the small based versions great maneuverability.

Walking sticks with three or four legs are ideal for people who still have a lot of mobility, but find a standard walking stick doesn't offer them the balance assistance they need.

4. Walking frames

These mobility aids provide a wide, four-legged support frame which the user leans on as they walk. Although they make the rate of progress fairly slow, they are commonly used, particularly inside.

They offer more stability than walking sticks or crutches, but they do restrict the speed at which the user is able to travel. The method of use is to lift or edge the frame forwards, then catch up to it with small steps, before repeating the process.

Usually made from aluminium, they are generally lightweight and easy to control. They do however require a certain degree of strength and balance to use safely. Sometimes called 'zimmer frames' or 'pulpit frames', they deliver balanced support at slow speeds.

Some walking frames have front wheels, helping the user edge them forward. Handles on the top of the frame help the user transfer weight through the upper body rather than the legs. Heavier bariatric patients may require a frame reinforced with steel, with a user weight limit of over 34 stone. Like regular frames, these can be adjusted to suit your height.

As with walking sticks and crutches, rubber or plastic ferrules on the ends of the legs reduce the chances of slipping.

Walking frames are ideal for moving around homes on one level. Bear in mind, though that they can't be used to climb stairs.

If space is an issue, ultra-narrow walking frames might fit the bill. Essential Aids has a range of quality models to choose from.

Folding walking frames are great for transportation. They have a simple mechanism which allows them to collapse down to fit easily in the boot of a car.

'Reciprocal frames' have hinges built in which allow one side of the frame to move independently of the other. This creates a 'stepping' action which some people find more to their liking than the standard rigid frame. Reciprocal walking frames have the advantage that they are easier to guide through tight gaps.

Forearm or 'trough' walking frames have gutters above the standard handles. These allow users to employ their upper body strength to help support themselves when mobilising, by leaning their forearms into the troughs.

The troughs have handles at the far end, allowing the user to securely hold on.

These are often used by people with arthritis in their hands, who might find it painful gripping the handles of a conventional walking frame.

5. Rollators or wheeled walkers

Rollators are essentially robust walking frames with wheels. They are usually used outside, having larger wheels and even integral seats built in.

They are great for trips to the shops for people with reduced mobility, who need a bit more support than a walking stick offers.

There are numerous models available, some with three wheels and some with four. Almost all modern rollators fold down. This makes them easy to store or transport on buses or in the boot of a car.

Four-wheeled walkers are the most stable, while those with three wheels are generally slightly easier to maneuver.

Most models of either type feature brakes, often similar to the type you find on bicycles. Others have brakes which engage as the rollator is pressed down. This is a feature which is useful for those which have seats, ensuring that it does not roll away from under you.

Three-wheeled walkers are sometimes called 'delta' frames. Like the four wheelers, they have swiveling caster-like wheels.

Many models have baskets built-in under the seats. This is a handy feature for carrying shopping or your handbag.

When using rollators when you're out and about, it's important to consider the terrain you need to cover. They are not always easy to use on uneven ground or over obstacles like high curbs. Wide wheelchair ramps are usually suitable for wheeled walkers, provided they are stable.

6. Wheelchairs

The issues surrounding the topic of wheelchairs are extensive and we'll go into it in detail in another blog post. Here we'll just focus on self-propelled wheelchairs and how they function as a mobility aid, getting the user from A to B under their own steam.

Self-propelled wheelchairs have small wheels on the front and large diameter rear wheels. This allows them to be pushed and turned by the occupant. It is worth considering that that this requires a certain amount of upper body and hand strength.

You may need to buy wheelchair accessories like padded pushing gloves, which make turning the wheels easier on the hands.

Some people find that using a self-propelled wheelchair is useful if they want to stay relatively independent when travelling with others. It maybe that they like the feeling of transportation without needing someone to push them.

At home, with the right adaptations, this type of wheelchair can be used extensively. The installation of wheelchair ramps in suitable locations, as well as adapted bathrooms and kitchens can make their routine use viable.

For people living day-to-day in a wheelchair, detailed remodeling of their living environment may be necessary.

Outside the home, there are obviously restrictions in terms of terrain, so prior planning needs to be given to routes and likely obstacles. Wheelchair ramps may not always be available, so how you are going to overcome steps and curbs requires considerable thought.

For those using a wheelchair for extended periods of time, it's vitally important to take advice from a specialist physiotherapist or occupational therapist. There are numerous factors relevant to using wheelchairs, including size, user posture and various other potential issues which require specific professional guidance.

Your GP will be able to refer you for an assessment if you are in this situation.

Many people like to buy wheelchair accessories add a bit of flair to their chair! There are large colourful hubcaps available, plus sticker kits which move things away from the standard metal tubing. Essential aids has an extensive range if you need to buy wheelchair extras.