Which Mobility Aid is Right for Me?

By Romy Villaluz, Physical Therapy Assistant, UC Davis

Laura Sifuentes, Physical Therapist, Board Certified Neurologic Specialist, UC Davis

Norika Malhado-Chang, MD, Professor of Neurology, Movement Disorders Specialist, UC Davis

A common question our patients and their families have is, “Which is the best assistive device to help me get around?” The answer is, “It depends,” but this article will help break down the options and review the benefits of each device. Before delving into the world of mobility aids, we’d like to acknowledge the reservation and reluctance many feel about using any devices at all. Many share concerns that they will become “dependent” on assistance and never walk independently again. Fear not! As our research has proven, exercising daily and staying active are the keys to success with Parkinson’s. So, if you can walk comfortably and safely for 30 minutes with a 4 wheeled walker (for example), but only 10 minutes without one, take the walker and get in those steps!

When it comes to selecting the right mobility aid, your best resource is your physical therapist – specifically one with experience in treating Parkinson’s. Your physical therapist will conduct a formal assessment of fall risk, balance, strength, walking speed, and coordination. Let your PT know which activities you engage in regularly and, more importantly, which activities you would like to return to, as this may play a role in their recommendation. Your therapist should trial different devices with you to find the best fit and ensure understanding of how to correctly use the device.

Below is a list of commonly recommended mobility aids from least supportive to most supportive:

1.     Hiking poles

2.     Various base size canes (single point cane, self-standing cane, quad cane)

3.     Forearm crutches

4.     Four-wheeled walker with or without a platform attachment (Various types: Rollator, UP Walker provides elbow support)

5.     U-Step 7-wheeled walker with various tools and modifications (most notably the reverse braking system)

6.     Front wheeled (2-wheeled) walker with or without a platform attachment

7.     Manual wheelchair or transport chair (Note: a transport chair is lightweight and has small wheels, designed for easy folding and portability. A wheelchair takes up more space due to the large rear wheels designed for self-propelling; it is generally too heavy to lift into the trunk of a car.)

8.     Power wheelchair or scooter

Your physical therapist may recommend differing types or combinations of assistive devices based on your Parkinson’s symptoms, your goals, or the change in your fall risk over the years. For example, a 4-wheeled walker is a popular choice because it rolls smoothly and is easy to maneuver over various types of terrain. Having hand brakes, a seat, and storage compartment, comes in handy, too! However, if you experience “festination” – where your feet shuffle faster and faster when walking – a 4WW may “run away” from you too easily. In this example, a 2WW might be a safer choice. So, the device we recommend initially may not remain the device you will use for the long term. Many times, the assistance one needs may vary and fluctuate, year-to-year, day-to-day, or even hour-to-hour! Your neurologist can provide you with a medical supply prescription for Medicare coverage of certain devices. Your local medical supply store is also a great resource where you can try before you buy. Remember, top priority always is YOUR safety and the safety of those around you!