Pragmatic implementation of a walking aid skills training program to prevent secondary harms

Issue

Many individuals who experience work-related lower body injuries use crutches, canes, or walkers acutely or chronically. Although these walking aids facilitate independent upright ambulation, and reduce the risks of deconditioning and deep vein thromboses, walking aid use also results in repetitive upper limb weight-bearing, which may lead to secondary upper limb pain or injury, such as stress fracture, nerve entrapment or arterial aneurysm. Walking aid use has also been associated with increased risk of falling, potentially resulting in fracture, laceration, or traumatic brain injury. The addition of a walking aid-related injury to an individual with already impaired mobility may compound disability, impair quality of life, and delay return to work. Patients often do not receive adequate training on walking aid fitting or use after a lower body injury, and that this may increase the risk of walking aid-related injury. In addition, when education is provided in many clinical settings, patients often only recall 15-40% of the interaction. Over the last 2 years, we have developed an interactive video- and question-based app to reduce the risks associated with walking aid use by addressing factors of inadequate walking aid fitting and training education. The app is called Improving Canadians’ Walking Aid skills, Learning, and Knowledge© (ICanWALK). We aim to evaluate the effectiveness of this app in improving movement confidence and reducing pain.