Assistive Technology Devices (ATDs) include aids to locomotion such as canes, walkers and wheelchairs, as well as a wide variety of other technologies for accommodating the functional limitations that result from a disabling condition like stroke. They have the potential to reduce residual disability, slow functional declines, lower health care costs and decrease burden of care. Seniors with stroke living at home own a large number of assistive devices (almost 16 devices per person on average; Mann et al., 1995).
The most commonly adopted ATDs following stroke are locomotion aids since locomotor disability, as defined by difficulties in activities of daily living related to lower limb function, is among the first basic components of daily activities to be trained in the early stages of physical rehabilitation (Isaacs, 1985) and is a common consequence of stroke.
Devices such as canes and walkers are frequently used by stroke survivors. The principal reason is that, for those who reside at home following completion of a hospital rehabilitation program, tolerance for walking tends to be significantly reduced (Chiou & Burnett, 1985; McMurdo & Johnstone, 1995; Myers et al., 1996; Overstall et al., 1977).
Patients who suffer a stroke, particularly when associated with hemiplegia, often require the use of an assistive device such as a wheelchair, walking aids or robotics. The major functions of walking aids post-stroke are to increase stability, to improve muscle action. Aids such as canes serve to increase the base of support and improve ambulation for those with impaired balance. Canes and walkers appear to be effective in compensating for their decreased postural sway and for enhancing their participation in activities of daily living (Fernie et al., 1982), especially if they have hemiplegia (Maeda et al., 2001).
The main advantages for early use of wheelchairs post-stroke are related to support for the hemiplegic sides and greater limited functional improvement and independence. The use of robotics to aid stroke rehabilitation of the upper extremities has gained recent attention. Robotic devices for gait training are modeled by evidence that body-weight support locomotion training improves gait.
Authors*: Wing Chung Chan, BSc OT; Catherine Cusson, BSc OT; Andréane Lalumière Saindon, BSc OT; Nicol Korner-Bitensky, Ph. D OT
Evidence reviewed as of before 10-12-2009