Question
What are your thoughts on using assistive devices for gait training with a patient diagnosed with Huntington’s disease?
Answer
As therapists, we can get so focused on trying to force the center of gravity over the base of support that we use very large assistive devices that clients with Huntington’s disease are not used to. My thought process goes back to the idea of old learning versus new learning. An assistive device requires a certain amount of cognitive processing in order to use it, and typically, these clients do not have that cognitive processing when it comes to using assistive devices. I tend to stay away from assistive devices. In my practice, if we do gait training, we put our hand out in front of the client, let them take hold of our hand, and we walk sideways, slightly posteriorly, and off to one side of them. We are there to guard them but not to hold them.
Wheeled walkers tend to work a little better than a regular pickup walker, but four-wheel walkers with brakes on them tend to be a little more challenging because these clients are not used to using the brakes. If you get a rollator with just two wheels in the front, you are going to see more of a success rate than if you have four wheels where one must use the brakes to start and stop the walker.
