Aid for mobility: Distinguishing between walkers and canes based on circumstances
Carrying a cane or using a walker can greatly assist elderly adults or those living with disabilities who struggle with balance and mobility. The decision to opt for a cane or a walker is contingent upon the degree of aid an individual needs, their lifestyle, and their financial circumstances.
Advancing years often brings about chronic conditions that make mobility increasingly challenging. According to the Centers for Disease Control and Prevention (CDC), older adults tend to experience falls each year. In later stages of life, these falls can lead to severe muscle and bone injuries.
Assistive devices play a crucial role in enabling individuals to maintain their independence and minimize the risk of falling. Different types of mobility assistance devices are available to cater to varying needs, with wheelchairs being most appropriate for individuals with no or limited mobility, while canes and walkers are suitable for those with some degree of mobility.
This article delves into the differences between canes and walkers, providing insights on when and how to use each device and offering guidance on choosing the best option.
The table below outlines a broad comparison of walkers and canes:
| Device | Advantages | Disadvantages | Conditions | Cost || --- | --- | --- | --- | --- || Cane | Boosts balance, Adjustable. Available in standard, 3-legged, and 4-legged versions. Some models feature a curved handle for a more secure grip. | Limited to minimal weight bearing, some users may find the curved handle difficult to grasp, especially those with joint or muscle conditions. | Mild balance issues or mild to moderate arthritis of the lower limbs. | $10-$40 || Walker | Increased stability, Foldable. Available in standard, 2-wheeled, and 4-wheeled (rollator) versions. Some models offer additional features like a seat, basket, and brakes for added comfort. | Requires lifting with each step, lacks wheels. Less ideal for navigating outdoor terrains. | Conditions affecting the function of muscles or nerves or for fractures. | $20-$60 for standard, $35-$100 for rollator |
-helps with balance-adjustable
What medical conditions necessitate a cane versus a walker?
-for minimal weight bearing only-some have a curved handle that some may find difficult to grasp and cause pain, especially for people with joint or muscle conditions
Canes and walkers offer stability during mobility. Canes help individuals dealing with minor balance or stability issues, weakness in their lower limbs or trunk, or discomfort from conditions like arthritis.
-mild balance issues-mild to moderate arthritis of the lower limbs
Typically, a person holds a cane using one hand. Canes may have 1 to 4 legs, with an increased number of legs and a broader base resulting in enhanced stability. In slippery conditions, users may choose to add ice grips to their cane.
$10-$40
However, individuals who have undergone total knee or hip replacement surgery or those displaying more significant balance and mobility issues may be better suited to using a walker. This device, comprising three or four legs, requires the use of both hands. For added comfort, users can attach wrist or arm supports, as well as a variety of accessories such as wheels or brakes, depending on their needs.
Types of canes and walkers
-offers greater help with balance than a standard cane-can bear more weight-adjustable
Standard canes are often made of wood or aluminum, featuring a rubber tip and a hook-shaped or flat handle. Although suitable for those requiring minimal assistance, these canes may not adequately accommodate those who require greater support.
-heavier-more cumbersome-may be harder to use on stairs
Canes with three or four legs stand independently, offering greater stability for users experiencing discomfort on one side. Some multi-legged canes, known as "sit-to-stand" canes, also boast a secondary grip, providing extra assistance with getting up or sitting down.
-one-sided muscle weakness (hemiparesis) or more significant issues with balance
According to the Arizona Center on Aging, there are three types of walkers available to cater to different needs:
$15-$40
- The standard walker is four-legged, offering more stability but necessitating the user to lift it with each step.
- Two-wheeled walkers feature front wheels and back sliders, making them easier to maneuver, though less stable and requiring more cognitive effort to handle.
- Four-wheeled walkers, or rollators, enable users to maintain a more natural gait and have additional features like brakes, a seat, and a basket, yet are heavier to maneuver and less stable than standard walkers.
Every walker type has its benefits and pitfalls, depending on the user's specific needs and abilities.
-stable-foldable
Is it better to use a walker or a cane?
-no wheels-needs lifting with each step
Effective cane usage requires an individual to have enough strength to walk steadily while maintaining balance, as well as the ability to secure themselves should they start to slip. While a cane can help address minor balance problems, it necessitates a person's ability to stabilize themselves independently. They must also be able to coordinate the cane's movement with their arm as they walk.
-for conditions that affect the function of muscles or nerves or for fractures
Walkers, conversely, are more appropriate for those with more extensive balance impairments, as they allow users to shift some or all of their body weight away from their lower body during movement. Using a walker, a person can utilize their arms to support their body weight, with their strength and endurance gradually increasing, allowing them to place more weight on their legs when ready.
$20-$60
Whether to utilize a walker with or without wheels depends on whether the device is needed only at home or outdoors and the terrain that needs to be navigated.
When should one switch from a walker to a cane?
-easier to move-may have a seat and basket for comfort
Determining whether to switch between a walker and a cane or vice versa involves several considerations, such as assessing balance and strength improvements or worsening, seeking medical advice, and evaluating the appropriateness of everyday routines for each device.
-less stable than standard-not foldable
Where can one acquire a cane or a walker?
-issues affecting the spinal cord, conditions that slow down mobility like heart or lung diseases
Individuals may be able to purchase the desired mobility aid directly from a supplier or receive it through a clinic, hospital, insurance company, or non-profit organization for older adults or people with disabilities.
$35-$100
How much does a cane or a walker cost?
According to American Family Physician, canes usually cost between $10 and $40, while walkers may be slightly pricier, ranging from $20 to $100.
DME and Medicare
Walkers and canes are considered Durable Medical Equipment (DME) by Medicare. Users can rent or purchase a cane or walker through Medicare Part B if they are deemed medically necessary and required for home use. However, the medical professional accepting Medicare must issue the prescription, and the device must be acquired from a Medicare-approved supplier.
"Learn more: Medicare and walkers" "Learn more: Medicare and canes"
Safety considerations for canes and walkers
Regardless of the chosen mobility device, users should prioritize safety. It's essential to ensure the handle is at wrist level with relaxed arms and aim to keep their arms slightly bent while using the device, maintaining an upright posture without leaning forward.
Cane safety
When standing, a person should try to hold the cane with the hand opposite the affected or painful side. When walking, they should place the cane ahead, step forward with the painful or injured leg, and follow with the other leg. However, when going upstairs, they should step up using the stronger leg first while holding onto the handrail. When going down, they should place the cane down first, then the weaker leg, followed by the stronger one.
Walker safety
While using a walker, the user should place it one step ahead, move the injured or painful leg to the middle, and then bring the stronger leg to meet it, taking small, slow steps.
The safest way for a person to sit down is to back up to the chair, feel for the seat, and lower themselves slowly down. To stand, they should push up with their arms and grasp the walker's handgrips. It is generally advisable not to use a walker on stairs or escalators.
Conclusion
As people age, chronic conditions may develop, making mobility more challenging. Each year, approximately 1 in 4 older adults experience a fall, which can result in severe injuries to muscles and bones.
However, assistive devices are readily available to help individuals maintain their independence, aid in recovery from injury, and minimize the risk of falling. Canes and walkers are suitable options for individuals with some degree of mobility. Both offer mobility support, with the user's choice contingent upon the support needed, their lifestyle, and the cost of the device.
[1] Friedreich's Ataxia Research Alliance, Frequently asked questions, https://www.curefa.org/blog/frequently-asked-questions/[2] Centers for Disease Control and Prevention, CDC grand challenge: Healthy aging, https://www.cdc.gov/grandchallenges/healthyaging/index.html[3] Paws with a Cause, Paws for Mobility, https://www.pawswithacause.org/services/paws-mobility/[4] The Mayo Clinic, Caneversus walker, Mayo Foundation for Medical Education and Research, 2021.
- Chronic medical conditions like arthritis or other complications that may impair balance or mobility may necessitate the use of a cane or walker.
- Canes are suitable for individuals with minimal weight bearing capacity or mild balance issues, while walkers cater to those with more significant muscle or nerve-related conditions, or for those who require more support following surgeries.
- Types of canes include standard, 3-legged, and 4-legged, and can have adjustable height for added convenience. Walkers are available as standard, 2-wheeled, or 4-wheeled (rollator) models, with some featuring extra features like seats, baskets, and brakes.
- Determining whether to use a cane or a walker depends on the person's specific needs, such as assessing balance and strength improvements or worsening, seeking medical advice, and evaluating everyday routines.
- Mobility aids like canes and walkers can be acquired through various means, such as purchasing directly from a supplier, being provided by a clinic or hospital, or receiving from an insurance company or non-profit organization.
- Canes typically range in price from $10 to $40, while walkers can be slightly more expensive, with prices ranging from $20 to $100.
- Both canes and walkers are considered Durable Medical Equipment (DME) by Medicare, and users may rent or purchase them through Medicare Part B with a prescription from a medical professional.
- When using canes or walkers, it's essential to prioritize safety and ensured that the handles are at wrist level, arms are relaxed, and users maintain upright posture without leaning forward. Different safety guidelines apply for canes and walkers when standing, sitting, or navigating stairs or inclines.
