Upper Limb Contributions to Frontal Plane Balance Control in Rollator-Assisted Walking

• Published in: Assistive technology Vol. 26; no. 1; pp. 15 - 21
• Main Authors: Tung, James Y., Gage, William H., Poupart, Pascal, McIlroy, William E.
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 02-01-2014
• Subjects: Adult; Aged, 80 and over; assistive devices; Canada; Education, Continuing; Female; Gait - physiology; Health technology assessment; high-risk fall patients; Humans; Male; older adults; Postural Balance - physiology; Self Report; Self-Help Devices; Upper Extremity; Walking; Young Adult; Canada
• ISSN: 1040-0435; 1949-3614
• DOI: 10.1080/10400435.2013.789456

While assisting with balance is a primary reason for rollator use, few studies have examined how the upper limbs are used for balance. This study examines upper limb contributions to balance control during rollator-assisted walking. We hypothesized that there would be an increased upper limb contribution, measured by mean vertical loading (F
z
) and variation in frontal plane center-of-pressure (COP
high
), when walking balance is challenged/impaired. Experiment 1 compared straight-line and beam-walking in young adults (n = 11). As hypothesized, F
z
and COP
high
increased in beam-walking compared to baseline (mean F
z
: 13.7 vs. 9.1% body weight (BW), p < 0.001, RMS COP
high
: 1.35 vs. 1.07 cm, p < 0.001). Experiment 2 compared older adults who regularly use rollators (RU, n = 10) to older adult controls (CTL, n = 10). The predicted higher upper limb contribution in the RU group was not supported. However, when individuals were grouped by balance impairment, those with the lowest Berg Balance scores (< 45) demonstrated greater speed-adjusted COP
high
than those with higher scores (p = 0.013). Furthermore, greater COP
high
and F
z
were correlated to greater reduction in step width, supporting the role of upper limb contributions to frontal plane balance. This work will guide studies assessing reliance on rollators by providing a basis for measurement of upper limb balance contributions.