The development of an observational screening tool to assess safe,effective and appropriate walking aid use in people with multiple sclerosis

Purpose: The purpose of this study was to identify potential items for an observational screening tool to assess safe, effective and appropriate walking aid use among people with multiple sclerosis (MS). Such a tool is needed because of the association between fall risk and mobility aid use in this population.

Methods: Four individuals with MS were videotaped using a one or two straight canes, crutches or a rollator in different settings. Seventeen health care professionals from Canada, Ireland and the United States were recruited, and viewed the videos, and were then interviewed about the use of the devices by the individuals in the videos. Interview questions addressed safety, effectiveness and appropriateness of the device in the setting. Data were analyzed qualitatively. Coding consistency across raters was evaluated and confirmed.

Results: Nineteen codes were identified as possible items for the screening tool. The most frequent issues raised regardless of setting and device were “device used for duration/abandoned”, “appropriate device”, “balance and stability”, “device technique”, “environmental modification” and “hands free.”

Conclusion: With the identification of a number of potential tool items, researchers can now move forward with the development of the tool. This will involve consultation with both healthcare professionals and people with MS.

• Implications for rehabilitation

• Falls among people with multiple sclerosis are associated with mobility device use and use of multiple devices is associated with greater falls risk.

• The ability to assess for safe, effective and efficient use of walking aids is therefore important, no tools currently exist for this purpose.

• The codes arising from this study will be used to develop a screening tool for safe, effective and efficient walking aid use with the aim of reducing falls risk.