Should my patient use a front wheeled walker or a four wheeled walker? This is a simple yet important choice. A choice that must give us pause when picking out the best mobility aid for an older adult who needs a little help getting around, because a wrong answer could (more likely would) cause a fall.
The biggest determinant between a person being able to use a four wheeled walker (4WW) and a front wheeled walker (FWW) is balance. Older adults with good stability and balance, along with fair posture, are likely more suitable for a 4WW. They can handle the additional challenge that this more mobile platform provides, while benefiting from some of the 4WW’s unique features. A person who lacks stability will find themselves falling more frequently while using a 4WW. The 4WW may roll away from them when they place too much weight forward. It can also be unsafe if they tend to lose their balance in more than one direction. A person who is prone to placing significant weight forward onto their arms is more appropriate for a FWW that won’t fly out from under them as the downward pressure only increases the stability of this type of walker.
Additional differences between the 4WW and the FWW are the seat that can be included on a 4WW to allow an individual the opportunity to turn around and rest easily wherever they may be. Hand brakes also come standard on all 4WWs. However, there is a learning curve in how to use them properly, and often an older adult may need training in safety principles for the use of a 4WW. FWWs offer collapsibility as a feature and their low weight is often favored when picking them up to place in a vehicle.
Whichever mobility aid is right for your patient, the knowledge that you won’t be increasing their fall risk should help you sleep easier at night. Walkers are wonderful! Promoting an older adult’s independence by allowing them to interact and maintain preferred activities is a gift. Much like a high schooler with their first set of car keys, this opens up doors to new places and activities--and maybe--a few old ones too!