Assistive walking devices in nonambulant patients undergoingrehabilitation after stroke: the effects on functional mobility,walking impairments, and patients’ opinion

Objective: To assess the immediate effects of assistivewalking devices on functional mobility, walking impairments,and patients’ opinions in nonambulant patients after stroke.Design: Randomized crossover trial.Setting: Inpatient rehabilitation units of 3 United Kingdomhospitals.Participants: Twenty nonambulant patients with stroke undergoing rehabilitation to restore walking.Interventions: Five walking conditions: (1) Walking withno device (the control condition), (2) walking with a walkingcane, (3) ankle foot orthosis, (4) slider shoe, and (5) a combinationof all 3 devices.Main Outcome Measures: Functional mobility (functionalambulation categories), walking impairments (speed, steplength of the weak leg), and patients’ opinions.Results: Functional mobility improved with all assistivedevices (P�.0001–.005; effect sizes 1.68–0.52; numberneeded to treat�2–5). Walking impairments were unchanged(P�.800 –.988). Participants were generally positive about thedevices. They felt their walking, confidence, and safety improvedand found the appearance and comfort of the devices acceptable.They would rather walk with the devices than delay walking untila normative gait pattern was achieved without them.Conclusions: Assistive walking devices improved functionalmobility in nonambulant rehabilitation patients withstroke. No changes in walking impairments were found. Participantswere generally positive about using the devices. Theresults support the use of assistive walking devices to enableearly mobilization after stroke; 2 patients would need to betreated with a cane or combined devices for 1 to improvefunctional mobility