A Better Way to Move: Evaluating Assistive Devices for Easier Ambulation

Published June 16, 2025

Science News

Submitted by: Oksana Sayko, MD
Edited by: Nakul Katyal, MD

Citation: Canter DJ, Canter DJ, Reidy PT, Finucan TP, Timmerman KL. A comparison of energy expenditure and perceived exertion between standard axillary crutches, knee scooters, and a hands-free crutch. PM R. 2024;16(6):543-552. doi:10.1002/pmrj.13109

Summary: Injuries to the knee, lower leg, ankle, and foot accounted for nearly 17% of all emergency department visits in 2017. The functional limitations resulting from these injuries, along with weight-bearing restrictions, often necessitate use of assistive devices. Ambulation using standard axillary crutches (SACs) is associated with increased energy expenditure (EE) and decreased ability to perform activities of daily living (ADLs). The researchers explored if using a hands-free crutch (HFC) displays potential for easier completion of ADLs and reduction in energy requirements.


This study was a randomized crossover-controlled trial. 20 health college students participated and completed a 6-minute walk test at 50 m/min, an ADLs course, and a 2-flight stair climb with SACs, HFC, knee scooter (KS), and unassisted ambulation (UA). The order of trial conditions was randomized. EE, HR, time to complete ADLs course and stair climb, and rating of perceived exertion (RPE) during each condition were obtained. One-way analysis of variance was performed to compare EE, HR response, and RPE between the assistive devices and UA.
In all outcomes UA resulted in lower EE, HR, and RPE compared to all the assistive devices (p < .05). For the ADLs course, EE was the same for the 3 assistive devices, whereas HR was significantly lower for HFC compared to SACs and KS (p < .05). RPE for HFC and KS was lower than SACs (p < .05). For the 6MWT, each device significantly differed from the other devices for EE, HR, and RPE, with KS eliciting the lowest values, followed by HFC. For the stair climbing task, HFC elicited lower EE, HR, and RPE than SACs. Fourteen participants indicated their overall preference for HFCs. In individuals prescribed weight-bearing restrictions, using a HFC may offer an easier and more preferred alternative to more commonly used SACs during ambulation, stair climbing, and other ADLs.

Comments: I find this study useful in the rehab field, especially when decisions on use of assistive devices need to be made for patients with comorbidities. 


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