Walking Aids for Enabling Activity and Participation: A Systematic Review.

In this systematic literature review, we examined whether and how walking aids (i.e., canes, crutches, walkers, and rollators) enable activity and participation among adults with physical disabilities. Medline, Embase, all EBM reviews, PsychInfo, CINAHL, and Web of Science databases were used to identify studies published since 2008. Quantitative and qualitative designs were included. Data regarding participants, assistive device use, outcome measures, and domains of participation were extracted. Two reviewers independently rated the level of evidence and methodological quality of the studies. Outcomes were categorized per types of walking aids and activity and participation domains. Thirteen studies were included. Two studies involved canes, four pertained to rollators, and seven dealt with multiple types of walking aids. Mobility was the most frequently examined domain of activity and participation. Both negative and positive results were found. Negative outcomes were linked to the physical characteristics of the device, the use, environment, and personal reluctance. When incorporated in daily life, walking aids were found to enable several domains of activity and participation. Whether walking aids facilitate activity and participation may depend on the user's ability to overcome obstacles and integrate them in daily life. More high-quality research is needed to draw conclusions about their effectiveness.