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Forsberg A1,2, Fredriksson C1, Norling Herrmansson L3, Holmefur M1, Nilsagård Y1,4
1Örebro University, Faculty of Medicine and Health, Örebro, Sweden, 2Region Örebro County, Physiotherapy, Örebro University Hospital, Örebro, Sweden, 3Örebro University, Faculty of Medicine and Health, University Health Care Centre, Örebro, Sweden, 4Region Örebro County, Health Care Management, Örebro, Sweden
Background: Rolling walker is a common assistive walking device, in Sweden about 250 000 persons use rolling walkers and most of them are above 80 years of age. According to the National Board of Health and Welfare, prescribers of assistive devices should assess, select and adapt, and follow up to ensure safety and use. However, the adherence to the prescription process is not known.
Purpose: to investigate experiences of the prescription process of rolling walkers to elderly persons (older than 65 years old) living in their own home, from the perspective of prescribers.
Methods: This study was a cross-sectional survey using a web-based questionnaire to prescribers of assistive devices in five counties in central Sweden. The questionnaire started with the question “Have you prescribed a rolling walker to a person older than 65 years who is living in his/her own housing in the past six months?”. Only study persons that responded with a yes to that question could continue. The questionnaire then consisted of 37 questions covering the prescription process. After two weeks, a reminder was sent out. Answers on the questionnaire were anonymous.
Results: Totally, 658 responded, and of them 354 had prescribed a rolling walker during the last 6 months. The mean age was 42 years (range 23-67) and 296 (84%) were women. Most prescribers were physiotherapists (77%), and occupational therapists (21%).
Main reasons for prescribing was decreased balance and walking ability, risk of falls, weakness; to reduce pain, and/or external factors such as difficulty to walk outdoors. Only a few responded that the main reason was to enhance activities and participation. Mostly (68%) the assessment occurred during a treatment period where the need of using assistive device was detected. The need occurred successively in 61%, and acutely after a fracture or surgery in 37%. Often the assessment occurred indoors, in the patient´s home or health care facility, even though the rolling walker was planned to be used outdoors. Only 17% used an outcome measure.
During the adaptation and training phase, information was given about maintenance, fees and safety. About half actually practiced handling and walking with the rolling walker, and only a few practiced outdoors. Half of the prescribers had not or did not plan a follow-up of the use of the rolling walker. Mostly they performed a follow-up if the patients contacted them with a problem. Only a few followed if the rolling walker did compensate for decreased balance and walking ability.
Conclusion(s): This study showed that rolling walkers are prescribed to compensate for reduced balance and walking ability, however if the purpose has been achieved is rarely followed. The training procedure mainly focus on maintenance. Assessment and training mainly occurs indoors even though the rolling walker should be used outdoors.
Implications: The rolling walker is a simple assistive device but proper handling should routinely be evaluated in the prescription process to ensure a safe use.
Keywords: Assistive device, prescription, older people
Funding acknowledgements: Research committee in Region Örebro County (OLL-549541)
Purpose: to investigate experiences of the prescription process of rolling walkers to elderly persons (older than 65 years old) living in their own home, from the perspective of prescribers.
Methods: This study was a cross-sectional survey using a web-based questionnaire to prescribers of assistive devices in five counties in central Sweden. The questionnaire started with the question “Have you prescribed a rolling walker to a person older than 65 years who is living in his/her own housing in the past six months?”. Only study persons that responded with a yes to that question could continue. The questionnaire then consisted of 37 questions covering the prescription process. After two weeks, a reminder was sent out. Answers on the questionnaire were anonymous.
Results: Totally, 658 responded, and of them 354 had prescribed a rolling walker during the last 6 months. The mean age was 42 years (range 23-67) and 296 (84%) were women. Most prescribers were physiotherapists (77%), and occupational therapists (21%).
Main reasons for prescribing was decreased balance and walking ability, risk of falls, weakness; to reduce pain, and/or external factors such as difficulty to walk outdoors. Only a few responded that the main reason was to enhance activities and participation. Mostly (68%) the assessment occurred during a treatment period where the need of using assistive device was detected. The need occurred successively in 61%, and acutely after a fracture or surgery in 37%. Often the assessment occurred indoors, in the patient´s home or health care facility, even though the rolling walker was planned to be used outdoors. Only 17% used an outcome measure.
During the adaptation and training phase, information was given about maintenance, fees and safety. About half actually practiced handling and walking with the rolling walker, and only a few practiced outdoors. Half of the prescribers had not or did not plan a follow-up of the use of the rolling walker. Mostly they performed a follow-up if the patients contacted them with a problem. Only a few followed if the rolling walker did compensate for decreased balance and walking ability.
Conclusion(s): This study showed that rolling walkers are prescribed to compensate for reduced balance and walking ability, however if the purpose has been achieved is rarely followed. The training procedure mainly focus on maintenance. Assessment and training mainly occurs indoors even though the rolling walker should be used outdoors.
Implications: The rolling walker is a simple assistive device but proper handling should routinely be evaluated in the prescription process to ensure a safe use.
Keywords: Assistive device, prescription, older people
Funding acknowledgements: Research committee in Region Örebro County (OLL-549541)
Topic: Older people; Older people
Ethics approval required: Yes
Institution: Uppsala University
Ethics committee: Research Ethics Committee in the Uppsala-Örebro region
Ethics number: 2016-017
All authors, affiliations and abstracts have been published as submitted.
