Walker inlet-closure strap for unsteady patients with lower-extremity amputations

Some patients with lower-extremity amputations who use a walker fall backwards after advancing too far forward into the walker's base of support. In a pilot study of 14 patients with unilateral lower-extremity amputations who stepped into the forward two thirds of the walker base, this problem was corrected by using a knee-high elastic strap to close the open posterior "inlet" of the walker. Without the strap, the stance-phase position of the leading ankle was in the forward third of the walker base for 8 subjects and in the middle third for 6. With the walker strap, the ankle position was in the middle third for one subject, in the posterior third for 6, and at or behind the walker inlet for 7 (p < .0002). This simple intervention appears to correct the potentially dangerous behavior of stepping too far into the walker base.