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Canes, walkers, and other assistive devices offer a triple play of better balance, improved mobility, and fewer falls. If a person can get past the idea that assistive devices are just for “old people,” they can re-open a world that might have become smaller as a result of balance and mobility deficits.

However, using canes and walkers can create problems if not selected carefully or used properly. A 2011 study in American Family Physician found that most patients with assistive devices have never been instructed on their proper use, and often have devices that are inappropriate, damaged, or are not the correct height.

Canes

Canes help reduce pressure on joints, relieve pain, provide support, and prevent falls. Anyone with back or lower extremity pain, joint instability, or balance deficits may be at a higher risk of falls. This can include patients with arthritic ankles, knees, hips, or back, but the use of a cane is not limited to just arthritic conditions. A cane is especially helpful to a person with debilitating pain on one side of the body.

Canes and other assistive devices are sold at medical supply stores, supermarkets (Walmart, for example) or pharmacies (such as Walgreen’s, Rite-Aid, or CVS), and you also can shop online. Prices vary between basic models and those with special features, but aluminum canes are available for between 20 and 40 dollars. Wooden canes cost less. Don’t rush. Take as much time as you need to select the cane that is right for you.

Height

When standing up straight, the handle of the cane with its rubber tip removed should be at the crease of your wrist. To account for heel height, wear your walking shoes when testing a cane. If you wear shoes/heels of varying heights, choose an aluminum cane whose height can be adjusted. A cane that is too long forces excessive wrist flexion and strains your shoulder. The height of canes typically ranges from 34 to 42 inches.

Grips

Cane grips (handles) can be thick, thin, firm, padded, L-shaped, T-shaped, or rounded. Unless there is a reason for a specific grip, choose a cane that is comfortable and useful. A good grip is especially important if you have hand arthritis. Avoid candy-cane shaped canes. Grabbing a curved handle can be challenging and won’t center your weight over the shaft of the cane. Look for one with a straight handle that is offset but centered over the shaft.

Style and composition

The three styles of canes are standard (curved handle), straight-handled (if your hand is weak), and broad-based, or “quad” (for extra stability). Although wooden canes are less expensive, aluminum shafts are lighter, adjustable, easier to maneuver, and can come with more features. If you live in a cold, icy climate, get one with a pivoting spike that can be removed indoors. If you live in a warm climate, consider a cane with a rubber tip that can be replaced periodically. Your doctor or physical therapist can recommend the type of cane best suited for you.

Walkers

If you have joint pain on both sides of your body, have difficulty balancing, or are at high risk of falling, you may benefit more from a walker than a cane. A walker provides a wider base of support to help with balance. Some models have to be lifted and set down as you walk; others roll on wheels.

Walker grips are made of plastic, a soft material, or foam, and vary in thickness. If you have trouble grasping objects, you may prefer a walker with a larger grip. Choose a grip that won’t slip.

Adjust your walker so that the top of the device lines up with the crease in your wrists when your arms are down and relaxed. Your elbows should bend comfortably (about 15 degrees).

Using a walker

• Look forward, not down.
• The tips or wheels of the walker should be in contact with the ground before you put your weight on it.
• Lift or push the walker at arm’s length in front of your standing position.
• Step forward with the weakest leg.
• Then step forward with the opposite leg and place it in front of the weaker leg.

Reachers/grabbers

Reachers, also called grabbers, are lightweight mechanical devices that enable people of any age to reach and remove (or replace) objects off of high shelves, cabinets, or other pieces of furniture, or off the floor.

There is no research that associates reachers with fewer falls or better balance, but according to the National Institutes of Health, “This simple tool lets you take lightweight items from high shelves and other places and pick up objects from the floor so you do not have to bend over. Use a reacher rather than standing on a stool to get something from above or bending down to pick up something from the floor.”

For more information about reducing your fall risk, purchase Easy Exercises for Balance and Mobility from www.UniversityHealthNews.com.