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2018 Smart walking aids - preparing their route to clinical adoption - GMAHSN Ignite

Walking aids are widely used by older adults for stability and mobility, and the number of users is rising as the population ages. Alarmingly, use of walking aids has been linked to an increased falls-risk, yet clinicians have no objective way of assessing user stability. We have recently developed the first objective measure of stability of walking aid users [Costamagna et al. 2017], which offers a way of addressing this problem. The measure, termed the stability margin (SM), is calculated using force measurements taken from each of the walking aid’s legs and the user’s shoes, together with the position of the anatomical feet relative to the walking aid. To measure these forces we have already instrumented three walking aids with load cells (a Zimmer frame, a front-wheeled walker and a rollator) which allow for calculation of SM. Our prototype systems are now being used in a number of studies of user stability. This application aims to pave the way for clinical adoption as follows:

  1. Focus Group Work: It is our objective to consider the applications of the instrumented walking aids within the NHS, and to inform prototyping of software, i.e. to guide software development regarding visualization of our stability outcome measure, for easy-to-understand feedback to clinicians and their patients. For this, a qualitative approach is planned. Guided questions will explore 1) clarity of the outcome measure (how can it best be explained/visualised), 2) how a smart walking aid system might impact on clinical practice, and 3) willingness to engage with the technology, and barriers to its adoption. The focus group (n=10) will be a mixed sample of therapists, walking aid users, and carers. Findings will inform a first software iteration, which will then be re-assessed in a second meeting of the focus group, to identify if data visualization now meets end-user needs.
  2. Developing commercial partnerships: It is our objective to assemble a competitive team for further product development. For this we will travel to potential commercial partners to discuss ways forward for their involvement and collaboration.
  3. Market research: It is our objective to gather NHS and private market size data on the use of walking equipment and walking frames, and to review guidelines for prescription and their actual use. This includes a review of the literature and enquiries via telephone/Email. Furthermore, we will identify responsibility for the procurement & prescription in health and adult social care services (policy/literature/tender reviews and phone interviews).

We will be working closely with the Manchester University NHS Foundation Trust as our clinical partner, and also with Trustech, an organization who bridges the gap between NHS Providers/Commissioners and the commercial, academic and international healthcare sectors, to facilitate the development or adoption of new medical technology for improved patient care.

Longer-term, smart walking aids have the potential to benefit older people through evidence-based prescription and user training, thereby enhancing mobility whilst reducing falls, and allowing users to walk independently and safely for longer.