Comparison of Older Adults Walking with An Anterior, Posterior and without A Wheeled Walker

Objective: To evaluate the effectiveness of posterior walkers in older adults using visual gait analysis. Design: Repeated measures, within subject design. Setting: Senior Center, Charlottesville, VA Participants: 20 independent, community living adults 79.1 years (± 6.7) years. 5 physical therapist raters. Measurements: Five physical therapists were asked to observe video data of 5 older adults (75 years ± 5) walking with both anterior and posterior walkers. While viewing the video data, the physical therapists were asked to complete a modified version of the Gait Abnormality Rating Scale (GARS) for each of the 5 participants with each of the 2 walkers for a total of 10 assessments. After completing the GARS assessments for each participant, the physical therapists were asked their general preference between the two walkers. Results: The GARS showed poor intraclass correlation coefficients (ICC = 0.413, 0.582)
between the therapist raters. Also, there was no difference between the GARS scores with the anterior and posterior wheeled walkers. The physical therapists had mixed preferences about the two different walkers. Conclusions: ecommendations for the GARS include 1) several group training sessions with all raters in an attempt to maximize the ICC, 2) using only one rater, or 3) using a different assessment tool with better reliability for visual gait analysis. Future research should investigate using visual gait analysis to evaluate other assistive devices such as canes, crutches and walkers to see if consistent biomechanical differences with these walking aids can be quantified. In conclusion, the therapists saw no consistent improvement in gait biomechanics when the
participants walked with the posterior walker versus the anterior walker.