Equipment Advice
K7 PHYSIO | SERVICES
Mobility Aids
Mobility aids are equipment that assists an individual to walk. There are a variety of mobility aids available in the market, but consult a physiotherapist before buying new equipment. At K7 physiotherapy as part of our assessment, we recommend an appropriate mobility aid that suits the individual’s needs.
The widely used mobility aids in elderly rehabilitation in the United Kingdom are walking sticks, elbow crutches and walking frames.
Walking Frames
Walking frames are lightweight frames that help individuals with their mobility. Walking frames can be used both indoors and outdoors. The main walking frames used in the United Kingdom are:
- Zimmer frame,
- rollator frame/wheeled walking frame,
- gutter frame,
- delta frame/three-wheeled walker,
- four-wheeled walker.
Zimmer Frames
What is a Zimmer frame?
It is a lightweight aluminium frame that has four legs attached to four rubber ferrules. Zimmer was the manufacturer’s name, and later became the common name for this type of frame.
Can a Zimmer frame be used outdoors?
The answer is yes and no. It is designed to be used indoors and is unsafe to use outdoors. However, it can be used on a flush surface outdoors, but definitely not on an uneven surface.
Gutter Frame
What is a gutter frame?
It is a lightweight aluminium frame with two wheels at the front and two sticks at the back with rubber ferrules. Alternatively, it may have four sticks with rubber ferrules. The main difference between a normal walking frame and a gutter frame is that the latter has forearm troughs, or gutters, in which the user places their forearm and transfers most of their upper-body weight.
Who can benefit from gutter frames?
- People with partial weight-bearing status,
- People with non-weight bearing status for one lower limb,
- People with issues involving their wrists and fingers,
- People with obesity.
Delta Frame/Three-Wheeled Walker
What is a delta frame/three-wheeled walker?
It is a walker with three wheels and rubber tyres. Therefore, it is smooth to manoeuvre. It can also be used outdoors. An added advantage to these types of walkers is that they have brakes.
Who can benefit from a delta frame/three-wheeled walker?
- Individuals with breathing difficulties,
- Individuals with walking difficulties who need to walk long distances,
- Individuals with low endurance,
- Individuals with pain in lower limbs,
- Individuals with poor balance,
- Individuals with a fear of falling.
What are the advantages of using a delta frame/three-wheeled walker?
- It can be used in small spaces, small bungalows or corner shops.
- It is easy to transport in a vehicle (will fit in a small boot).
- It can be lifted easily into a vehicle.
Four-Wheeled Walker
What is a four-wheeled walker?
As the name implies, it has four wheels with tyres. Therefore, it is easy to manoeuvre outdoors. The added advantages are brakes, a seat and space for groceries and personal items.
Who can benefit from using a four-wheeled walker?
Individuals can use it as a seat or to perch on while resting in between walks. Therefore, they can cover longer distances. This type of walking aid is especially helpful to:
- individuals with respiratory issues,
- individuals with back pain,
- individuals with pain in their lower limb,
- individuals with poor balance,
- individuals with a fear of falling,
- individuals with reduced endurance.
Always consult a physiotherapist before purchasing a walking aid.
Elbow Crutches
What is an elbow crutch?
An elbow crutch is a lightweight, long aluminium stick with a cuff at the top to go around the forearm. It also has a hand grip. Most of the upper body weight is transferred to the ground through the crutches. The hand grip can be standard or ergonomical/a Fisher grip with troughs, or gutters. A physiotherapist can suggest an appropriate handle depending on the particular needs. Elbow crutches are usually used as a pair, but can be used for a single side if the need dictates.
Who can benefit from elbow crutches?
- Individuals with weight-bearing restrictions such as partial weight bearing or non-weight bearing on one lower limb,
- Individuals with neurological issues,
- Individuals with peripheral neuropathy.
Tripod and Quadripod
Tripods and quadripods are similar. The only difference between them is that a tripod has three sticks attached to three rubber ferrules, and a quadripod has four sticks attached to four rubber ferrules at the bottom end. Both facilitate individuals to transfer weight, to one side in particular.
Who can benefit from a tripod or quadripod?
- Individuals with one-sided weakness, such as that following stroke,
- Individuals with poor balance,
- Individuals with a falls risk,
- Individuals with a fear of falling,
- Individuals with poor posture.
Always consult a physiotherapist to recommend an appropriate walking aid.
Rollator Frames
What is a rollator frame or wheeled walking frame?
It is a lightweight aluminium frame. It has two wheels at the front and two sticks with rubber ferrule at the back.
Can a rollator frame or wheeled walking frame be used outdoors?
The answer is yes and no. It is designed to be used indoors and is unsafe to use outdoors. However, it can be used on a flush surface outdoors, but definitely not on an uneven surface.
I am using a stick but a frame appears to provide more support. Can I use a frame for mobility instead of a stick?
This is an important question. Many people look at a frame and see that it is has a wider base and has support on three sides. On seeing this, most automatically assume that the frame is more supportive and can prevent falls. However, the truth is strikingly different. Imagine a teenager using a baby walker: they cannot stride forward at a comfortable pace and tend to frequently stumble on the post of the walker in front of them. The same principle applies to a person who uses a frame after being recommended a stick, and vice versa.
Second, if an individual falls with a stick rather than with a frame, they are likely to suffer fewer injuries.
Third, the more an individual has support, the quicker they lose their skill. If a person starts by using a walking frame, it is difficult for them to then use a stick.
Therefore, patients should be assessed by a physiotherapist before acquiring or switching to a walking aid. The more supportive aids introduced to an individual, the more scope for deformity being indirectly inflicted on them. It could even take away their independence.
Small Equipment
There are many small pieces of equipment that assist an individual around the home to improve function and quality of life.
What is a sofa riser/chair riser?
If an individual is struggling to rise from a chair or sofa that is low in height, a riser will increase the height. There are four that go under the sofa/chair legs. An individual can stand from normal level rather than a low level.
Who can benefit from a sofa riser/chair riser?
- Individuals who are struggling with sit-to-stand transfers,
- Individuals having arthritic pain in hip or knees or both,
- Individuals who have had a total hip replacement or total knee replacement,
- Individuals with neurological issues.
Toilet Frame
What is a toilet frame?
Toilet frames are frames that go around the toilet, with two hand pads for an individual to push on to stand.
Who can benefit from a toilet frame?
- Individuals struggling with sit-to-stand transfers,
- Individuals with arthritic hips and knees,
- Individuals with pain in lower limbs,
- Individuals with neurological issues.
Does a toilet frame fit all toilets?
There should be space available to fit a toilet frame around most toilet. If the toilet is positioned especially close to the wall, it can be difficult to fit a frame around it.
Threshold and Half Step
A threshold, or step, into your front or back door may have always been there. However, when you have any issues with your lower limbs or experience neurological problems, negotiating that one step can feel like climbing Mount Everest. Often, you may not be able to climb it. On such occasions you can use a half step.
What is a half step?
A half step simply raises the level of the entrance to your door. The lower limb only needs lifting to half of the height of a standard step.
What is an alternative to a half step?
An individual can have installed a mini ramp. It gradually inclines and is easy for the user to navigate. However, at least two metres of space is required in which to install the ramp. If the space is less than two metres, the climb will be steep, and the user may not be able to navigate it.
Who can benefit from a half step?
- Individuals with arthritic hip and knees,
- Individuals with pain in lower limbs,
- Individuals with neurological issues.
Raised Toilet Seat
What is a raised toilet seat?
It is a plastic rim that can be fitted to the toilet. It raises the height of the toilet.
What is the purpose of a raised toilet seat?
The main use of a raised toilet seat is that it raises the overall toilet height. Therefore, the user need not move all the way down to sit and is not required to flex their hip and knees beyond 90 degrees.
Who can benefit from using a raised toilet seat?
- Individuals who have had hip surgery and are taking hip-related precautions,
- Individuals who have difficulty with their sit-to-stand transfer,
- Individuals with neurological issues,
- Individuals with pain in their lower limbs.
What is the disadvantage of a raised toilet seat?
It can become unclean quickly. It is fixed to the toilet and cannot be lifted up like a toilet seat, so can be difficult to use for those who urinate from standing position.
Perching Stool
What is a perching stool?
It is an adjustable stool with back and side support that offers a person a sloping position in which to sit. With this position, the user can achieve their functional activities such as washing and dressing their upper body and cooking on the worktop without restriction.
Who can benefit from using a perching stool?
- Individuals who are unable to stand for a short time,
- Individuals with pain in a lower limb,
- Individuals with neurological issues,
- Individuals who require energy conservation,
- Individuals who have frequent falls,
- Individuals prone to falls,
- Individuals with a fear of falling.
Powered Chair
What is a powered chair?
It is a wheelchair that is powered by electricity from a charged battery. There are powered chairs available in the market built exclusively for indoor use. Moreover, there are powered chairs built for both indoor and outdoor use.
The other major difference is rear-wheel drive and mid-wheel drive. The latter is easy to manoeuvre and turn 360 degrees compared to the former. Rear-wheel drive is especially useful to climb kerbs and navigate rough terrain.
Both have their merits and demerits. A physiotherapist considers all factors before prescribing an appropriate wheelchair for the individual.
Who can benefit from an electrically powered wheelchair?
People who have difficulty propelling a wheelchair, stroke survivors with one usable upper limb, and amputees.
Walking Stick
At K7 physiotherapy we find height-adjustable walking sticks especially helpful. It is also advisable to acquire a walking stick with a rubber ferrule at the bottom. This helps mitigate the risk of slips and trips and wet surfaces.
Who can benefit from having a walking stick?
Walking sticks are useful for individuals who:
- are fairly mobile, both indoors and outdoors,
- have low endurance,
- are suffering from respiratory issues,
- are experiencing pain in their lower limbs,
- have a fear of falling,
- are unable to stand unaided for more than 60 seconds,
- have poor balance and reduced lower limb strength.
What are the important points to consider before using a walking stick?
As a rule of thumb, do not use a walking stick without consulting a physiotherapist. K7’s physiotherapist can recommend an appropriate walking aid for particular needs. The following are important things to consider:
- Always use your walking stick on your unaffected side.
- Never change the height of the walking stick without consulting your physiotherapist.
- Using a walking stick of an inappropriate height is dangerous.
- Using the wrong walking aid can accelerate your deformity.
- Your physiotherapist can eliminate these dangers.
What if I am struggling to hold a stick?
Individuals suffering from arthritis or injury to their fingers/hands struggle to hold a stick. In this situation sticks with an ergonomic handle can be used. This stick is commonly called a Fischer walking stick. This type of walking stick is easy to grip, and the user bears their weight through their palm.
What do I need to consider when buying a Fischer walking stick?
You need to establish in which hand you are going to hold the stick before purchase. You cannot hold a left-handed Fischer walking stick using your right hand, and vice versa, due to its design. Your physiotherapist will advise you on the appropriate side.
Where can I use my walking stick?
There are no restrictions to using your walking stick. It can be used both indoors and outdoors.
Why is it important to clean walking aids, wheelchairs and all related equipment daily?
When you start using the walking aids/wheelchair, it becomes part of you. You go with your walking aids/wheelchair everywhere, including to the toilet and public places. It rapidly accumulates germs, food particles and other dirt. It is good practice to clean it with anti-bacterial wipe every time you return home or use the toilet.
It can be a time-consuming task. If you are struggling to clean every time you use it, clean it once daily as a minimum. If you struggle to clean it by yourself, request that your carer cleans it on your behalf, or, if you have a care package, include this task in your care plan by speaking to your social worker.
What do I need to check before using a walking stick?
Checking your walking stick is simple. You need to ensure that:
- the handle is not frayed or broken,
- the rubber ferrules/tyres are not worn out,
- the structure is intact.
Commode
What is a commode?
A commode is a moveable toilet. It does not have drainage or a flush affixed and has to be emptied after every use. A commode can be used in any part of the house and is convenient for the elderly population.
Who can benefit from using a commode?
- Individuals with mobility issues,
- Individuals with a fear of falling
- Individuals prone to falls,
- Individuals who have frequent falls,
- Individuals with neurological issues,
- Individuals with pain in their lower limb,
- Individuals who need to use the toilet at night,
- Individuals with no carer to monitor them overnight.
What are the disadvantages of using a commode?
Emptying the commode is the main disadvantage. Furthermore, a user may be left with excretion in their room for a period of time, until a carer empties the commode.
What are the types of commode?
- Static commode
It has four legs similar to a chair. There is a toilet seat on top of a basket to collect the excretion, instead of a seat in a chair.
- Commode on wheels
It is similar to a wheelchair. Instead of a seat in a wheelchair, there is a toilet.
The user’s physiotherapist or occupational therapist can suggest an appropriate type of commode following assessment.
Wheelchair
What is a wheelchair?
It is a chair fitted with wheels for the purpose of mobility, for those who are unable or struggle to walk due to disability, injury or other medical condition.
What is the purpose of a wheelchair?
The main purpose of a wheelchair is mobility. A wheelchair can be used both indoors and outdoors. There are many variations of wheelchairs. Our K7 physiotherapist can recommend an appropriate wheelchair for the individual.
What are the types of manual wheelchair?
There are several types of manual wheelchair in the market. The main variations are:
- self-propelling manual wheelchair
- attendant-propelled manual wheelchair
What is a self-propelling wheelchair?
If the user can propel themselves using a propeller in a wheelchair and move from one place to another, it is a self-propelling wheelchair.
What is an attendant-propelled wheelchair?
If the individual sits in the wheelchair, and another person pushes the wheelchair around, holding the handles, it is an attendant-propelled wheelchair.
What is a one-arm drive self-propelling wheelchair?
Usually, a user sits in the wheelchair and propels it by holding the propellers on both sides. However, if a person has only one arm or is able to use only one arm, both of the propellers will be fitted to the working-arm side. Initially, it may be difficult to manoeuvre. After a time, most users master the art.
Mobility Scooter
What is a mobility scooter?
It is an electric vehicle similar to an electrically powered chair but designed similar to a motor scooter. The main benefit is that it can be driven outdoors. The handling and manoeuvring is far more sophisticated when used outdoors compared to that of a powered chair.
The main disadvantage is that you cannot spend long sitting on it, compared to a powered chair, due to its scooter design.
Who can benefit from a mobility scooter?
- People who have some remaining mobility,
- People who are mobile indoors but struggle with outdoor mobility,
- People withrespiratory disorders such as COPD,
- People with cardiac disorder,
- People who use it only for mobility purposes,
- People with pain,
- People with arthritis,
- People with a neurological disorder.
How do I get exercise when I use a mobility scooter?
When an individual begins to use a mobility scooter, they often lose the capability of walking long distances, and their endurance can be reduced. It is recommended that individuals build their exercises into their daily routine. For example, on visiting the supermarket, the individual can park the scooter and walk unaided inside the supermarket.
It is not recommended to walk long distances from the outset. Gradually increase exercise tolerance by slowly increasing the number of steps taken each day.
Riser Recliner
What is a riser recliner chair?
It is a chair with a leg fitting that can be elevated. Sometimes, the back rest moves backwards and allows the individual to be in the lying position. The individual, although in a lying position, does not completely lie flat, akin to being in bed, or have enough space to roll around in. Moreover, the chair can lift the user all the way to a standing position. Therefore, they can walk straight away, without having to stand themselves. A riser recliner chair completely eliminates the need for sit-to-stand transfers.
Who can benefit from a riser recliner?
If there is a way to live without the use of a riser recliner, it is better to avoid it. However, people who have chronic arthritic knees where the bone is on top of other bones, severe neurological issues or swollen legs that need to be elevated for long periods can benefit from this type of chair.
Is it advisable to sleep on a recliner chair overnight?
No, definitely not. Essentially, it is a chair not a bed. To keep fluid under control, the user needs to sleep on a bed.
A recliner chair can be used for sleeping temporarily, for example, one or two hours during the day, but not for eight or nine consecutive hours.
Is buying a riser recliner chair for my parents a good idea?
No, definitely not. Everyone wants the best for their parents and wants them to lead a comfortable life. Therefore, people buy things to make their lives simpler. In terms of riser recliners, they are the absolute last resort. Where there is a situation where an individual is unable to stand from a chair after trying all other options, a riser recliner should be used. Even then, a physiotherapist should be consulted prior to purchasing one.
Never buy it for an individual who is able to rise from a chair by themself, even with difficulty. The quadricep is a large thigh muscle that helps people to stand. Every time a person stands up from a chair, quadricep muscles are exercised. This muscle is one that weakens quickly if only exercised rarely or not at all. When it weakens, it becomes difficult for an individual to stand upright, reducing their balance and risking falls. It creates an unnecessary vicious cycle that is difficult to overcome.
Balance Problems
When an individual is unable to maintain equilibrium or their line of gravity within their base of support, they are experiencing balance problems.
What are the two main balance problems?
- Static balance: an individual is unable to maintain sitting or standing positions without leaning away from the base of support.
- Dynamic balance: an individual can maintain stability and work within the base of support without losing that state or falling while preparing a function such as walking, stepping, climbing stairs, transferring from a chair or going in and out of a bathtub.
What happens when balance is affected?
A person with intact balance can usually walk, climb stairs, get in and out of the bathtub, visit a shopping mall, travel on a bus, use the escalator in the shopping mall and negotiate the crowd easily, without realising what they have achieved. When balance is affected, all the above activities become difficult to perform. The individual needs to think several times before executing a function, and they often fall, hurting themselves in doorways or on stairs.
Balance Exercises
What are balance exercises?
Balance exercises are a series of graded exercises that help improve the balance of an individual.
On most occasions, a physiotherapist will challenge the current level of balance an individual possesses to improve the balance.
What are the main factors that reduce balance?
- Musculoskeletal conditions such as arthritis,
- Neurological conditions such as Parkinson’s disease and stroke,
- Cardio-respiratory conditions such as dizziness, light-headedness and shortness of breath,
- Frequent falls,
- Ageing,
- Post-surgical conditions such as total hip replacement and total knee replacement,
- Medication,
- Audio-visual issues,
What are the benefits of balance exercises?
- Reducing falls risk,
- Improving mobility,
- Improving functions,
- Improving joint proprioception,
- Improving static balance,
- Improving dynamic balance,
- Improving quality of life,
- Improving confidence,
- Improving posture.
Who can benefit from balance exercises?
- Elderly population,
- Frequent fallers,
- Individuals following surgery,
- Individuals suffering from neurological conditions such as stroke, Parkinson’s, spinal injuries and head injury,
- Individuals with posture issues.
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K7 physiotherapy
Aspire Health
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Rugby
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