Step by Step Towards Better Balance: Your Guide to Gait Aids to Prevent Falls in Older Adults

As we age, maintaining our independence and mobility becomes increasingly important. Sometimes, a little extra support can make a world of difference in staying active and confident on our feet. This is where gait aids come in! For older adults, these assistive devices can significantly improve balance, reduce the risk of falls, and help you continue enjoying your daily activities safely.

At Daniel Krasner Physiotherapy, I believe in empowering you with the knowledge and tools to live your best life, right in the comfort of your own home. Let's explore the world of gait aids, how to choose the right one, and ensure it's perfectly fitted for you.

Understanding the Different Types of Gait Aids

Gait aids come in various forms, each designed to address specific needs and levels of support. Here are the most common types:

• Canes:

  • Single-Point Cane: Offers minimal support, primarily for balance assistance or to offload weight from one leg. Great for mild balance issues or temporary injuries.

  • Quad Cane (Small or Large Base): Provides a wider base of support than a single-point cane, offering more stability. Ideal for individuals who need more balance assistance but still have good lower body strength.

• Walkers:

  • Standard Walker (No Wheels): Requires the user to lift and move the walker with each step. Offers excellent stability and support, often used for significant balance issues or after surgery.

  • Front-Wheeled Walker (Two Wheels): Has two wheels at the front and two glides or rubber tips at the back. Easier to maneuver than a standard walker as it doesn't need to be lifted entirely. Good for individuals who need support but also need to maintain a more fluid walking pattern.

  • Four-Wheeled Walker (Rollator): Equipped with four wheels, hand brakes, and often a seat and storage basket. Provides excellent mobility and is suitable for individuals who need continuous support, extra storage, or want the option to rest. However, the wheels can make it less stable on uneven surfaces.

• Hiking Poles:

  • (Often Used in Pairs): While not traditional "gait aids" for indoor or everyday use, hiking poles offer excellent stability and support on uneven terrain like trails, sidewalks with cracks, or during recreational walking outdoors. They engage the upper body, reduce impact on joints, and significantly improve balance, especially when traversing hills or challenging surfaces. They are a great option for active older adults who enjoy outdoor activities but need extra confidence on varied ground.

How to Pick the Right Gait Aid for YOU

Choosing the perfect gait aid is a crucial decision that should always be made in consultation with a healthcare professional, like your in-home physiotherapist. We'll consider several factors to ensure the aid matches your unique needs:

1. Your Balance and Strength: 

   • Mild Balance Issues / Minimal Support: A single-point cane might suffice.

   • Moderate Balance Issues / Unsteadiness: A quad cane or a front-wheeled walker could be more appropriate.

   • Significant Balance Issues / Weakness: A standard walker or a rollator will likely offer the necessary stability.

   • Outdoor Activities / Uneven Terrain: Hiking poles can provide excellent support and confidence.

2. Weight-Bearing Status: Are you able to put full weight on both legs, or do you need to offload one limb (ex. After hip surgery)? This will influence the level of support required.

3. Endurance and Fatigue Levels: If you tire easily, a rollator with a seat can be incredibly beneficial.

4. Living Environment & Activity Levels: Consider the layout of your home and the types of activities you engage in. Are there narrow doorways or tight spaces? Do you enjoy walking outdoors on varied terrain?

5. Cognitive Ability: Some gait aids require more coordination and cognitive awareness to use safely.

6. Personal Preference and Lifestyle: Ultimately, the best gait aid is one you will actually use! We'll discuss your daily routines and preferences to find an aid that fits seamlessly into your life.

   
   

The Perfect Fit: Adjusting Your Gait Aid to the Correct Height

Even the best gait aid won't be effective (or safe!) if it's not adjusted to the correct height. An improperly fitted aid can lead to poor posture, increased strain, and even a higher risk of falls. Here's how we ensure a proper fit:

For Canes:

1. Standing Tall: Stand upright with your shoulders relaxed.

2. Cane Placement: Hold the cane in the hand opposite to your weaker leg.

3. Wristwatch Test: The top of the cane handle should reach the crease of your wrist (where you would wear a watch) when your arm is hanging loosely at your side. When gripping the handle, your elbow should have a slight bend. This allows for comfortable and effective weight bearing.

   
   

For Walkers:

1. Standing Tall: Stand inside the walker with your shoulders relaxed.

2. Handgrip Height: The top of the walker handgrips should align with the crease of your wrist when your arms are hanging loosely at your sides.

3. Elbow Bend: Similar to a cane, when you grip the handgrips, your elbows should have a slight bend.

   
   

For Hiking Poles:

1. Standing Tall: Stand upright, wearing the shoes you'll typically hike in.

2. Elbow Bend (on Flat Ground): When the pole tip is on the ground next to your foot, your elbow should be bent at approximately a 90-degree angle.

3. Adjust for Terrain: For uphill sections, you might shorten the poles slightly to push off more effectively. For downhill, you might lengthen them slightly for added stability and reach. Many hiking poles have adjustable height mechanisms for this purpose.

   
   

Important Note for All Aids:

• Shoes Matter: Always adjust your gait aid while wearing the shoes you typically wear.

• No Slouching: Ensure you're not slouching or leaning over the aid. The correct height promotes an upright posture.

Beyond the Basics: Other Important Considerations

• Training and Practice: Once you have a gait aid, proper training on how to use it safely and effectively is crucial. I will happily help guide you through walking techniques, turning, navigating obstacles, and getting in and out of chairs (and even how to use hiking poles on different terrains!).

• Home Safety Check: We'll also assess your home environment for potential hazards, such as throw rugs, cluttered pathways, and inadequate lighting, to maximize your safety.

• Maintenance: Regularly check your gait aid for wear and tear, especially the rubber tips, glides, or wheels. Replace worn parts promptly.

• Don't Be Afraid to Ask for Help: If you feel unsteady, or have questions about your gait aid, and live in Toronto, don't hesitate to reach out. I am here to support you every step of the way.

  
  

P.S. I am dedicated to helping older adults maintain their mobility, balance, and confidence in the comfort of their own homes. If you're considering a gait aid or already have one and want to ensure it's the right fit, contact me today for a FREE! consultation. Let's work together to help you walk with greater ease and live life to the fullest!