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Effect of uphill and downhill walking on walking performance in geriatric patients using a wheeled walker

Effekt von Bergauf- und Bergabgehen auf die Gehfähigkeit geriatrischer Patienten mit Rollator

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Abstract

Background

Wheeled walkers are recommended to improve walking performance in older persons and to encourage and assist participation in daily life. Nevertheless, using a wheeled walker can cause serious problems in the natural environment. This study aimed to compare uphill and downhill walking with walking level in geriatric patients using a wheeled walker. Furthermore, we investigated the effect of using a wheeled walker with respect to dual tasking when walking level.

Methods

A total of 20 geriatric patients (median age 84.5 years) walked 10 m at their habitual pace along a level surface, uphill and downhill, with and without a standard wheeled walker. Gait speed, stride length and cadence were assessed by wearable sensors and the walk ratio was calculated.

Results

When using a wheeled walker while walking level the walk ratio improved (0.58 m/[steps/min] versus 0.57 m/[steps/min], p = 0.023) but gait speed decreased (1.07 m/s versus 1.12 m/s, p = 0.020) when compared to not using a wheeled walker. With respect to the walk ratio, uphill and downhill walking with a wheeled walker decreased walking performance when compared to level walking (0.54 m/[steps/min] versus 0.58 m/[steps/min], p = 0.023 and 0.55 m/[steps/min] versus 0.58 m/[steps/min], p = 0.001, respectively). At the same time, gait speed decreased (0.079 m/s versus 1.07 m/s, p < 0.0001) or was unaffected.

Conclusion

The use of a wheeled walker improved the quality of level walking but the performance of uphill and downhill walking was worse compared to walking level when using a wheeled walker.

Zusammenfassung

Hintergrund

Rollatoren werden im Alter zur Stabilisierung des Gangbildes und zur Verbesserung der Teilhabe genutzt. Der Gebrauch von Rollatoren kann aber auch zu erheblichen Problemen führen, wenn die Umgebungspassung nicht gegeben ist. Das Gangbild geriatrischer Patienten mit Rollator beim Bergauf- und Bergabgehen sollte mit dem Gangbild in der Ebene verglichen werden. Weiterhin sollte der Effekt der Nutzung eines Rollators unter dem Aspekt der geteilten Aufmerksamkeit in der Ebene untersucht werden.

Methoden

Zwanzig geriatrische Patienten (mittleres Alter: 84,5 Jahre) gingen mit und ohne Rollator 10 m auf einer ebenen Strecke, bergauf und bergab. Dabei wurden Gehgeschwindigkeit, Schreitlänge und Schrittfrequenz mit am Körper getragenen Sensoren gemessen. Aus Schreitlänge und Schrittfrequenz wurde die Walk-Ratio berechnet.

Ergebnisse

Verglichen mit Gehen ohne Rollator verbesserte der Gebrauch eines Rollators die Walk-Ratio (0,58 m/[Schritte/min] vs. 0,57 m/[Schritte/min]; p = 0,023), wohingegen die Gehgeschwindigkeit mit Rollator reduziert war (1,07 m/s vs. 1,12 m/s; p = 0,020). Beim Bergauf- und Bergabgehen mit Rollator war die Walk-Ratio schlechter als beim Gehen mit Rollator in der Ebene (0,54 m/[Schritte/min] vs. 0,58 m/[Schritte/min]; p = 0,023 und 0,55 m/[Schritte/min] vs. 0,58 m/[Schritte/min]; p = 0,001). Gleichzeitig war die Gehgeschwindigkeit beim Bergaufgehen langsamer im Vergleich zur Ebene (0,079 m/s vs. 1,07 m/s; p < 0,0001) und zeigte beim Bergabgehen keinen Effekt.

Schlussfolgerung

Der Gebrauch eines Rollators verbesserte das Gangbild in der Ebene. Dem gegenüber verschlechterte sich das Gangbild beim Gebrauch eines Rollators beim Bergauf- und Bergabgehen verglichen mit dem Gehen in der Ebene mit Rollator.

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Acknowledgements

The authors thank Aileen Currie for proofreading the manuscript. Data collection was performed by Lukas Bollenbach and Tobias Scharpfenecker. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Geriatrics and Clinic for Geriatric Rehabilitation, Robert-Bosch-Hospital, Auerbachstr. 110, 70376, Stuttgart, Germany

    Ulrich Lindemann, Michael Schwenk & Clemens Becker

  2. Research Initiative Human Factors in Ageing, Technology and Environment, University Stuttgart, Stuttgart, Germany

    Ulrich Lindemann, Syn Schmitt, Michael Weyrich, Wolfgang Schlicht & Clemens Becker

  3. Network on Aging Research, University of Heidelberg, Bergheimer Str. 20, 69115, Heidelberg, Germany

    Michael Schwenk

  4. Institute of Sports and Movement Science, University of Stuttgart, Allmandring 28, 70569, Stuttgart, Germany

    Syn Schmitt

  5. Institute for Automation and Software Engineering, University of Stuttgart, Pfaffenwaldring 47, 70569, Stuttgart, Germany

    Michael Weyrich

  6. Department of Sport and Exercise Science, Chair Exercise and Health Sciences, University of Stuttgart, Nobelstraße 15, 70569, Stuttgart, Germany

    Wolfgang Schlicht

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  1. Ulrich Lindemann
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  2. Michael Schwenk
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  6. Clemens Becker
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Correspondence to Ulrich Lindemann.

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Conflict of interests

C. Becker has a financial relationship to Lilly company and Bosch company. U. Lindemann, M. Schwenk, Syn Schmitt, M. Weyrich and W. Schlicht declare that they have no competing interests.

Written informed consent was obtained from all individual participants included in the study prior to data collection.

All procedures performed in this study involving human participants were in accordance with the standards of the ethic committee of the local university and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Lindemann, U., Schwenk, M., Schmitt, S. et al. Effect of uphill and downhill walking on walking performance in geriatric patients using a wheeled walker. Z Gerontol Geriat 50, 483–487 (2017). https://doi.org/10.1007/s00391-016-1156-4

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  • DOI: https://doi.org/10.1007/s00391-016-1156-4

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