Effect of a modified grip angle of a walker on the wrist deviation angle, muscle activation and palmar load during walker-assisted gait in elderly people.
Sang-Yeol Lee, Seon-Chill Kim, Young-Ik Lee
PMID 28356620WHAT IT FOUND
In elderly walker users, a 15-degree tilted handle lowered wrist deviation, wrist muscle activity, and pressure on the ulnar side of the palm during short-term walker gait compared with a flat handle.
Key findings
01The tilted handle reduced ulnar deviation from 33.86 ± 3.35 degrees to 24.00 ± 3.12 degrees and wrist extension from 24.90 ± 3.54 degrees to 22.20 ± 3.82 degrees.
02Extensor carpi radialis longus activity was lower with the tilted handle at 31.77 ± 4.72 percent of maximum voluntary contraction than with the standard handle at 40.98 ± 4.50 percent of maximum voluntary contraction.
03Pressure on the proximal ulnar part of the palm decreased from 5.52 ± 1.76 kg with the standard handle to 4.47 ± 1.39 kg with the tilted handle.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The paper does not state how many participants were analysed. Participants had to walk more than 50 m with a walker, use one for at least one year, score 24 or higher on the Mini-Mental State Examination, and have no recent limb surgery or stroke, so the results may not apply to frailer or cognitively impaired walker users. The comparison was a short laboratory walk of 10 cycles, with only the middle 6 cycles analysed, and it did not measure gait variables, pain, falls, or long-term wrist injury. The paper does not state the order of handle conditions, whether the sequence was randomised, or whether participants or assessors were blinded. Only the right hand was measured, and only vertical palm force was measured, not shear force. The study tested only a 15 degree handle inclination, so other angles are unknown. The results text mentions flexor carpi radialis activity being lower with the standard handle, while the table and discussion report extensor carpi radialis longus activity being lower with the tilted handle.
Declared interests
No conflicts of interest were declared, and financial disclosure was none.
The easy way to misread this
Do not conclude that a 15-degree tilted walker handle prevents wrist injury or improves walking. The study measured only short-term wrist angle, muscle activity, and palm pressure during 10 gait cycles in a laboratory, and it did not report pain, falls, injury, or walking performance. It also does not state how many participants were analysed.