Original article
Effect of Different Walking Aids on Walking Capacity of Patients With Poststroke Hemiparesis

https://doi.org/10.1016/j.apmr.2009.02.010Get rights and content

Abstract

Allet L, Leemann B, Guyen E, Murphy L, Monnin D, Herrmann FR, Schnider A. Effect of different walking aids on walking capacity of patients with poststroke hemiparesis.

Objective

To examine the effects of 3 different walking aids on walking capacity, temporo-spatial gait parameters, and patient satisfaction.

Design

Observational study.

Setting

University Hospital of Geneva.

Participants

Hemiparetic inpatients (N=25) with impaired gait, at an early stage of rehabilitation, unfamiliar with any of the walking aids tested.

Interventions

On 3 consecutive days subjects used, in random order, 1 of 3 walking aids: 4-point cane, simple cane with ergonomic handgrip, and Nordic stick.

Main Outcome Measures

Maximal walking distance in 6 minutes, temporo-spatial gait parameters determined with a commercial electronic gait analysis system, and patients' preference on a subjective ranking scale.

Results

Walking distance was greatest with the simple cane with an ergonomic handgrip, followed by the 4-point cane and the Nordic walking stick. Walking velocity was highest with the simple cane, which was also indicated as the preferred walking aid by the patients. There was no significant difference in step length symmetry.

Conclusions

The simple cane with the ergonomic handgrip was not only preferred by patients, but was also the most efficient among 3 commonly used walking aids. It appears justified to take patients' subjective preference into account when prescribing a walking aid.

Section snippets

Subjects

Twenty-five hospitalized patients with a first stroke confirmed by computed tomography or magnetic resonance imaging scan at an early stage of gait rehabilitation (as soon as the patient was able to walk 10m holding a handrail without therapeutic support) were enrolled in the study. Their gait rehabilitation prior to the study included walking between the parallel bars or alongside a treatment table.

We excluded patients if they were capable of walking more than 5m independently without a

Results

The patients' motor and cognitive function as well as their functional capacity are summarized in table 1. Patients showed mild to moderate motor and functional problems after the evaluation of the FIM (score>100 out of a maximum of 126), the Fugl-Meyer (score>22 out of a maximum of 34), the PASS (score>29 out of a maximum of 36), and the NIHSS (score<7 with a best score of 0 and worst score of 42 points).

Discussion

This study aimed to examine the effects of 3 different canes, widely used in clinical practice, on walking capacity and temporo-spatial gait parameters and to evaluate patients' satisfaction with each type of cane. Our study included patients after a stroke at an early stage of gait rehabilitation, as soon as they were able to walk short distances under supervision, holding a handrail. The study group was relatively homogenous for age, weight, and height and showed similar functional basic

Conclusions

The objective of this study was to examine the effects of 3 different walking aids on walking capacity, temporo-spatial gait parameters, and patients' satisfaction at an early stage of rehabilitation. Overall, the simple cane with the ergonomic handgrip appeared to be the most useful. Patients' subjective preference, which has been neglected in previous studies, needs to be taken into account in order to achieve maximum benefits. Combining the evaluation of gait parameters (speed and walking

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    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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