COPD patients provided with rollators may forgo using them

By Megan Rauscher

NEW YORK (Reuters Health) - Rollators, four-wheeled walking aids with hand brakes, a basket for carrying items and a seat for resting, are very helpful for people with chronic obstructive pulmonary disease (COPD) who are unable to walk more than 300 meters unaided. However, providing rollators to COPD patients does not guarantee their regular use, investigators in Canada report.

Dr. Roger S. Goldstein from West Park HealthCare Centre in Toronto and colleagues assigned 18 COPD patients to a rollator group and 13 to a usual-care group for 8 weeks, following completion of a pulmonary rehabilitation program.

As reported in the October issue of Chest, subjects in the rollator group were asked to incorporate the walking aid into their daily lives, and to log how often they used the device and for what types of activities. Fifteen rollator patients and 12 usual-care patients completed the study.

During testing, subjects consistently achieved a higher score on the 6-minute walk distance test with a rollator than without. At the start of the study distances were 292 meters with the rollator versus 263 without. At 4 weeks, distances were 296 and 275 meters, respectively, and at 8 weeks, 6-minute walk distances were 283 versus 259 meters.

However, despite evidence of effectiveness during early testing and despite the fact that the majority of patients allocated to the rollator group indicated a preference for walking with it, 8 of the 18 subjects used their rollator less than three times per week.

"This lack of use almost certainly influenced the lack of between-group differences in exercise tolerance and quality of life," the investigators write.

"Actual use of a rollator may be an important determinant of its effect," Dr. Goldstein told Reuters Health, noting that "when one looks at regular users versus non-users, there is a clear improvement in quality of life of the users."

He suggests that stigma, convenience, and other factors many prevent the regular use of rollators.

"Therefore, when prescribing a rollator, healthcare professionals should attempt to identify those most likely to use it," Goldstein and colleagues conclude. This is particularly important, given the substantial number of rollators funded for respiratory patients and their cost, which ranges between $400 and $500 (Canadian).

SOURCE: Chest October, 2006