Physical dysfunction is prevalent (26.4%) in older adults in the United States (US). Physical inactivity affects 31 million (27.5%) of US adults who are 50 years of age and older. A sedentary lifestyle has been associated with slower walking speeds, higher rates of joint pain, and greater reliance on walking assistance devices. However, studies comparing the influence of different walking assistance devices on functional walking speed are understudied.
PURPOSE: To perform a large-scale population-based cross-sectional analysis from the (1999--2002) National Health Assessment and Nutrition Examination Survey (NHANES) to determine whether 20-ft walking time differed between older adults who did (cane, walker, other) and did not (no walking assistance device) use a walking assistance device.
METHODS: Our population included 2,027 men and women 50 years of age and older who had complete muscle strength data from NHANES. Muscle strength variables included self-reported use of a walking assistance device (if any) and time to complete a 20-ft walk test. The 20-ft walk test was performed on a test track at the mobile examination center and was timed in sec with a hand-held stopwatch. All study participants provided informed consent prior to enrollment. A Kruskal-Wallis test compared mean rank differences in 20-ft walking time by self-reported walking assistance device (if any). Mann-Whitney U-Tests were run post-hoc with multiple comparison adjustments. Alpha levels were set a priori to p < .05.
RESULTS: Of the included population, 1,925 participants did not use a walking assistance device, 73 used a cane, 18 used a walker, and 11 used another type of assistance device. Significant differences in 20-ft walk test time were found for the following: a) no device versus a cane (p < .001), walker (p < .001), and other (p < .001); and b) use of a cane compared to a walker (p = .05). No significant differences were observed when comparing use of a cane to other walking assistance devices (p > .05).
CONCLUSIONS: Time to complete a 20-ft walking test differed between those who did and did not require use of a walking assistance device and between those who used a cane and a walker. Our findings confer that use of a cane may be more beneficial when compared to a walker for older adults requiring a walking assistance device.