PTOtherJournal of neuroengineering and rehabilitation2022

Mechanical effects of canes on standing posture: beyond perceptual information.

Marta Russo, Jongwoo Lee, Neville Hogan and 1 others

PMID 36088387

WHAT IT FOUND

On a narrow beam, canes steadied young healthy people as much as standing on the floor.

Leaning harder did not add stability, and pushing too hard made the canes wobble.

Key findings

01Holding canes while standing on a narrow beam reduced sway of the body and the total pressure area to levels close to standing on the ground.

02Increasing force on the canes did not further reduce total sway, but it reduced sway measured only under the feet, showing a shift of load onto the canes.

03The forward tripod placement increased sway along the beam length, and higher force increased movement of the hands on the cane handles.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

Only 16 healthy young adults were tested, so the findings do not show how patients with balance problems would respond. The task was standing on a narrow wooden beam in a laboratory, not walking or standing on real-world surfaces. Participants held the canes with straight arms, which may not match how people usually hold canes. The canes were instrumented aluminum canes, not ordinary clinical canes. Perceptual and mechanical effects could not be separated; the study exaggerated one aspect rather than isolating it. Trials where participants lost balance on the beam without canes were excluded, which may understate instability in the hardest condition. The study used short 30-second trials and did not test long-term use, fatigue, or rehabilitation outcomes. The paper reports laboratory sway measures, not patient outcomes such as falls, function, or participation.

Declared interests

Funding was provided by the National Science Foundation, Samsung, and Ministero della Salute. The paper does not report additional conflicts of interest.

The easy way to misread this

Do not conclude that canes improve balance in patients or that pushing harder makes balance safer. The study was a short laboratory test in 16 healthy young adults on a narrow beam, and higher force did not further reduce overall sway while increasing cane movement.

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