Challenges in walking generally start from the age of 60 years, but more significant changes are observed in the 75–80 years age group.
Losing balance is a common problem faced among many seniors. This may simply be due to the natural aging process that deteriorate the motor and sensory system which affects postural balance negatively. Side effects of medications or a combination of medications being taken together may cause vision changes, dizziness and impaired alertness.
Balance is required for the locomotors system to exhibit its optimal function, to perform activities of daily living, to protect the stability position while passing from one position to another and to live independently in the community. To maintain balance and body posture, there has to be a continuous flow of information about position and movement from every part of the body, including the head and eyes. Meanwhile, balance involves complex interactions of various systems, particularly the musculoskeletal and neuronal systems. Additionally, postural balance is achieved through the collaborative work of the muscle, bone, ligament, physiological system, and the nervous system.
It is known through various research that the use of a walking stick improves the balance and the independence level while reducing the risk of fall. Therefore, using a walking stick should be recommended to the elderly individuals who have balance disorders and the risk of falling.
Maintaining the balance during walking is quite different from the posture while standing. While standing, the purpose is to keep the center of gravity within the support surface. However, walking disturbs the stability of the body and adaptation is required according to alterations in the gravity line.
Some of the pointers one can consider when helping their love-one in choosing the right walking sticks are:
The Usage (balance vs weight bearing)
A walking stick is generally advanced in unison with and on the side opposite the weak or painful leg. Studies have shown that use in this way reduces force on the leg opposite the walking stick by almost two-thirds. Walking Stick can easily support up to 15% to 20% of a user body weight.
Challenges in walking can be divided into problem in 3 categories: sensory, muscular strength and joints. The standard walking stick is generally used for mild sensory and coordination problems. It can help to stabilize a walking style by providing an extra contact point with the ground, therefore, increasing the base of support.
If the walking stick is required to bear weight, such as for patients with osteoarthritic hip or knee pain, then a quad stick could provide greater stability, as it allows force to be placed directly along the walking stick shaft. If substantial weight bearing is required, such as in a hemiplegic patient, then a quad stick might be needed.
A quick test you can do at home would involve walking with the user while holding their hand. If a single assisting hand helps them walk, then logically a walking stick might be of potential benefit. If, however, you need to hold both their hands to steady their walk, a walker might be a better choice.
Ultimately, user performance and personal preference will dictate the correct aid. A large quad stick is more stable but is also heavier, bulkier, and cannot be use in a small apartment, especially if there are stairs to negotiate. Further, unattractive large quad stick might spend more time in the closet if not endorsed by your love one and their lifestyles. If problems do arise, consider referring a physiotherapist for a complete mobility assessment. A physiotherapist can make further recommendations about appropriate walking aids to maximize function.
- The length
Recommendation given by many difference sources have suggested that the ideal and preferred length of a walking stick was determined when the elbow was in 20–30° flexion (elbow slightly bended) and the bottom part of the walking stick is about 15 cm from the feet (half feet apart).
However, research have found that the elderly could make the best decision and could choose an appropriate walking stick for themselves based on confidence level and comfortability of using the walking stick.
- The features
Choosing the correct walking sticks, however, involves considering many factors, including the user cognitive function, physical endurance, walking environment, portability, psychological concern on the image of carrying a walking stick.
There are many different designs available in the market to address different needs.
Cognitive function will deteriorate as part of aging process. Being able to move out of the house to increase social interaction with others is an important factor that will help in this area. Most of the common walking stick do not address this concern however if the senior is being encouraged to interact freely with the community outside their house with their preferred choice of walking aid, they may be more willing to have move social interaction outside their house.
In recent years there has been an increase in the options of ‘designer’ walking sticks with fancy craving and colourful tubing to add vibrancy.
Seniors can also consider the Smart walking Sticks with music therapy functions to assist them to slow down the rate for cognitive impairment. There are many researches done to support the benefit of Music therapy by improving the cognitive function. Playing their favourite tune not only will help them to increase their mental activities but will also uplift their mood and help in their emotional stability.
When choosing a walking stick with music playing features, it is important to select one that is easy to add in the user’s favourite songs and able to play their favourite radio station. The user can be updated about the news through the radio program. Being able to load their own songs also makes it possible to load audio books through which stories can be read to them and keep them entertained.
The image of carrying a walking stick can be a main concern for a user who is new to the use of walking stick. Some walking sticks are integrated with an umbrella to avoid the stigma of carrying one. In areas where rainfall is common, the image of carrying an umbrella is accepted by the society. For users who depend on a weight bearing quad stick, they can consider a smaller base option to avoid the stigma of carrying a bulky quad stick.
For users who need rest at regular interval may opt for walking sticks integrated with stool. This give them the opportunity of taking a short break whenever they need to rest their feet.
The ergonomic design of the seat and maximum sitting load are 2 key consideration when choosing a walking stick with a sitting function. The ergonomics of the seat is determined by the saddle shape, material and the sitting height. The right sitting height will not only mean better stability while sitting but also ease the standing motion from the sitting position too. Users often have to compromise between having a larger sitting surface for comfort with a more portable smaller saddle when choosing this type of walking stick.
The seating load is normally about 15% less than the weight of the user in a static condition. However, the dynamic load of sitting can be up to 20% of the sitting load. As such it is important to choose a chair with max loading capacity that is higher than the user weight.
For the convenience of travelling overseas, compact and light-weight sticks will be an important feature. Foldable or detachable walking stick could be a useful feature here.
When choosing a foldable or detachable sticks, stability and reducibility are the key concern. Stability and integrity will always be compromised for every section it is sub divided into. The broken section of the tubing is considered the ‘weakest-link’ in the chain and thus should be strengthened or reinforced. A common way to achieve this reinforcement is to use a precision machine joint at the interval section. However, because of the higher requirement precision engineering, it is more common to see shrink fitted joint for foldable walking sticks in the market.
Different terrain will require a different base. Most of the common tips attached on the walking sticks should be sufficient for walking in the park with rough pathway. However, if the user needs to walk on smooth flat tile that is common in shopping malls, they may need to consider a tip with Anti-Slip properties as it can be dangerously slippery when there is water on the floor. For icy surface, user will need to attach an Ice Tip for the extra grip.
These pointers will help organize your approach when determining whether your love one have the right walking stick and whether they are using them properly.
External support is needed to increase the sensory input and psychological support in physical disabilities while walking. The elderly start using a walking stick because of balance and postural disorders and to prevent falling because of these disorders. A walking stick is the most preferred walking aid, because it is easy to use, it improves postural stability, it decreases the load on the weak side of the lower extremities and it is accepted by the society.