Choosing a Mobility Aid for Parkinson’s Disease

Parkinson's disease can affect every aspect of your ability to walk, including balance, posture, step length, coordination, and stopping and starting. If walking on your own is starting to feel difficult, a mobility aid may make it easier to get around safely and confidently.

"Parkinson's disease is complex, and people are different in terms of how much they'll benefit from a device. If a device provides the balance you need to walk, then it can be really useful," says Fay Horak, Ph.D., a professor of neurology at Oregon Health and Science University and founding director of the OHSU Balance Disorders Laboratory in Portland, OR.

Ultimately, the decision to use a mobility aid for Parkinson's disease should be made with your doctor and physical therapist. If you're starting to look into your options, these are some of the ways you may benefit and devices that can help.

How Can Parkinson's Affect Mobility?

Parkinson's disease happens when the brain produces less dopamine than it should. The decrease makes it harder for your brain to send smooth, automatic signals involved in movement. That can affect things like walking, balance, and coordination, according to the Parkinson's Foundation.

Difficulty with mobility can pose a safety risk as Parkinson's disease progresses. "It creates a higher level of fall risk while moving and walking," explains Carolyn Utesch, a certified occupational therapy assistant who works with Parkinson's patients at Bloomington Regional Rehabilitation Hospital in Bloomington, IN. If you're having trouble walking, it also limits your ability to be physically active, which is essential for managing your Parkinson's disease, adds Utesch, who is also an ambassador for the Davis Phinney Foundation, a Parkinson's disease nonprofit.

When Is It Time to Consider a Mobility Aid?

Deciding when to use a mobility aid when you have Parkinson's is personal. The timing usually depends on symptom severity and whether they are starting to limit your independence or are putting your safety at risk.

"If you find yourself no longer leaving the house because you're afraid of falling, that would be an ideal time" to look into a device, says Dr. Horak. There's no such thing as too soon: It's better to seek mobility support now, rather than wait until you actually fall and potentially get injured, she adds.

If you're on the fence, consider asking those you're close with what they think. Often, family members or friends will have a more objective view of your needs and abilities. "If your loved one feels that it's unsafe for you to walk on your own, then it's time for a mobility aid," says Rebecca Gilbert, M.D., Ph.D., chief mission officer of the American Parkinson Disease Association in New York City.

What Types of Mobility Aids Are Used for Parkinson's?

Several types of mobility aids can help people with Parkinson's disease. If you're just starting to learn about the options like walkers vs. rollators, this overview can give you a general sense of what's out there.

You should be evaluated by your care team before choosing and buying a device. "It's important for people with Parkinson's disease to see a physical therapist or occupational therapist who knows about Parkinson's and about different kinds of mobility devices," says Dr. Horak. Together, you can decide on a device that will meet your mobility needs and make sure the device is adjusted to work for your body.

Canes and Walking Poles

Canes and walking poles offer light support for mild balance problems, helping some people with Parkinson's disease feel steadier without significantly restricting their movement. They can also reduce fatigue, helping you walk farther or stay on your feet for longer, according to Parkinson's Community Los Angeles.

Another benefit: Both canes and walking poles encourage people to take larger steps by acting as visual targets as you plant them in front of you with each step. That's especially true for laser canes, which have a laser attachment in the front that projects a red line on the ground whenever the cane touches the ground. Seeing the line can guide your steps and act as a cue to reduce freezing, per the Michael J. Fox Foundation.

You'll need to have a sturdy grip to use a cane or walking pole. "Grip strength is vital when using a cane because individuals typically transfer a significant amount of their body weight through their hands and arms," says Utesch. A physical or occupational therapist can evaluate your grip to see whether a cane or pole will work for you.

Standard and Two-Wheeled Walkers

Walkers provide a wider base of support than a cane or walking poles. But not all walkers are appropriate for people with Parkinson's disease.

Standard walkers, which have four posts and have to be lifted when you take a step, should be avoided, according to the Parkinson's Foundation. "Picking up the walker could cause the person to fall backwards. That would be dangerous," Dr. Horak says.

Two-wheeled walkers have two wheels in the front and two posts in the back. The wheels don't typically swivel, so they offer less stability than four-wheeled walkers or rollators (more on those later). They can also make turning difficult, the Parkinson's Foundation notes.

Four-Wheeled Rollators

Rollators are walkers with four swivel wheels. They typically have a built-in seat for when you need to take break and a storage basket that lets you carry items while keeping both hands on the handles. They also have handbrakes that can be engaged when you stop walking or sit on the device, per the Michael J. Fox Foundation.

Because rollators glide and do not require someone to lift and place them, they allow for more fluid movement and can be helpful for people with Parkinson's who need a moderate level of support. But in order to use one safely, you need to easily be able to operate the hand brakes. "If a freeze occurs with the feet stuck to the floor, and the person is not fast enough to engage the brake, the walker will continue to move, potentially precipitating a fall," says Dr. Gilbert.

U-Step Walkers

These four-wheeled walker rollators are designed specifically for people with neurological conditions like Parkinson's disease. They have a U-shaped base to increase stability and a reverse braking system where you have to squeeze a hand lever in order to make the walker move forward (if you don't squeeze the lever, the brakes stay in the locked position). "Therefore, if a freeze occurs, the walker should stay stable," Dr. Gilbert says.

Manual and Power Wheelchairs

A wheelchair can be an option when walking with other types of mobility devices has become unsafe. Some people with Parkinson's disease who struggle with fatigue also opt to use wheelchairs for times when they'll be covering longer distances that would be too much on foot, the Michael J. Fox Foundation notes.

Manual wheelchairs require you to move your chair forward with your arms and hands. Power wheelchairs and scooters are controlled with a joystick and use electricity to move, so they may be better for users who can't propel a manual chair. They may be more expensive than other types of mobility devices, per the Michael J. Fox Foundation.

Walker vs. Rollator for Parkinson's: What Is the Difference?

Rollators are typically a better fit for people with Parkinson's disease than walkers, but that may not be the case for everyone. Understanding what sets the two apart can help you make the right decision with your care team about the best tool for you.

Features to Look for in a Parkinson's Mobility Aid

Ultimately, "the easiest way to choose what mobility aid is right for a particular person is to utilize the expertise of a physical therapist and try out different devices to find the one that works best," says Dr. Gilbert.

Together, here are some of the factors that you and your care team will want to consider:

• Brake style. Are you able to quickly and easily engage a device's handbrakes, or would it be easier for you to use a device with a reverse braking system?
• Wheels. Larger wheels generally tend to offer more stability, especially if you'll be using your device outside, Dr. Horak says. Your device "should also have wheels with a 360-degree turn so you can make turns easily and go down sidewalk curbs," she adds.
• Weight. A heavier device may be more stable, but extra pounds can make it hard to lift into a car to transport. "An expert can help you evaluate whether a device's weight will work for you," Dr. Horak says.
• Additional amenities. Do you need a laser for visual cueing? A basket for storing your things, or a seat so you can stop and rest as needed? Think about which extra features would be right for you.

Can a Mobility Aid Help With Freezing of Gait?

Mobility devices don't automatically stop freezing of gait, that temporary feeling of being stuck or glued to the floor. "External cues and specific movement strategies are the most helpful for restarting movement," says Utesch.

What a mobility device can do: Help you maintain your balance and stability during a freezing episode. On the other hand, if the device disrupts your walking rhythm or becomes another object to navigate (especially when turning or moving through tight spaces) it may make gait issues worse, says Dr. Horak. For that reason, the fluid motion of a rollator may be preferable for someone who experiences freezing episodes.

Talk with your doctor or physical therapist about whether a mobility device might be helpful for your freezing episodes, and if so, how to restart movement safely with your device when freezing happens.

Choosing Support Is a Way to Preserve Independence

It's normal to hesitate about using a mobility device. After all, a tool to help you walk is basically acknowledging that your disease is getting worse, and that can be hard.

Reframing the narrative may help you see things differently. Rather than seeing it as an admission of your limitations, think of a mobility aid as the tool that can bring you more independence and reduce your risk of falls and injuries. "A mobility aid enables you to remain mobile and engaged in the activities you love. Without it, you risk losing the freedom to do what matters most to you," says Dr. Gilbert.

A mobility device can also help you stay physically active, which is a key for managing Parkinson's symptoms long-term, concluded experts in a recent Journal of Neurology, Neurosurgery, and Psychiatry review. "We know exercise can help slow the progression of Parkinson's disease, so you don't want to stop exercising," Dr. Horak says.

Bottom line: There is nothing easy about Parkinson's disease or the mobility challenges it brings. Various type of mobility aids can make your journey with Parkinson's easier. Talk with your doctor about the right type of support for your situation.

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