Impact of different types of walking aids on the physiological energy cost during gait for elderly individuals with several pathologies and dependent on a technical aid for walking.
In elderly individuals balance disorders and muscle weakness can lead to prescribing a walker. There are several different models. According to the very poor effort tolerance in this population, the energy cost necessary to operate walking technical aids should be taken into account when making a choice.


OBJECTIVE
Compare two types of walker in regards to energy cost produced during gait in weakened elderly individuals.


METHODS
Thirty subjects over the age of 65 (six men and 24 women, mean age 81.9 years) were admitted in geriatrics care. They all required a walker and performed the same 10-m course with a fixed walker, then with a model bearing front wheels. The walking speed (S) was computed, heart rate at rest (HRrest) and maximum heart rate (HRmax) were recorded during the test. The physiological cost index (PCI=HRmax-HRrest/S) was calculated. Finally a timed get-up-and-go (TGUG) test was performed with each of these technical aids.


RESULTS
With a rollator walker, HRmax was lower (P<0.05) and S higher (P<0.001). It was 2.01 with a fixed walker versus 1.23 with a rollator walker (P<0.01). We found this speed difference during the TGUG test (72.26 sec vs. 82.93 sec, P=0.001).


CONCLUSIONS
There are very little studies on the evaluation of physiological energy cost produced during gait with a walker. The characteristics of our population did not allow us to conduct our test without a technical aid. The use of a fixed walker leads to a major increase in gait PCI, probably due to the required repeated efforts for lifting the walker. This model must be avoided in case of cardiac or respiratory disorders.
Cetin
E
E
Service de médecine physique et réadaptation, hôpital gériatrique Les-Bateliers, 59037 Lille cedex, France. erhancetin@hotmail.com
Muzembo
J
J
Pardessus
V
V
Puisieux
F
F
Thevenon
A
A
D000368:Aged; D000369:Aged, 80 and over; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D005684:Gait; D006339:Heart Rate; D006801:Humans; D008297:Male; D014853:Walkers; D016138:Walking / Q000502:physiology*