The Downside of Over-reliant on Walking Aid in Stroke Rehabilitation

Working as a stroke physiotherapist, I have prescribed countless of walking aids to my stroke clients. On the other side, I have also stopped my stroke clients from using their walking aids for countless time.

Conservatively, walking aids are prescribed to people who has either short term or long term mobility issues, in order to improve their independence. This is great as it improves their quality of life.

However, this can become an issue when the walking aid prescription is done without any follow up, or plan.

For someone who has long term mobility issue, mainly elderly or those with chronic diseases like stroke or Parkinson's Disease, over-reliant on walking aid without proper rehabilitation program, can lead to progressive physical deconditioning. While the mobility issue is long term, as well as the use of walking aid, it doesn't mean that nothing need to be done.

Human body is very adaptive. Once the demand is taken away, the growth stopped. Taking walking frame as an example, both hands supported on the walking frame reduced the demand of the posture muscles and trunk extensors to work. Without proper rehabilitation, the person will become weaker and weaker, and more reliant on the walking frame. Any sudden movement or activities that demand the postural muscles and trunk extensors to work, will likely results in fall, if without walking frame. A comprehensive rehabilitation program targeting these muscles should be implemented to prevent the decondition of these muscles and maintain the mobility of the person as much as possible.

The video below is a good illustration of a case where over-reliant on walking aid after stroke can lead to poor physical improvement (not using her left leg to walk and support her body), and postural complication (scoliosis). The first priority of her stroke rehab program is to reduce her reliance on her quad stick, so that her weaker leg (left leg) has sufficient demand for growth, and improve her upright posture to prevent complication like back pain.

Our physiotherapist Mr Gan Jing Tap is a trained Neuro-Physiotherapist who has special interest in stroke and Neuro-Rehabilitation.

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