This is a very common question among the elderly and their caregivers. What I have found is that the folks asking this question are primarily concerned with helping to improve the posture of the walker user.
Before getting too far into this blog post, let me answer this question this way: It depends.
An upright walker is “taller” and allows a person to rest their weight on the walker using their elbows rather than putting the weight through their hands.
It still has brakes, like the rollator, but they are activated with the clients hands in the “neutral position” rather than the weight bearing position.
An upright walker is an excellent choice for someone who has a lot of pain when they bend forward, or they may need to “weight bear” through their elbows because they may have problems with their hands or wrists.
Another time when upright walkers may be a better choice is when a person may need support due to impaired balance/vertigo or have limited endurance for any number of reasons.
However, when compared with rollators, they tend to be taller due to the handle extension. So, they are not as compact and may not fold up as neatly for stowing. With some cars, they may not fit in the trunk but will need to be stowed in the rear seat compartment.
As is fairly common with the elderly, a good percentage of them present with a stooped or flexed posture when they stand and walk. Personally, I hear more from caregivers rather than actual patients, the feeling that the posture needs to be corrected. This may be due to the fact that most elderly cannot “see” the way that they walk. Also, it could be that caregivers think that the presentation of a stooped posture gives the impression that something is wrong that needs to be righted by changing medical equipment.
It has been my experience that there is more to a flexed posture than meets the eye. Many people mistakenly think that the choice and height of a walker will automatically cause a person to stand more upright. But, in the majority of cases, this is a wrong assumption.
In cases where the walker is obviously too short for a taller person, yes, it will force the person using it to bend forward to reach the handles to use while walking. But, this is easily spotted and suggests that the person is using the wrong equipment.
In most cases, the walker is the appropriate type and height, which means there must be something else that is causing someone to bend forward when they’re standing up.
If you’re wondering if an upright walker will help your loved one or care recipient stand up straighter, it may not. This is because the real reason why older and sedentary people walk hunched over is more a matter of muscle tightness and muscle weakness.
When a person sits for a goodly percentage of their day, a couple of things happen. The muscles that help keep a person upright are “turned off” so to speak and they tend to weaken. At the same time, the muscles that “flex” or help the body bend forward, shorten and tighten because this is the position that they maintain for extended periods.
So, when they stand up from a seated position, the weakness of the “extensors” have a hard time overcoming the tightness of the flexors and the result is a stooped or flexed posture.
Most people will try to overcome this presentation with raising the handles/height of a walker or buying an upright walker with the hope of helping the person stand more erect.
Unfortunately, what happens when you raise the height of a walker without addressing those other issues is that the patient or loved one simply pushes the walker out further in front of them, which inturn, causes them to lean further forward. But this also places them at a disadvantage because now their support is even further away.
One thing that I usually recommend to my clients is that they visit a medical supply store that may have items to try out in the store prior to making any purchase or seeking a prescription from your doctor. You don’t necessarily have to purchase your choice on the spot, but it would give you an opportunity to make a more informed choice.
Comparing an upright walker to a rollator in the store may save some time and frustration, but, having a home physical therapist assess your needs may also prove beneficial.