Auxiliary devices for walking: guidance, demands and falls prevention in elderly

OBJECTIVE: The high number of elderly fallers raises, among other issues, the importance of proper use of assistive devices (DAM): crutches, canes and walkers. Despite DAM aim the improvement in functional independence, balance and the reduction of disability, most patients are not instructed on their proper use and they often use inadequate/damaged models or unsuitable height. Few studies have confirmed the efficacy of isolated prescription of DAM to reduce the risk of falls and few studies have shown the proper way to indicate and adjust them individually. Thus, in order to describe, inform and guide about the proper use of DAM, a literature review was conducted using the databases Medline, Lilacs, Scielo and PubMed, literary references and book chapters wich approached the topic. A total of nine articles and three book chapters were identified. The results showed, for each type of DAM, its indication, use, variations and its characteristics, guidance about walk and transfers and height adjustments. In addition, other relevant issues have been described such as patients' features and limitations, their environment, their social and economic conditions and mostly their functional capacity. The prescription, guidance and proper follow up of DAM by a physical therapist provide better confidence, skill and adherence regarding their use. Possibly, such gain will interfere on patient's daily activities performance and it will act on falls prevention.