Biomechanical effects of human-mobility aid interaction: A narrative review

Background

The clinical benefits and widespread use of traditional mobility aids (such as canes, walking frames, wheeled walkers, etc.) have been hampered by improper use, fear of falling, and social stigma. Clarifying the biomechanical impacts of using mobility aids on users is fundamental to optimizing rehabilitation programs.

Research question

What are the biomechanical consequences of human-aid interaction and what differences in variables exist across patients and devices?

Methods

English-language articles from 2000 to May 2024 were identified by searching Web of Science, PubMed, and Google Scholar for the keywords "mobility aids," "walking aids," "assistive devices," "cane," "walking stick," "walking frame," "walker," or "rollator." Articles related to Nordic sticks, crutches, or wheelchairs, as well as dissertations and studies reported only in abstract form, were excluded.

Results

The biomechanical consequences of assisted gait are significantly variable due to individual characteristics, device configuration, and environmental conditions. It is essential to assess the user's residual abilities and assistive needs to determine how the aid will be operated. Appropriate mobility aid selection, height adjustment, and weight-bearing support can enhance the user's functional compensation for the affected side, improving gait, reducing lower limb joint loads, and stimulating muscle activation. Conversely, inappropriate prescriptions may lead to increased energy expenditure and cognitive demands, as well as harm to healthy tissues. Additionally, environmental factors should be taken into account to improve the usability of mobility aids in real-life situations.

Significance

Low adherence to the use of mobility aids has been influenced by mixed factors in different patient populations. These biomechanical findings provide important support for optimizing personalized guidance and improving assistive device design.