The differential effect of first time single-point cane use between healthy young and older adults

Introduction

Walking aids are often introduced to older adults to enable independent mobility. Single‐point canes are the most common device used. Benefits are tempered by research suggesting that walking aids increase falls risk. A better understanding of the effect of walking aid use on gait performance is required.

Objective

To evaluate differences in the effect of initial single‐point cane use on gait between younger (YA) and older adults (OA).

Design

Cross‐sectional.

Setting

Community‐dwelling.

Participants

Twenty‐six YA (aged: 23.7 ± 2.8 years) and 25 OA (aged: 70.8 ± 14.1 years) participated. Inclusion criteria were: age 18‐35 for YA or ≥ 50 for OA, able to ambulate unassisted, and without any condition affecting mobility.

Interventions

Not applicable.

Main Outcome Measure(s)

Gait velocity and stride time variability under different walking path configurations (straight path, Groningen Meander Walking Test, Figure of Eight Test) and conditions (unassisted walking, walking with a single‐point cane, and walking with a single‐point cane while completing a cognitive task) was recorded in a laboratory. The arithmetic task of subtracting ones from 100 was used as the secondary cognitive task. Data analysis included separate three‐way mixed ANOVAs (path/condition/group).

Results

There was a statistically significant two‐way interaction between walking path and condition for velocity (P < 0.001, ω2 = 0.03) and stride time variability (P = 0.032, ω2 = 0.02). Additionally, a significant main effect of group was also observed (velocity: P = 0.004, ω2 = 0.07; stride time variability: P = 0.001, ω2 = 0.09).

Conclusions

Using a single‐point cane decreased velocity and increased stride time variability in both younger and older adults. However, the cognitive load and effect on gait of initial cane use was not different between age groups. Standardized guidelines aimed at facilitating a client's transition towards the safe use of a walking aid are needed. Future research should evaluate if training can mitigate some of the adverse changes to gait stability observed with initial walking aid use.