The effects of a positional feedback device on rollator walker use: a validation study

Background: According to clinical guidelines, rolling walker users should walk with their feet between the posterior wheels of the walker; however approximately 50% of users do not. Objective: To describe the development and effects of a custom device designed to attach to a walker and provide visual feedback to encourage improved user position. Methods: Fourteen older adults participated in this study to validate the effects of this device when a 10% decrease in the users' habitual distance away from the walker was encouraged via feedback. Users' relative distances were recorded using a non-contact distance sensor within the device, while kinematics were measured using commercial wearable wireless inertial sensors. Results: Individuals were able to ambulate on average 20% closer or more to their walker when prescribed the visual feedback. This was primarily achieved through a reduction in shoulder flexion. Trunk and cervical postures were less generalizable as only small and variable changes were observed. Conclusions: These findings suggest that the device has promise, as individuals attended to the device and walked in a position closer to that recommended by clinical guidelines. The device did not appear to improve posture. Future work is needed to determine long-term effects.