Gait improvement in adults with hemiparesis using a rolling cane: A cross-over trial

Abstract

Stroke patients frequently require a quadripod cane for walking. The Wheeleo® rolling cane has small wheels, allowing the patient to roll the cane instead of lifting it. Compared with a quadripod cane, this study found that the rolling cane improved walking speed and distance without additional risk of falls. Patient satisfaction was increased. The rolling cane can therefore be used as a rehabilitation device for these patients. Objective: To assess the changes in gait parameters in adults with hemiparesis using a rolling cane (quadripod cane with small wheels; Wheeleo®) compared with a classical quadripod cane. Design: A prospective, multicentric, cross-over randomized trial. Participants: Thirty-two ambulatory adults with hemiparesis. Methods: Participants were assessed using a quadripod cane and a rolling cane. Outcome measures were changes in: walking speed during a 10-m walk test and a 6-min walk test; frequency of 2-step gait; physiological cost index; number of therapist interventions to control the balance; perceived exertion; and participant satisfaction. Results: The following outcomes were improved with the use of a rolling cane: walking speed during a 10-m walk test at comfortable (+22%: p < 0.001) and maximal (+30%: p < 0.001) speeds; walking speed (+50%: p < 0.001) and distance (+49%: p < 0.001) during a 6-min walk test; and the frequency of 2-step gait. The physiological cost index, perceived exertion, and number of therapist interventions to control the balance remained unchanged. Participant satisfaction improved. Conclusion: A rolling cane, Wheeleo®, increases walking speed in adults with hemiparesis without additional risk of falls.

Gait Analysis of Hemiparetic Adult Patients with a Quadripod Cane and a Rolling Cane

“…Compared to the normal gait pattern, they observed early co-activation of the tibialis anterior and gastrocnemius muscles in the stance phase of hemiparetic patients [8]. The hemiparetic gait pattern is also characterized by a decrease in step length [1,7,9]. Low speed and step variability are correlated with an increased risk of falling, dependence, and co-morbidity, regardless of the post-stroke time [1,[9][10][11].…”

“…The hemiparetic gait pattern is also characterized by a decrease in step length [1,7,9]. Low speed and step variability are correlated with an increased risk of falling, dependence, and co-morbidity, regardless of the post-stroke time [1,[9][10][11].…”

“…Moreover, considering that 70% of patients experience a falls during the first year after a stroke, gait rehabilitation is therefore of paramount importance [3]. Patients find themselves in a vicious circle: they develop a fear of falling, so they stay at home and become socially isolated, which increases, in return, physical deconditioning and the risk of falling [3,9]. Walking, thus, could reduce comorbidities like, e.g., osteoporosis, cardiovascular disease, arthrosis, and obesity [13].…”

“…Furthermore, gait pattern in older patients is a marker of robustness and good health, and gait alteration is an evident sign of functional decline [14,15]. Early rehabilitation improves neuroplasticity and increases the chance of recovery [9].…”

“…There are different types of walking aids, e.g., a cane, crutch, walker, and rollator. In order to choose the most appropriate aid, caregivers need to consider physical status, cognitive capacity, and patient preferences [9,16].…”