A walker is a medical device designed to provide a wider base of support, offering stability and balance for individuals with reduced mobility. This support helps to make walking safer, especially for those recovering from injury or experiencing muscle weakness and balance issues. An improperly sized device can lead to serious consequences, including an increased risk of falls, muscle strain, and poor posture. Correct adjustment is fundamental to maximizing its benefits and promoting independent movement.
Selecting the Right Walker Style
The first step toward achieving a safe fit is choosing the walker design best suited to a person’s physical needs and environment. The standard walker, sometimes called a fixed or pickup walker, has four non-wheeled legs and provides the greatest stability because the user must lift it to move it forward. This style is recommended for those who require maximum weight-bearing support and are moving short distances.
A two-wheeled walker features wheels on the front legs and rubber tips on the back, allowing the user to push the device rather than lift it, which conserves energy. A four-wheeled walker, or rollator, may be appropriate for individuals with good balance but reduced endurance or grip strength. Rollators include hand brakes and often a seat, but they offer less stability than fixed models, requiring more coordination and control.
How to Determine the Correct Height
Once the appropriate style is selected, the precise height must be measured to prevent the user from hunching over or overextending their arms. This process should begin with the user standing as straight as possible while wearing their typical walking shoes, as footwear changes their standing height. The most reliable method for initial height setting is the “wrist crease method,” where the arms are allowed to hang naturally at the sides.
The handgrip of the walker should align precisely with the crease found on the inside of the user’s wrist. This alignment ensures the arms are positioned correctly to bear weight without straining the shoulders or back. If the walker is too low, the user will be forced to bend forward, disrupting their center of gravity and causing back pain. Conversely, a walker that is too high forces the shoulders upward, preventing the user from effectively leaning on the frame for support.
The mechanical adjustment of the walker’s legs is typically accomplished by depressing small spring-loaded buttons or push pins on each leg. The leg must be slid up or down until the button snaps securely into the correct height hole. After setting the height, ensure all four legs are locked into the same height setting. Uneven legs will cause the walker to wobble, compromising stability and creating a fall hazard.
Verifying the Fit and Usage Posture
After setting the height, the next step is to confirm the adjustment through the elbow flexion test. The user should stand inside the walker and place their hands firmly on the handgrips. When gripping the handles, a properly fitted walker will result in a slight bend in the elbow, ideally between 15 to 20 degrees.
This slight elbow bend allows for shock absorption and permits the user to press down effectively for balance without locking their joints. If the bend is significantly greater than 20 degrees, the walker is too tall, causing the user to lean too far forward. If the arms are nearly straight, the walker is too low, which can lead to excessive forward leaning and poor posture.
Maintaining an upright posture is paramount for safe usage; the user should stand tall with their back straight and look forward rather than down at their feet. When walking, the user should push the walker forward a short distance, keeping it close to the body, and then step into the frame. The hands should use the walker for balance and support, providing a downward push with the arms, not bearing the entire weight of the body. Proper fitting and usage posture work together to keep the user’s center of gravity safely within the walker’s base of support.