A Comprehensive Mobility Device Guide for Homecare

If your patients or clients require a degree of mobility enhancement, there are products available to support a vast spectrum of needs, ranging from relatively foundational to intensely esoteric.

When providing care in the home, homecare professionals must be able to evaluate the mobility devices used by their patients. Many mobility products have implicit, often subtle deficiencies that can strain the user’s mobility experience and even lead to catastrophic falls and injuries. As a homecare provider, selecting mobility devices may not be within your control; however, recognizing your patients’ device limitations may allow you to flag potential issues and present compensatory interventions that keep your patients safe. Additionally, understanding these device limitations better prepares you to counsel patients and their families about selecting the right mobility devices. 

We will explore rollators, walkers, power robotic wheelchairs and a new device that integrates the functions of power wheelchairs and patient lifts. This representation is broad in scope and execution, but each mobility system exemplifies the application of technologies that homecare providers should be familiar with.

A Mobility History

Wheelchairs are some of the most ubiquitous mobility devices. While there is no clear insight into their origins, records indicate:

• Wheeled furniture was has been used in China and Greece since the sixth century.  
• The first known bespoke wheelchair, termed the invalid chair, was used by King Phillip II of Spain in the late 16th century due to his advanced gout. 
• In the late 18th century, wheelchair popularity increased. Entrepreneurs in Bath, England, rented them to visitors who were “taking the waters” at the famous health spa. 
• By 1900, wheelchairs became commonly used devices, and foldable versions emerged in the 1930s.
• Following World War II, wheelchair demand spiked in response to war veterans’ needs. 
• In 1949, inventor George Klein developed a motorized wheelchair. 

Walkers and rollators have a more recent and less illustrative background.  

• Walkers first appeared in the late 1940s. 
• While wheeled walkers had been around, Aina Wilfalk, who had polio, came up with the concept of a rollator in the late 1970s. 
• “Rollator” was initially a brand name that later became generic.

Basic Rollators

Rollators were created with the intent to provide stability when walking or standing. When designed properly, they can provide stability, encourage walking and reduce the risk of falling. 

You can determine if a rollator is properly designed by observing your patients: Are they hunched forward and walking with an abbreviated, awkward, downcast gate? Or are they noticeably upright, looking straight ahead? In other words, are they walking as someone would without the device? 

Rollators are simple devices, but cheap rollators are often inadequate. Using an inadequate rollator can cause physical stress or exacerbate instability, which can lead to falls. 

Here are a few ways to tell that your patient’s rollator is inadequate for their needs: 

• Users stand and walk behind the rollator; posture is stooped forward, straining the back, neck and arm muscles
• User looks downward while walking
• The user’s weight is carried on the rear wheels, causing unbalanced
• User’s shoes catch under the back of the rollator, resulting in trips or falls 
• Tiny plastic wheels catch in ruts and irregularities; these wheels can be hard to push and limit walking on interior or exterior surfaces
• Flimsy frames that do not provide adequate support
• Three-wheeled models can result in instability
• Built-in seats that are unpadded or lack adequate back support
• Tire contacts the brakes that result in lost power when the device is wet 
• Limited handle height adjustment and crude locking devices

In comparison, an ergonomically engineered rollator can eliminate these issues. By using ergonomical rollators, your patients will be better protected and more likely to walk with confidence.

Ergonomic engineering aims to consider the device’s intended purposes and infuse sound biomechanical designs that can dramatically influence the relationship between the user and device. 

The benefits of ergonomically engineered rollators include:

• Allowing users to stand and walk inside the frame instead of the back
• Weight is distributed to all wheels
• Clearance between the user’s stepping range and rear structure of the rollator 
• Large tires, often air-filled, that easily navigate ruts and irregularities in the user’s path
• All-terrain rollator models allow for smooth, stable movement on pavement 
• Rugged, special frame structures that include support under all circumstances   
• Comfortable seating that includes back support
• Handle height adjustments that accommodate a range of users
• Handle-locking features that can be adjusted by height

Most rollators can be folded for travel and are constructed of aluminum to limit weight. If your patients travel frequently, composite models can help ease physical strains. 

Extended Capability Rollators

Extended capability rollators can improve patient mobility, such as:

• Bariatric: Rollators that can accommodate user weights of 300 to 700 pounds and include seat widths of 19 inches. These rollators aim to eliminate tripping hazards and prevent the onset of an instability cycle. 
• Surrounding rollators: With an open, U-shaped frame and wheels along the frame rails, these rollators are available for patients who have acute balance or coordination concerns, such as those with Parkinson’s disease, multiple sclerosis (MS) or neurological issues. This design includes two larger steerable casters in the front, two smaller steerable casters in back and two non-steerable main wheels positioned toward the middle, which help surround and brace the user in all directions. These encompassing rollators aim to stand in for having another person’s support while walking. Additionally, they include all-terrain capabilities, a proactive emergency brake and spring-loaded front casters that can accommodate curbs and other obstacles.

Rollators Can Teach People to Walk Again

If you are providing therapeutic care for someone with Parkinson’s Disease, MS, brain injuries or other neurological or physical issues, rollators can help restore walking acuity.   

Mobility devices like rollators are equipped with digital electronic cues, including audible tones, vibration and laser lights that start with walking motions and help stabilize and normalize the user’s gate. The frequencies, volume and patterns of each functional cue can be tailored to the needs of the user. Disease-related traits, such as gate freezing and habituation, can be minimized or eliminated by using a multi-dimensional rollator.

Independent studies conducted by the University of the Hague revealed that 80% of respondents who used this type of device demonstrated significant improvement in peregrination and were less likely to experience a fall. These results have inspired newfound confidence in mobility devices, as well as improved cognitive performance among users.

Other distinctions or benefits of rollators include: 

Rollators With Split Personalities

Mobility enhancement devices can serve several functions. Many rollators aim to encourage the health benefits of walking. With an attached seat, these devices can become comfortable wheelchairs when users experience fatigue. This conversion procedure can often be completed in less than 60 seconds.  

Convertible devices help ensure that users have the right mobility aid, for both short walks and extended outings. 

Some Rollators Walk With You

Powered rollators incorporate an electric power system that propels the device. However, these devices are not intended to replace a power wheelchair or scooter, because the user walks with the device instead of riding on it. Powered rollators are designed to be virtually weightless under power and include push button controls, aiming to negate additional physical effort. 

Can a Rollator Be Smart?

Artificial intelligence (AI) has become a recent feature in the rollator world. AI-powered rollators can provide alternate control suites for power walkers, allowing the user to swing their arms while walking. Arm swinging while walking is natural and can help maintain stability. AI features can help translate arm swinging cadence into speed and directional responses. This feature seeks to be as therapeutic as it is fun. 

Rollator Ups & Downs

Most rollators are equipped with seats that offer a convenient resting place. While seat heights are not standardized, they generally range from 16 to 25 inches. The act of sitting down is usually not problematic; however, standing up can be difficult if the device’s knee height is above its hip height. 

Mini lift seats can help solve this problem, because they can be installed on most rollators. Fully-powered and semi-powered models can elevate the user into a nearly standing posture, making the act of standing easier and more dignified.

Non-Rollator Options 

New mobility options are emerging, including: 

Robotic Powered Wheelchairs

In contrast to rollators, power wheelchairs assist users by eliminating the need to physically push the chair. If necessary, users can control the chair through a smartphone. Robotic wheelchairs are designed to be premium devices, due to ergonomically-designed seating and safety-first operations. A powered wheelchair’s technologies include: 

• Omnidirectional wheels developed for industrial robots that can eliminate the need to coordinate left and right turns. Omnidirectional wheels permit off-pavement riding without bogging down, and help clear obstacles like curbs.
• A zero-degree turning radius. 
• Advanced digital controllers can receive commands from any smartphone and translate inputs into instantaneous responses. This allows patients who live alone to remotely summon the chair in the event of a fall or in order to help them escape emergencies, including fires.

The Chris Lift

The Chris Lift is a new lift device that is set to be available in late 2025. While many traditional lift devices are limited to a single plane of motion, the Chris List can lift and replace in one location.

Homecare providers and health care workers alike have the highest rate of musculoskeletal injuries among all occupations.

Frequent patient movement cycles, unplanned awkward positions, repeated bending and twisting contortions, working in cramped spaces and prolonged standing and kneeling often result in chronic pain and distress. As a result, caregivers often become disabled by the demands of caregiving.

The Chris Lift seeks to integrate the functions of lifting, transferring and repositioning with transporting to eliminate manual patient placement into an intermediate transport device. 

Controlled and automated by applied AI, the Chris Lift can bring patients to any home destinations, including the bathroom, shower or toilet. The control system helps monitor motions and maintain stability and safety. Additionally, the lift aims to protect caregivers from movements that could compromise a safe operating configuration.

The lift can also be used as a power wheelchair, including on pavement and to drive into a wheelchair-ready van. The lift system can be mounted to an undercarriage and features omnidirectional wheels, like the robotic wheelchair.

The lift features multiple facets of engineering and science to offer technological advancements, correct mobility augmentation and provide effective, safe and convenient mobility for patients.