Abstract

Mobility problems and disability increase with age. Mobility aids such as canes, crutches and walkers are used to increase a patient's base of support, improve balance, and increase activity and independence, but they are not without significant musculoskeletal and metabolic effects. Most patients who use mobility aids are never trained to use them and their devices often are inappropriate, damaged, or of incorrect height. Choosing the right aid depends on the patient's strength, tolerance, balance, cognitive function and environmental requirements. Canes can help redistribute weight from a lower extremity that is weak or painful, improve stability by increasing the base of support, and provide tactile information about the ground to improve balance. Crutches are useful for patients who need to use their arms not only for balance, but also for weight bearing and propulsion. Walkers improve stability in patients with lower extremity weakness or poor balance and facilitate improved mobility by increasing the patient's base of support and supporting his weight. Walkers require greater attentional demands than canes and make stair climbing, or descending, more difficult. The top of a cane or walker should be the same height as the wrist crease when the patient is standing upright with arms relaxed at his sides. Cane should be held contralateral to the weak or painful lower extremity and moved simultaneously with the contralateral leg. Physicians should routinely evaluate their patients' mobility aids to ensure proper height, fit, and maintenance, and also counsel patients on correct use of them. Today, about 1.6 million Americans adults use mobility aids including canes, walkers, and crutches. Two-thirds of these people are over 65 years old. With the growing number of older adults in the community and the population of those with chronic diseases, it is anticipated that disability and subsequent mobility problems will continue to increase. About 10% of adults older than 65 years use canes and 4.6% of them use walkers.