What Is a Rollator?

If you have been experiencing issues with balance or find yourself tiring more easily when you go on walks, your doctor may have talked with you about using a rollator. Also referred to as rolling walkers, rollator walkers, upright walkers, or four-wheeled walkers, a rollator is a mobility aid similar to a walker, but designed with wheels for easier, more fluid walking support.

Rollators are especially helpful for people living with health conditions in which walking gait or endurance is affected. "Parkinson's disease patients and also those managing age-related weakness may benefit from rollators," says Alexander Acosta, M.D., a clinician who works with mobility-restricted older adults and evaluates home medical equipment selection for seniors at SonderCare. With the support of this wheeled device, many people with Parkinson's are able to overcome the shuffling walk that can occur due to the disease.

But despite their many and varied use cases, rollators may not be right for everyone. If you are considering a rollator for mobility support, here's what you need to know.

What Is a Rollator Used For?

A rollator is used to help people with mobility challenges walk smoothly and steadily. It has wheels, making it easier to maneuver and creating a more natural walking rhythm. It can be particularly useful for someone who is reasonably stable on their feet but experiences fatigue or momentary changes in their balance as they walk. The built-in seat provides a place for rest, making the device especially handy for older adults who can walk independently but need to take short breaks.

A rolling walker gives confidence to people who might otherwise feel limited in their ability to locomote. "Used appropriately, it is a tool that can preserve independence," says Ron Schwartz, M.D., the senior director of continuum services at Masonicare in Wallingford, CT, and assistant clinical professor at the University of Connecticut School of Medicine. "A mobility aid should not be viewed as a sign of failure."

Different Types of Rollators

A standard rollator includes four wheels attached to legs that provide both stability and forward momentum. To stop the wheels from turning, rollators include handbrakes. There are several variations of the device available, targeting the needs of different people.

These are a few of the common forms a rollator can take:

Four-Wheel Rollator

This is the most common version of the device and is designed to essentially function as a walker with wheels. The rollator travels forward when you push it—you do not need to lift and place it the way you would with a walker. Four-wheel rollators feature handlebars and handbrakes, which you use to stop the device from rolling forward. Usually, a four-wheel rollator includes a seat and some sort of pouch to store essentials in.

Three-Wheel Rollator

The three-wheel rollator arranges its legs and wheels in an aerodynamic triangle shape, with one leading wheel and two rear wheels for support. This arrangement creates a more streamlined device that supports walking at a faster pace and negotiating small spaces. Three-wheel rollators also rely on handbrakes to stop the device from rolling forward. An important difference between four-wheel and three-wheel rollators is the seating. Many three-wheel rollators do not include seats because the legs are less stable. They do, however, typically include a storage pouch or basket.

Upright Rollator

Upright rollators were designed to solve posture strain that can occur in people walking with an assistive device. Due to differences in a person's height versus the height of the device, people with walkers are forced to stoop forward, creating poor posture that can make them less stable and lead to back problems.

Upright rollators feature higher handlebars and padded forearm rests that are usually adjustable, allowing users to remain fully erect while grasping the handbrakes for greater control. Like standard four-wheel rollators, upright rollators include seats and storage units for personal items.

Folding Rollator

A folding rollator is designed to collapse for easier storage and transportation. Most rollators have some folding capacity, but the mechanism varies by device. Some fold from side to side while maintaining their full height, while others break down into smaller units (but may require the removal of the seat and/or storage pouch to achieve this).

Always check the manufacturer's specifications so you can be sure the rollator you purchase will fold into a size that will fit in your car or storage space.

Bariatric Rollator

A bariatric rollator is a heavy-duty rolling walker designed for people who need a higher weight capacity and a roomier seat. Bariatric rollators are made with a reinforced frame and more space between the handles. Like a standard rollator, they include four wheels, handbrakes, and storage.

Just how much weight can it support? Limits vary by model, but most range from 400 to 600 pounds. Because they are wider and heavier than standard rollators, you should check doorway clearance and the product's exact weight capacity before buying.

Components of a Rollator

How to Use a Rollator

Rollators are fairly intuitive to use. Follow these step-by-step instructions to get started.

1. Stand facing the fully assembled rollator, about 6 inches away. Position yourself so you are equally spaced between the two rear wheels.
2. Place your hands on the handbrakes and give them a gentle squeeze. You should be standing at such a distance that you can reach the handbrakes without having to bend or lean forward. If you are using an upright rollator, rest your forearms on the armrests.
3. Release the brakes and take a step forward, using your normal stride. Allow the rollator to naturally roll forward with you as you walk.
4. To stop or slow the rollator, squeeze the handbrakes. Always lock the handbrakes before sitting or standing up to keep the device from moving unexpectedly.
5. If you are turning with the rollator, take smaller, slower steps to ensure the rolling walker provides proper balance support.
6. Avoid using the device on steep hills and keep your hands resting on the brakes for safety.

Benefits and Limitations of a Rollator

Because a rollator smoothly rolls forward as you walk, one of its major benefits is giving people confidence while also promoting proper posture and providing balance support. "As we age, we naturally lose muscle mass and power, particularly in the lower body," explains Dr. Schwartz. "Balance can also become less reliable, so a movement (like walking) that once happened automatically may suddenly require much more concentration." The reassurance of a rollator can help older adults worry less about walking and keep moving forward in a natural way.

Additional benefits include:

• No need to lift the device. "A rollator moves more easily and fluidly," says Kayleigh Little-Parks, OTR/L, an occupational therapist who works with seniors in Plymouth, MA.
• A seat to rest on. "The built-in seat allows for breaks anywhere if you get tired walking," says Little-Parks.
• Storage for personal items. A pouch for phones, glasses, and wallets lets you keep your hands free for steering the device.
• Useful indoors and outdoors. "The hand brakes allow you the ability to control the wheels when walking on an incline or uneven surfaces," says Dr. Acosta.

The rollator has some limitations, however. These include:

• Less stable than a standard walker. "A standard walker provides the most stability and weight-bearing support, while a rollator requires decent mobility and balance to operate," says Little-Parks.
• Requires hand strength and coordination. The brakes on a rollator rely on the user squeezing and holding. Someone with severe hand arthritis or slow reflexes may struggle to use them correctly.
• Not intended for significant weight-bearing support. "Leaning with full weight on a rollator has the potential for it to roll out from underneath you," notes Little-Parks. "It is, however, meant to support body weight when you are sitting."

Who Should Use a Rollator?

Do your mobility needs involve balance support and fatigue prevention? If so, you may find a rollator is a good fit. "If a person is stable enough to control a wheeled device but needs help with endurance, pacing, or frequent rest, a rollator may provide greater independence," notes Dr. Schwartz.

These challenges often coincide with getting older, but they are also considerations for people with Parkinson's, arthritis, and other health conditions, like obesity, that impact walking.

It's smart to evaluate your needs with your doctor before you start using a rolling walker. "We assess balance, gait, leg strength, coordination, endurance and the person's ability to perform everyday activities," explains Dr. Schwartz, adding that your doctor will also review the medications you are taking, any vision issues, sensation in the feet, and neurological conditions that can affect gait. "We also consider whether someone has fallen or nearly fallen, whether they become unstable when turning or changing direction, and whether they can get up from a chair without using their arms."

Who Should Not Use a Rollator?

Despite its benefits, a rollator isn't right for everyone. If you have significant balance issues or weakness in your lower body, talk with your doctor before using this device. "A rollator is not simply a more convenient walker," says Dr. Schwartz. "It requires more control because the device can move away from the person. Someone with very poor balance or difficulty controlling the device may actually be less safe with a rollator."

In addition, rollators require someone to have relatively quick reflexes so "cognitive status is also a factor," says Dr. Acosta. "A person who might forget to apply the brakes on a rollator would be much safer using a regular walker."

As noted, it is not the best choice for anyone who needs a mobility aid that fully supports their body weight or someone with hand weakness that prevents them from squeezing the handbrakes. In these cases, a standard walker may be the better option.

Differences Between Walkers and Rollators

The main difference between rollators and walkers is that walkers have four stationary legs that require the device to be lifted and placed with every step, while rollators have wheels so that a person can roll the device forward as they walk.

But their differences go beyond that. Walkers are designed to support people with significant lower body injury or weakness that prevents them from bearing weight as they walk. Walkers are stable and strong enough to support a person's body weight with each step. Rollators, meanwhile, glide forward to create a smooth and fluid walking experience, but they are not intended to fully bear a person's weight.

Walkers are more stable; rollators provide additional support in the form of a seat for resting. Both are intended to help people with mobility challenges continue to walk independently.

Using a Rollator Indoors vs. Outdoors

Rollators are intended to be used both indoors and outdoors. Because their frame is slightly bigger than a walker, it's always good to measure doorways and hallways in your home to be sure the rollator will fit.

Outdoors, avoid using your rollator on inclines greater than 15 degrees for safety reasons. Steeper inclines can destabilize the device. If you are using the seat to rest, make sure the rollator is situated on a flat surface.

Wheel diameters will influence whether the rollator is suited to outdoor use. "The size of the wheels affects the manner in which the device crosses over bumps in the road and pieces of pavement," says Dr. Acosta. Here's what to look for:

• Wheels with a smaller diameter (6 inches or less) are better used indoors on flat, smooth floors. Plush carpeting may make it harder for small wheels to turn.
• Wheels that are at least 6 inches wide or greater are better for outdoor use. Larger wheels (8-10 inches) provide more stability and traction on uneven dirt surfaces but may also require more space to turn indoors than smaller wheels.

Does Medicare Cover Rollators?

Medicare Part B may cover a rollator as durable medical equipment (DME) when it is medically necessary and prescribed for use in the home. Both the prescribing provider and DME supplier must be enrolled in Medicare in order to receive coverage. After the Part B deductible is met, you generally pay 20% of the Medicare-approved amount when the supplier accepts assignment. Learn more from Medicare. If the supplier does not work directly with Medicare, it's still likely that their products are eligible for coverage via your FSA or HSA account.

Choosing the Right Rollator

With multiple models and specs, there is no right or wrong rollator—the one you get should be the one that matches where and how you plan to use it. Three-wheel models are easier to maneuver in tight spaces, while four-wheel models typically provide greater stability and a seat.

Upright rollators support the forearms and encourage a more vertical posture, whereas standard models use traditional handlebars. Check the seat dimensions, overall width, weight capacity, and handle-height range to ensure a comfortable fit.

Takeaways on Rollators

Rollators come in various versions, including four-wheel and upright models. The devices are intended for balance and endurance, not stability or weight-bearing support. They can be a tremendous boost in mobility and independence, but it's worth noting that struggling to walk shouldn't automatically be accepted as a sign of getting older. If you are experiencing mobility issues, talk with your doctor.

"Mobility decline should not be treated as an inevitable consequence of aging," says Dr. Schwartz. "A change in gait is often a clinical signal and when we investigate it early, we may be able to address the underlying problem, improve strength and balance, and help a person remain independent much longer."

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