Implementation of an App-based Walking Aid Skills Training Program

Walking aids (WA), such as crutches, canes, and walkers allow individuals to move independently after lower body impairment. Improper WA use may lead to upper body discomfort, pain, or injury. Improper WA use has been associated with increased risk of falls, which may result in traumatic brain injury or even death. WA-related accidents and injuries may not only affect an individual patient's quality of life; they may also increase healthcare system resource use and caregiver burden. WA-related injuries may be preventable if WA are properly fit and sufficient training is provided to the WA user. Smartphone applications (apps) are widely used technologies that have been used to improve health outcomes in populations of healthy and chronically ill individuals. We have developed an app that can be used to teach WA users how to properly fit and use their devices. This app is called Improving Canadians' Walking Aid skills, Learning, and Knowledge (ICanWALK©). The development of the Walking Aids Skills Test© (WAST©) allows for the objective measurement of how well an individual uses their walking aid. It is important to develop such a measurement in order to see whether interventions such as mobile applications change a walking aid user's ability to walk with their device. This 12-item objective evaluation measures the ability of an individual to use their walking aid in different settings, while picking up an object off the ground, navigating stairs, or encountering terrains such as gravel or grass. Three hypotheses will be explored through this clinical trial. Hypothesis 1: Patients who use the ICanWALK© app will have improved balance confidence compared to the control group. Hypothesis 2: Patients who use the ICanWALK© app will have improved balance, improved mobility, less pain, and fewer falls compared to the control group. Hypothesis 3: The WAST© will have an inter-rater reliability of 70% (k=0.85).