Walker-assisted walking on ramps: Additive effects of wheels and slope on cardiovascular load and perceived exertion

This study examined the independent and combined effects of device type (fixed four-legged walker vs four-wheel rollator) and surface inclination (flat vs 10% incline) on cardiovascular demand and perceived exertion during assisted walking. Twenty-five healthy adults completed four randomized 8-min treadmill trials at a standardized speed of 0.2 m/s. Heart rate (HR) was continuously recorded, cardiovascular load was quantified using relative heart-rate reserve (%HRR), and perceived exertion was assessed with the Borg CR-10 scale. Two-way repeated-measures ANOVA showed significant main effects of both device type and surface inclination on HR and %HRR (all p < .001), with no significant interaction. Walking with the fixed walker and walking on the incline each increased cardiovascular demand, while perceived exertion showed a generally consistent pattern. The highest physiological and perceived demands occurred when the fixed walker was used on the incline. These findings indicate that device configuration and surface inclination contribute independently and approximately additively to the physical demands of assisted walking. Further studies in habitual walker users and clinical populations are needed to determine the clinical relevance of these effects.