TY - JOUR
T1 - Postural and Metabolic Benefits of Using a Forearm Support Walker in Older Adults With Impairments
AU - Jayaraman, Chandrasekaran
AU - Mummidisetty, Chaithanya Krishna
AU - Loesch, Alexandra
AU - Kaur, Sandi
AU - Hoppe-Ludwig, Shenan
AU - Staat, Manfred
AU - Jayaraman, Arun
N1 - Funding Information:
Supported in part by the Shirley Ryan AbilityLab and ProtoStar Inc. Supported in part by the Shirley Ryan AbilityLab and ProtoStar Inc. The authors thank the Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, for assistance with using the CAPS data acquisition system. The authors thank Randall Orians, AAS, Assistive Technology Technician, Shirley Ryan AbilityLab, Chicago, for assistance with embedding the FSR sensors inside the glove. The authors thank Lori McGee-Koch, BS, Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, for help with IRB procedures. The authors thank Mudassir Khan, BS and Brian Lipuma, BS, for their assistance with data collection and analysis. Special thanks to Adam Burns for designing the hardware for the FSR glove data acquisition system. Supported in part by the Shirley Ryan AbilityLab and ProtoStar Inc.
Funding Information:
Supported in part by the Shirley Ryan AbilityLab and ProtoStar Inc .
Publisher Copyright:
© 2018 American Congress of Rehabilitation Medicine
PY - 2019/4
Y1 - 2019/4
N2 - Objective: To investigate the postural and metabolic benefits a walker with adjustable elbow support (LifeWalker [LW]) can provide for ambulation in population with impairment. The clinical outcomes from the elbow support walker will be compared with standard rollator (SR) and participants predicate device (PD). Design: Case-crossover study design. Setting: Clinical laboratory. Participants: Individuals aged between 18 and 85 years using a rollator walker as primary mode of assistance and certified as medically stable by their primary physician. Participants (N=30; 80% women [n=24]) recruited from a convenient sample provided voluntary consent and completed the study. Intervention: Not applicable. Main Outcome Measures: The trunk anterior-posterior (AP) sway (during the 10-meter walk test), oxygen consumption (during the 6-minute walk test), the mean forearm load offloaded to the elbow support as percentage of body weight, and mean peak hand grip load (during the 25-meter walk test) were measured. Results: Ambulating with a LW led to (1) reduced trunk sway in the AP direction [(Z LW vs PD = −2.34, P=.018); (Z LW vs SR = −3.461, P=.001)]; (2) reduced erector spinae muscle activation at the left lumbar L3 level [(Z LW vs PD = −2.71, P=.007); (Z LW vs SR = −1.71, P=.09)]; and (3) improved gait efficiency [(Z LW vs PD = −2.66, P=.008) Oxygen cost ; (Z LW Vs. SR = −2.66, P=.008) Oxygen cost ]. Participants offloaded between 39% and 46% of their body weight through the elbow support armrest while ambulating with the LW. Irrespective of the walker used, participants exerted ∼5%-6% of their body weight in gripping the walker handles during walking. Conclusions: Using the forearm support-based LW led to upright body posture, offloaded portions of body weight from the lower extremity, and improved gait efficiency during ambulation in comparison to the SR and the participants’ own PD. Further studies focusing on population-specific benefits are recommended.
AB - Objective: To investigate the postural and metabolic benefits a walker with adjustable elbow support (LifeWalker [LW]) can provide for ambulation in population with impairment. The clinical outcomes from the elbow support walker will be compared with standard rollator (SR) and participants predicate device (PD). Design: Case-crossover study design. Setting: Clinical laboratory. Participants: Individuals aged between 18 and 85 years using a rollator walker as primary mode of assistance and certified as medically stable by their primary physician. Participants (N=30; 80% women [n=24]) recruited from a convenient sample provided voluntary consent and completed the study. Intervention: Not applicable. Main Outcome Measures: The trunk anterior-posterior (AP) sway (during the 10-meter walk test), oxygen consumption (during the 6-minute walk test), the mean forearm load offloaded to the elbow support as percentage of body weight, and mean peak hand grip load (during the 25-meter walk test) were measured. Results: Ambulating with a LW led to (1) reduced trunk sway in the AP direction [(Z LW vs PD = −2.34, P=.018); (Z LW vs SR = −3.461, P=.001)]; (2) reduced erector spinae muscle activation at the left lumbar L3 level [(Z LW vs PD = −2.71, P=.007); (Z LW vs SR = −1.71, P=.09)]; and (3) improved gait efficiency [(Z LW vs PD = −2.66, P=.008) Oxygen cost ; (Z LW Vs. SR = −2.66, P=.008) Oxygen cost ]. Participants offloaded between 39% and 46% of their body weight through the elbow support armrest while ambulating with the LW. Irrespective of the walker used, participants exerted ∼5%-6% of their body weight in gripping the walker handles during walking. Conclusions: Using the forearm support-based LW led to upright body posture, offloaded portions of body weight from the lower extremity, and improved gait efficiency during ambulation in comparison to the SR and the participants’ own PD. Further studies focusing on population-specific benefits are recommended.
KW - Assistive technology
KW - Elbow support
KW - Elderly
KW - Gait
KW - Grip strength
KW - Low back pain
KW - Rehabilitation
KW - Repeated strain injuries
KW - Rollator walker
KW - Trunk posture
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U2 - 10.1016/j.apmr.2018.10.001
DO - 10.1016/j.apmr.2018.10.001
M3 - Article
C2 - 30367875
AN - SCOPUS:85057253117
SN - 0003-9993
VL - 100
SP - 638
EP - 647
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 4
ER -