Understanding how people use walking frames in their daily lives

Reference # R530/1116
Date January 2017 – September 2018
Funding £74,907
Project lead Dr Sibylle Thies
Organisation University of Salford
University of Salford

Published October 2020


Many older people use walking aids to get around, but there are questions over their effectiveness. Using technology to measure the stability of walking frame users in different environments, Dr Sibylle Thies was able to understand more about the use of these aids in daily life, and develop new advice for safer usage.

Nobody had looked at this question before – how walking frames were actually being used at home and whether that was in line with current guidance

Dr Sibylle Thies

Walking aids can help older people to move around and are designed to increase stability and lower the risk of falling. But research shows that walking aids do not reduce the risk of falling for older people as much as one would think. We wanted to understand why this was: what was it about the use of the walking aids that wasn’t fully helping in the prevention of falls?

We realised that nobody had investigated how walking frames were actually being used at home, whether usage patterns were in line with existing safety guidance, and how different usage patterns affect stability. Funding from the Dunhill Medical Trust allowed me and our post-doctoral fellow, Dr Alex Bates, to find out.

Portrait photo of brown-haired woman in white top smiling
Dr Sibylle Thies
What did we find?

We had previously developed instrumentation and software which allows us to calculate a number reflecting the stability of the user and their walking frame at any instant in time. We call our measure the Stability Margin (SM). It is calculated using force measurements from sensors in each leg of the walking frame as well as the user’s shoes, combined with the position of their feet relative to those of the walking frame. The smaller the SM, the more unstable the user and their walking frame are.

In this research, we used that technology to ask whether the frame was being used as the current guidance suggests, and how the patterns with which it is used affect stability.

Close-up photo of walking frame, showing integrated force measurement sensors
We used integrated force measurement sensors in each leg of the walking frame – as seen above – to record the stability of the frame at any moment in time.

Analysing the data, we found that people don’t always follow current guidance on how to use walkers when they are at home. We discovered that people weren’t always using the walking frames in the most stable manner (for example, lifting them when they shouldn’t). This is partly down to the home environment itself – there are pieces of furniture to navigate around and corners to turn – yet advice on how to use walking aids often doesn’t take into account the complexity of home life.

As a result, we were able to develop some new advice leaflets on the use of walking frames.

The DMT is much more than just a funder – they supported our aims and team throughout

Dr Sibylle Thies

Producing advice wasn’t something we set out to do – it happened because we realised that our findings provided an opportunity to improve on current guidance and hence make a real difference.

Alongside these leaflets, we created videos so that people could see visual examples of our guidance in action. Clinicians have said these are especially helpful during the COVID-19 pandemic when they have often not been able to see patients for face-to-face demonstrations.

How the Dunhill Medical Trust supported us

Without the Dunhill Medical Trust, we might have struggled to get funding for this important real-world work. The DMT allowed us the freedom to use our novel methods to explore a very important, but somewhat neglected area.

The DMT showed a real interest in our research, visiting the lab to find out more and meet the team. They also organised an Early Career Researchers networking day, which was invaluable for Alex.

This makes the Dunhill Medical Trust much more than a funder – they supported our aims and team throughout.

What’s next for this research?

Our future research will develop three different areas.

First, we will keep refining walking frame advice as our understanding about stability and real-world usage grows.

Secondly, we’ll advance a discovery made during this research – that a particular type of walking frame with unidirectional wheels may not be the most appropriate design, as people rarely move in straight lines. We’ve now entered a Knowledge Translation Partnership with a leading walking frame manufacturer to design an improved version that better enables people to perform everyday tasks.

Finally, we’ll be conducting research to understand what barriers there might be for people that have walking aids, but who don’t use them – and how often and when this ‘non-use’ is likely to occur – so that we can develop ways to address the issue.

Find out more

Our guidance page on the University of Salford website can be found at this link: it contains all of the safety leaflets and videos we produced as a result of our findings, as well as the publications arising from our work.