Effect of Different Types of Walking Aids on Gait and Balance in Patients with Stroke: A Review

Abstract

Background: Stroke is a primary cause of fatalities as well as disabilities in the elderly, leading to an array of physiological impairments related to mobility and daily living tasks.1Among all the potential sensorimotor effects of a stroke, poor postural control has the biggest influence on gait and ADL independence. The mechanism underlying balance recovery after stroke has drawn more attention recently since developing successful rehabilitation strategies for stroke patients requires an understanding of these factors2. Different types of walking aids are generally used to maintain walking capacity which is mostly compromised in stroke.1 Therefore creating a need to investigate the effects of different types of walking aids on gait parameters and balance in patients with stroke to provide a better prescription criterion. Objective: The objective of this literature review is to assess and evaluate the effect of different types of walking aids on gait and balance, which are most affected parameters in patients with stroke patients. Study design: Literature Review Significance: Unfortunately, many patients receive little or no professional consultation in selecting a walking aid, therefore this review was done to give a better perception about which kind of walking aid is best to improve gait parameters and balance among stroke patients. Method: An electronic database search was conducted using google scholar, science direct, pub Med, Cochrane library and reference list from all the retrieved articles. Results & Discussion: Professionals are often unsure which walking aid is best suited for post-stroke patients at the various stages of rehabilitation. Proper knowledge about the walking aids and proper assessment about the need of the patient is required to prescribe the best suited walking aid to the patient. Post-stroke patients are generally associated with an increased cardio-vascular loading during ambulation, that hampers their balance associated with reduction in walking velocity, cadence, step length etc. So, walking aids serves as the most appropriate option in improving gait and balance in order to improve their activities of daily living. Post-stroke patients walking with a cane showed significant improvement in their balance, stability and the temporo-spatial gait parameters. Use of cane showed more significant effect based on speed and step length in patients who are intermediate walkers as compared with independent ambulators. Conclusion: The present literature review offers an idea for proper prescription of a walking aid for post-stroke patients. Canes are found as the widely used walking aids in comparison to walkers, crutches and sticks, especially the simple cane with ergonomic hand grip. Walking with a cane have positive impact on the various temporo-spatial gait parameters. Single point cane is found to be more beneficial for post-stroke patients with good balance who needs improvements in their gait parameters, whereas quad cane is more beneficial for patients with poor balance as it increases stability. Various other canes (haptic cane, roller cane and instrumented cane) also have positive impact on the gait parameters of the patient. Key words:Walking aids, Gait parameters, Balance, Stroke.