5. Walker

one hand (i.e., upper limb) on the seat to control the speed and bear weight of sitting. Then the user sits gradually, using the other upper limb on the bar to control

(b) moving the hand on the seat to the horizontal pole of the parallel bar to maintain stability.

Positioning for learning how to use the parallel bars: (a) learning how to stand when using the parallel bar,

The following weight bearing status can be used with parallel bar: non-weight bearing (NWB), touch down weight bearing (TDWB), partial weight bearing (PWB), weight bearing as tolerated (WBT), full weight bearing (FWB).

The user slides the upper limbs on the horizontal bars forward to an arm's length (weight of the body is on unaffected lower limb and the affected lower limb is not touching the ground). The user shared his/her body weight between the unaffected lower limb and parallel bar by putting body weight on the parallel bar using the upper limbs. The user then moves the affects/involved lower limb (freely without bearing weight, i.e., NWB) forward and finally moves his/her body (weight), by propelling himself/herself forward (hopping) using the upper limbs to complete the cycle. The user is made to repeat this cycle in order to continue to move

The user slides the upper limbs on the horizontal bars forward to an arm's length distance, with the body weight borne on unaffected lower limb while allowing the foot or toes of the affected lower limb to touch the ground without bearing any weight. Then the user put body weight on the parallel bar using the upper limbs and moves himself/herself forward, completing the cycle. This way the user finally moves forward. The user is made to repeat this cycle in order to continue to move

the movement back to seating.

4.7 Non-weight bearing (NWB)

4.8 Touch-down weight bearing (TDWB)

forward.

Figure 6.

Prosthesis

forward.

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4.6 Weight bearing status possible with parallel bar

#### 5.1 Description and components

Walker is also known as walking frame or called zimmer frame. It is a modified and mobile version of the parallel bar (Figure 7). It is a medical ambulatory device

#### Figure 7.

Two types of walkers (walking frame); (a) with four rubber ferrules and (b) two rubber ferrules behind and two wheel rollers in front.

with about four legs or less in which the user holds the handle bars at wrist height and place the device in front during movement (Figure 7). It has horizontal bars on vertical posts for adjustment and folding. It has a permanent hand grip and rubber ferrules. The horizontal bars are about 18 inches apart to fit the body of the user while the height can be adjusted by the vertical posts. Adult walker height is between 32 and 37 inches (81–92 cm). Pediatric walkers are also available with adjustable height [16].

folding styles for walkers. The folding help for easy transportation and storage

1.Hinged front legs: the folding mechanism is activated by pulling a ball mounted on a piece of string. When the ball is pulled towards the user, the brace bar situated around the bottom of the frame slides up. At the same time the front section moves inwards until the front and back legs meet. This mechanism offers the user the choice of reducing the size of the walker.

2. Side folding frame: the locking motion on the walker is activated by the user pressing on the close and open button on the front horizontal bar of the frame. This therefore allows each side to be folded in to meet the front section. Once fully retracted, this type of frame becomes completely flat and more space

Forearm walker: this type of walker is basically the same as the standard walking frame but with forearm support rather than handgrips. This allows the user to transfer their weight through their forearms rather than their hands. This is particularly helpful to those who have arthritic hands and find gripping the frame

Reciprocal walker: a reciprocal walker operates with a pivot mechanism for each side. This provides the user with the option of lifting the frame up and moving around one step at a time. Many users prefer this movement as it is more intuitive to how one naturally walks. However, consideration needs to be given to how much weight is being placed on one side of the body, specifically arms. It is advisable to consult a physiotherapist or other health practitioner about the suitability of this

Walkers are usually adjustable; the height of the walker is adjusted to fit the user. The adjustment is estimated base on the user's height. The height of the walker should be at the level of the greater trochanter of the user and the elbow joint should be able to flex to about 20 or 30 degrees when user hold the hand grip of the frame in an upright position. Immediately the user stand and the horizontal bars are too short or too tall for the user the user is allow to sit and the horizontal bars

Prior to ambulation using a walker, the following safety and precautions should

• The stability of the walker should be checked. All the vertical posts (limbs) of

5.6 Safety and precautionary measures when using a walker

• The open and close button should be in open position.

• All the push button should be visible and same level.

• The ferrules or wheels are not loose or worn out.

of the device

efficient.

challenging.

frame.

be checked.

69

5.5 Fitting a walker

are adjusted to fit the user height.

the walker should touch the floor.

Other forms of walkers are:

Ambulatory Devices: Assessment and Prescription DOI: http://dx.doi.org/10.5772/intechopen.89886

The parts that formed the walker include handgrip, ferrule (or wheels), open and close button (for folding or collapsing the walker), push buttons (for adjustment of the height of the walker). The horizontal bars and vertical posts are made of different materials such as wood, hard plastic, stainless steel, aluminum steel and iron. The material used to manufacture the walker determines the weight, durability, cost, strength, comfort and safety.
