Objective assessments for walking aid prescription in balance impairment and falls risk: a scoping review of current evidence

Walking aids are widely used by people with mobility limitation. A guideline to inform walking aid prescription is lacking and many walking aids are acquired without any professional advice. The literature was reviewed to identify gaps in evidence to guide future research examining walking aid prescription objective assessments. To summarise and identify gaps in the current literature regarding the walking aid prescription objective assessments for those with balance impairment and/or falls risk. Method: Medline, AMED, Embase, CINAHL, Pedro and Cochrane were searched combining keywords for walking aids AND falls/balance. Fourteen studies were included in the scoping review from 11,492 citations. Cross-sectional study designs were used in thirteen studies. Four articles recruited participants of all ages, the remaining ten studies recruited participants ≥60 years. Seven studies examined people with particular medical conditions, namely Parkinson’s disease, stroke, dementia, mobility impairment and Guillain–Barré syndrome, chronic inflammatory demyelinating polyneuropathy, polyneuropathy and spinal cord injury. In eight studies, the objective assessments were tested against professional walking aid prescription. Thirteen objective assessments reported the ability to distinguish the need for walking aid use. This scoping review identified limited evidence on objective assessments used for prescribing walking aids for people with balance impairment and/or falls risk. The findings provide guidance for future research, specifically aiming to discern people needing different walking aids. Research designs that use longer time frames, include methods and outcome measures where patients’ perspective can be evaluated and utilise professional prescription rather than usual aids would strengthen future investigations. Several objective assessments have been evaluated for walking aid prescription across various medical conditions and populations. These assessments may guide clinicians in walking aid prescription.The Global Balance Rating Scale is not recommended for older adults. Tools such as a combination of the 5-meter timed Up and Go test and the Activities-specific Balance Confidence scale, Posturography, One-leg standing, knee extension strength, walking speed (10 meter and 8 meter), the Berg Balance Scale, the side tapping test, Timed Up and Go, Performance-Oriented Mobility Assessment (POMA) balance subscale (B-subscale), the 2-step test, the “S” test, and the 10-second tandem stance test are better suited to identify walking aid needs. Several objective assessments have been evaluated for walking aid prescription across various medical conditions and populations. These assessments may guide clinicians in walking aid prescription. The Global Balance Rating Scale is not recommended for older adults. Tools such as a combination of the 5-meter timed Up and Go test and the Activities-specific Balance Confidence scale, Posturography, One-leg standing, knee extension strength, walking speed (10 meter and 8 meter), the Berg Balance Scale, the side tapping test, Timed Up and Go, Performance-Oriented Mobility Assessment (POMA) balance subscale (B-subscale), the 2-step test, the “S” test, and the 10-second tandem stance test are better suited to identify walking aid needs.