What are your thoughts on using wheeled walkers with clients with Parkinson disease?
Answer
Wheeled walkers are generally the best way to go for clients with PD. I do not like the old fashioned, hospital-based, aluminum, straight wheeled rolling walkers because patients with Parkinson's Disease will need to lift them to turn. Anyone needs to lift them to turn because they do not have swivel wheels. We also know what a great likelihood a fall is going to be with patients when they turn. So, I try to avoid those. If I am going to use a wheeled walker with my patients, I tend to use a larger wheel base; maybe a 5-inch to an 8-inch. I like the kind with the brakes so that they can slow down easily. For my patients who festinate and feel as though the walker is always getting away from them, there is the reverse braking system. There are also walkers out there that you squeeze to make the walker go and you release to make it stop. Those can be very beneficial for patients as well.
Heather J. Cianci, PT, MS, GCS
Heather Cianci, PT, MS, GCS is the founding therapist of the Dan Aaron Parkinson’s Rehabilitation Center (Good Shepherd/Penn Partners) at Pennsylvania Hospital in Philadelphia, PA. Heather also works for LSVT® Global as a BIG trainer, teaching PTs and OTs throughout the US and recently in Europe. She received her Bachelor’s in Physical Therapy from the University of Scranton in Scranton, PA and her Master’s in Gerontology from Saint Joseph’s University in Philadelphia. Heather has practiced physical therapy for 18 years, with the majority of those years dedicated to working with patients with Parkinson’s disease. She is a certified LSVT® BIG clinician, PWR! (Parkinson Wellness Recovery) Expert, and a graduate of the National Parkinson Foundation’s (NPF) Allied Team Training Program (ATTP). Heather’s research includes movement strategies for bed mobility, falls and freezing of gait. She also is the author of the 3rd and 4th editions of Fitness Counts, and a co-author of Activities of Daily Living: Practical Pointers, educational manuals for the NPF, as well as a chapter on rehabilitative strategies in Comprehensive Nursing Care for Parkinson’s Disease (Springer Publishing). Heather teaches about rehabilitation and Parkinson’s at Thomas Jefferson University’s Department of Physical Therapy in Philadelphia and lectures at many local and national support groups and conferences. She also is a board member of CurePSP, the Foundation for PSP/CBD and Related Brain Diseases, and is chair of their Medical Professional Education Committee. Heather’s recent courses include Parkinson’s Disease Across the Lifespan: A Roadmap for Nurses, and Parkinson’s Disease: A Practical Approach to Evaluation and Treatment for the Physical Therapist, both sponsored through the Parkinson Disease Foundation.
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