Parkinson’s walker – Guide & advice from a physiotherapist

Do you or a loved one have Parkinson’s disease, and are you wondering which walker or technical aid is best suited to your needs?

A walker can be used to facilitate walking and limit falls.

When to use a walker (= rollator) rather than one or two canes ?What type of walker is best? What precautions should I take? Are some models better than others?

Here are the answers to these questions. To answer them, I draw on my experience as a home physiotherapist working alongside Parkinson’s patients.

But also from my research and in-depth reading of international scientific literature (all references at the end of the article).

As you will see from this article, the rollator / 4-wheel walker is often the most suitable walking aid for Parkinson’s disease.

♻️ Last updated: 27 December 2024.
👩‍⚖️ Declaration of financial interests: amazon affiliate links. My complete declaration of financial interests is available in the legal notice section. Written by Nelly Darbois, physiotherapist and scientific editor

When should a walker be used in Parkinson’s disease?

There are a number of situations that may lead to the question of whether the use of a technical walking aid would be appropriate for a person with Parkinson’s disease:

• fear of falling from people or their surroundings ;
• occasional or increasingly frequent falls , at home or outdoors;
• reduced gait and walking speed, less physical activity, isolation ;
• difficulty leaving the house, going out into the garden;
• need to hold on to furniture and walls to move around the house;
• recommendation from your healthcare professional (doctor, physiotherapist, etc.) or family and friends.

Canes or walker?

There are various technical aids for walking. Here they are, ranked from the least stabilizing to the most stabilizing:

1. walking poles, hiking poles ;
2. T-shaped single cane;
3. crutches (known as English canes) or axillary canes (for people who cannot use their wrists properly because of fractures or paralysis);
4. walking frame, 2-wheel walker, 4-wheel walker (rollator), 2-wheel walker, 3-wheel walker, walker with antebrachial support.

Physiotherapists, or possibly your GP, can assess which technical aid is most appropriate for you, depending on the difficulties you encounter, your environment (cramped home with stairs VS apartment to disabled standards) and your wishes.

In the case of Parkinson’s disease, the use of simple hiking poles can sometimes be enough to stabilize you, especially outdoors.

When balance problems become more severe, the use of two crutches is sometimes necessary.

However, using 2 crutches to move around with Parkinson’s is often impractical.

You need to coordinate your movements well, remember to put your rods down without dropping them when you stop, and above all, it’s not easy to carry objects at the same time.

Crutches are also less stable than a walker. They are, however, more practical in cramped accommodation, or for getting up and down stairs.

It’s often the walker that’s most appropriate for Parkinson’ s disease, when you realize that canes are no longer enough, or you start holding on to furniture and walls at home to get around.

Is there a risk that we won’t be able to do without it?

It’s a very common fear. When a technical aid such as a rollator or a 2-wheel walker is suggested to someone who hasn’t used one before, the reaction is often:“If I start using it, I’ll never be able to do without it again, I’ll become dependent.“

Sometimes, it’s even the people around them who are apprehensive, thinking that using a technical aid will doom their loved one’s autonomy.

The reaction is understandable. Indeed, some people who walk with a walker can’t walk again without anything afterwards.

It should not be forgotten, however, that they took out a walker precisely because they could no longer walk long enough, or safely enough.

If the assessment carried out by your physiotherapist shows that you have difficulty walking, and if you are keen to walk more or better, then a walker should be considered.

If you’re not satisfied, you can of course do without the walker. You’ll regain your former abilities.

What’s more, even if you adopt a cane or walker, you don’t usually use it for 100% of your journeys. Thehabit of walking without one is retained.

Frequency of walker use in Parkinson’s disease

One study looked at the frequency of use of a walker (of any type) by people with Parkinson’s disease, under the care of hospital neurologists.

At the start of the study, 30% of people used a walker indoors, and 52% outdoors. Three years later, 40% used them indoors and 66% outdoors.

Often, people used a cane indoors and a walker outdoors.

Walkers with wheels (vs. those without wheels, known as walking frames) were the most widely used both indoors and outdoors.

Which walker to choose?

One study looked at which type of walking aid was most suitable in general for people with Parkinson’s disease.

The technical aids studied were as follows:

• T-rods;
• crutches ;
• market frames ;
• 4-wheel walkers ;
• 2-wheel walkers ;
• U-step walkers.

Of course, the results of this study do not mean that ALL people with Parkinson’s disease should walk with a 4-wheel walker, or that this technical aid is the most suitable.

On the other hand, it means that for a person who is falling or walking less and less for fear of falling, trying out a 4-wheel walker may be a good idea. Physiotherapists can help you find the most suitable technical aid.

Another study shows that walkers without wheels (walking frame) increase the gait blockages typical of Parkinson’s sufferers, whereas 4-wheel walkers do not.

Walking frames (walkers without wheels) should therefore be avoided, except in the special cases described below, after assessment by a physiotherapist.

To find the most suitable technical aid, your physiotherapist can carry out an assessment with you and work out what’s best for you. Here is some general information.

2, 3, 4 wheels or without wheels?

The 4-wheel walker is the best compromise between walking speed and safety for Parkinson’s sufferers.

On the other hand, it often takes up more space. Depending on the type of home, it may not be suitable. It may also be unsuitable for people with severe balance problems.

In this case, the walker moves forward too quickly and risks dragging them along.

In this case, you’ll need to weight it down (by putting a heavy object on it that won’t fall off) or try another technical aid, such as a 2-wheel walker.

The 3-wheel walker is not significantly different from a 4-wheel walker. It is slightly more maneuverable, but less stable. It is therefore reserved for people with good balance.

The 2-wheeled walker may be suitable for people who would be dragged too far forward by a 4 or 2-wheeled walker.

Its 2 feet do, however, cling to the floor, particularly on old tiles indoors or flagstones outdoors. It requires a little more arm strength, and is less maneuverable.

It may be more suitable for people who need to lean on it a lot, especially in cases of knee or hip pain, or weakness of the lower limbs due to fractures.

The 2-wheeled walker can be adapted by placing pierced tennis balls under its 2 feet, for example, so that it glides better, but still less than a 4-wheeled walker, which would drag people forward too much.

The walking frame (walker without wheels) can be interesting because of its lightness, for people who need to lean on something a lot to walk (e.g. in case of weakness or pain in a lower limb, following a fall or other problem).

However, it must be lifted with each step, which can cause the person to fall backwards. It is not often recommended for Parkinson’s disease.

Light or heavy?

For a person with very few balance problems, a light walker is suitable. It will not be suitable for someone with severe balance problems.

People are often afraid of having a walker that’s too heavy. If the walker has 4 wheels, however, it will be very maneuverable, even if it’s heavy, and even with little arm strength. It will also be more stable.

A heavy walker, on the other hand, is less easy to transport (in a car, on stairs, up a curb, etc.). The help of a third party is necessary in these situations.

With or without seat?

Most walkers with wheels offer a seat.

It’s a real plus, allowing you to take a break when you’re tired at any time, to stand up easily (the handles act as armrests) or to carry small objects. Be sure to place the walker against a wall when sitting on it, to avoid falling backwards.

Only walking frames (walkers without wheels) have no seat.

Folding or not?

If the walker is to be used outside the home (e.g., to run errands in the car), it’s best to opt for a folding one. Make sure that when folded, it fits comfortably (and relatively easily) into the car.

For home use only, a non-folding walker is ideal. It’s better to have 2 walkers in an upstairs house (1 per floor) than a single one, which is very difficult to transport up and down stairs, whether folding or not.

Electric?

Electric walkers are more of a gadget than a useful technical aid, and are very expensive (costing around 2,000 to 3,000 euros). They require considerable training and maintenance.

Electric walkers can also be a source of falls when misused.

Their use in Parkinson’s disease is therefore not to be recommended.

All-terrain?

Walking frames and 2-wheel walkers are recommended for use on uneven terrain, even grass or mud. On the other hand, 3 and 4-wheel walkers (rollators) are suitable for this type of terrain. In this case, you’ll need a walker that’s heavy enough to prevent it from tipping over in the event of a hole or bump.

Special Parkinson’s walker?

Some manufacturers or retailers of paramedical equipment may suggest the purchase of a walker specially designed for Parkinson’s sufferers.

These are generally 4-wheel walkers (rollators) fitted with a laser. The laser is designed to help the person walk more smoothly, especially when blocked.

However, one study shows that this type of technical aid not only fails to improve walking speed (compared with a 4-wheel walker or no technical aid at all), but also does not significantly improve balance.

What precautions should you take when using your walker?

The main risk with a walker in Parkinson’s diseaseis tipping backwards.

People tend to shift their center of gravity backwards involuntarily.

This is manifested, for example, by greater pressure on the heels, or a backward imbalance when standing up or walking, as in post-fall syndrome. These people tend to pull with their hands to avoid falling.

With a walker, you have to lean on it, not pull yourself.

After a few rehabilitation sessions, if the retropulsion (backward) attitude has not lasted too long, safe walking with a walker is possible.

If not, then the walker needs to be weighted to prevent it from lifting off the ground when being pulled.

Where to buy a walker

In pharmacies or online?

Wherever you buy your walker, a refund (including shipping costs) is possible.

If you buy it from a pharmacy or medical device retailer, the staff will usually take care of your reimbursement claim, or even arrange for third-party payment (i.e. you don’t have to pay in advance).

New or used?

Used alkers of all types are regularly for sale. It is also sometimes possible to find walking frames and 2 and 4-wheel walkers for sale at depot-sale sites or on value-added building sites, but this is not systematic.

If you have any questions, don’t hesitate to leave them as comments, I’ll be happy to answer them!

You may also like :

1. How to prevent the risk of falls among the elderly?

📕 Sources 📕

Kader et al. 2018. Mobility device use in people with Parkinson’s disease: A 3-year follow-up study.

Kegelmeyer et al. 2013. Assistive devices alter gait patterns in Parkinson disease: advantages of the four-wheeled walker.

Cubo et al., 2003. Wheeled and standard walkers in Parkinson’s disease patients with gait freezing.

Bryant et al. 2011. Gait changes with walking devices in persons with Parkinson’s disease.

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