Walking Aids Explained: How to Choose the Right Walker or Walking Stick
Walking aids such as walking sticks, walking frames, two-wheeled walkers and four-wheeled walkers can be useful for people experiencing difficulties with balance, strength, mobility or confidence when walking. They may be recommended following an injury or surgery, or for people living with longer-term conditions that affect their mobility.
However, choosing a walking aid is not simply a matter of selecting the device that provides the most support. Different walking aids provide different levels of stability, mobility and weight-bearing assistance. The most appropriate option depends on the individual's strength, balance, walking ability, environment and goals.
A physiotherapist can assess these factors and help determine whether a walking aid may be appropriate, which type may be most suitable, and how it should be fitted and used safely.
Why Might Someone Need a Walking Aid?
Walking aids can be considered when someone has difficulty walking safely or comfortably without additional support. Common reasons for using a walking aid include:
Reduced balance or increased risk of falling
Weakness in one or both legs
Pain affecting walking
Recovery following surgery or injury
Reduced walking endurance
Neurological conditions affecting movement
Arthritis or other musculoskeletal conditions
Changes in walking ability associated with ageing
A walking aid may provide additional stability, allow some weight to be transferred through the upper limbs, or improve confidence during walking.
Importantly, needing a walking aid does not necessarily mean that someone should stop trying to improve their strength or balance. Where appropriate, a walking aid can be used alongside exercise and physiotherapy rehabilitation to support safe participation in everyday activities.
What Types of Walking Aids Are Available?
Different walking aids provide different levels of support. The main options include walking sticks, standard walking frames, two-wheeled walkers and four-wheeled walkers or rollators.
Walking Sticks
A walking stick or cane generally provides the least support of the common walking aids. It can be useful when someone requires a small amount of additional stability or needs to reduce some of the load placed through one painful or weaker leg.
A walking stick is generally most appropriate for someone who has sufficient balance, upper-body strength and coordination to use it safely. It is usually held in the hand opposite the weaker or painful leg. This can allow some body weight to be transferred through the stick while walking.
Because a walking stick provides a relatively small base of support, it may not be appropriate for someone with significant balance problems or substantial weakness affecting both legs.
Walking Frames
A standard walking frame provides a larger base of support than a walking stick and may be considered for people who require greater assistance with balance or weight-bearing.
Walking frames without wheels can provide a high level of stability, but they require the user to lift and reposition the frame with each step. This can make them more demanding to use and may not be suitable for everyone.
Two-Wheeled Walkers
A two-wheeled walker has wheels at the front and rubber tips at the rear. The wheels allow the device to be moved forward without needing to lift the entire frame.
This type of walker may be useful for someone who needs more support than a walking stick can provide but finds a standard walking frame difficult to manoeuvre.
Four-Wheeled Walkers and Rollators
Four-wheeled walkers, commonly known as rollators, can provide support while allowing the user to maintain a more continuous walking pattern. Many models also include hand brakes and a seat, which may be useful for people who require regular rest breaks.
However, a rollator generally provides less stability than a standard walking frame because it is designed to move more freely. This means that a rollator is not automatically the best option for someone with significant balance or weight-bearing difficulties.
Research reviewing walking with rollators in older adults suggests that they can influence walking patterns, but the evidence regarding their effects on gait remains limited and further research is needed.
How Do You Choose the Right Walking Aid?
The most appropriate walking aid depends on the individual's needs rather than simply their diagnosis.
A physiotherapist may consider several factors when assessing which walking aid may be suitable.
Balance
How well can the person maintain their balance while standing and walking?
Strength
Is there sufficient strength in the legs and upper body to use the walking aid safely?
Weight-Bearing Ability
Does the person need to significantly reduce the amount of weight placed through one or both legs?
Walking Pattern
How does the person currently walk, and does the walking aid improve or interfere with their movement?
Endurance
Can the person walk the distances required for everyday activities?
Cognition and Coordination
Can they remember and perform the correct sequence for using the device?
Environment
Will the walking aid need to be used on stairs, uneven surfaces, narrow spaces or outdoors?
Goals
Does the person want to walk around their home, go shopping, exercise or return to community activities?
These factors are important because a walking aid that works well for one person may not be appropriate for another.
Getting the Correct Walking Aid Height and Fit
Correct sizing and fitting are important parts of using a walking aid safely.
For many standard sticks and walkers, the handgrip is positioned around the level of the wrist crease when the person is standing upright with their arms relaxed. When holding the handle, the elbow should generally have a small amount of bend rather than being completely straight.
However, correct fitting should be individualised. The person's posture, strength, walking pattern and type of walking aid all need to be considered.
An incorrectly adjusted walking aid may be uncomfortable, inefficient or more difficult to control. Regular checks may also be appropriate because equipment can become worn or damaged over time.
How Can Physiotherapy Help With Walking Aids?
Physiotherapy assessment can help determine whether a walking aid is appropriate and, if so, which device may best match the person's abilities and goals.
A physiotherapist may assess walking, balance, lower-limb strength, transfers and functional activities before recommending a walking aid. They can also provide instruction on how to use the device, including techniques for turning, negotiating different surfaces and managing everyday environments.
Research into gait-aid prescription suggests that simply providing a walking aid may not be enough. A 2022 systematic review involving 555 community-dwelling older adults found inconsistent effects of gait-aid prescription on walking speed and limited evidence regarding its effects on falls and balance. The authors highlighted the potential importance of more extensive training in how to use walking aids safely.
This supports the importance of walking aid education, training and practice, rather than simply purchasing a device and using it without instruction.
Physiotherapy may also incorporate exercises targeting leg strength, balance, coordination and walking ability. These interventions can be used alongside a walking aid where appropriate, with the aim of supporting mobility while addressing factors that may be contributing to difficulty walking.
For older adults at risk of falls, clinical practice guidelines commonly support a broader approach that may include exercise, gait and balance assessment, environmental modifications and physiotherapy referral.
Are Walking Aids Only for Older People?
No. Walking aids can be appropriate for people of different ages depending on their circumstances.
For example, a younger person recovering from lower-limb surgery may temporarily use a walking frame or crutches, while someone with a neurological or musculoskeletal condition may require a walking stick or walker for longer-term mobility.
The important consideration is not age but the individual's walking ability, safety, physical requirements and goals.
Do Walking Aids Make You Weaker?
A common concern is that relying on a walking aid will automatically cause the legs to become weaker. This is not necessarily the case.
A walking aid can sometimes allow a person to participate in activities that would otherwise be too difficult or unsafe. At the same time, it may be appropriate to address strength, balance and walking capacity through a rehabilitation program.
Whether someone should continue using a walking aid, progress to a less supportive device or work towards walking without an aid depends on their individual circumstances. This should be assessed rather than assumed.
Take-Home Message: Choosing the Right Walking Aid
There is no single “best” walking aid for everyone. A walking stick may provide enough support for someone with mild balance difficulties or one-sided lower-limb symptoms, while a walking frame or wheeled walker may be more appropriate for someone requiring greater stability or weight-bearing assistance.
The correct walking aid, appropriate fit and safe walking technique are all important. A walking aid that is too high, too low or unsuitable for the individual's abilities may be difficult to use safely.
Physiotherapy assessment can help determine whether a walking aid may be appropriate and which option best matches a person's strength, balance, walking ability and goals. Physiotherapy may also provide education and practice with the device while addressing strength, balance and mobility through an individualised rehabilitation program.
If you are unsure whether you need a walking aid, are having difficulty using your current walking aid, or have noticed a change in your walking ability, speaking with a physiotherapist or other appropriate healthcare professional may help identify the safest and most suitable approach.
References
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