The effects of a "new" walking aid on exercise performance in patients with COPD: a randomized crossover trial

Generally, the use of a rollator improves mobility in patients with COPD. Nevertheless, not all patients benefit from its use, and many patients feel embarrassed about using it. Therefore, other walking aids are worthwhile to consider. We compared the direct effects of a "new" ambulation aid (a modern draisine) with the effects of a rollator on 6-min walk distance (6MWD) in patients with COPD.

Twenty-one patients with COPD performed two 6-min walk tests (6MWTs) during prerehabilitation assessment (best 6MWD: 369 ± 88 m). Additionally, two extra 6MWTs were performed on two consecutive days in random order: one time with a rollator and one time with a modern draisine. Walking pattern (n = 21) was determined using an accelerometer, and metabolic requirements (n = 10) were assessed using a mobile oxycon.

Walking with the modern draisine resulted in a higher 6MWD compared with walking with the rollator (466 ± 189 m vs 383 ± 85 m). Moreover, patients had fewer strides (245 ± 61 vs 300 ± 49) and a greater stride length (1.89 ± 0.73 m vs 1.27 ± 0.14 m) using the modern draisine compared with the rollator (all P ≤ .001). Oxygen uptake, ventilation, heart rate, oxygen saturation, and Borg symptom scores were comparable between both walking aids. Ten percent of the patients felt embarrassed using the modern draisine compared with 19% for the rollator, and a significantly smaller proportion of patients would use the modern draisine in daily life.

The mean difference in 6MWD between a modern draisine and a rollator seems clinically relevant, with the same metabolic requirements and symptom Borg scores. Therefore, this "new" ambulation aid could be a good alternative to the rollator to improve functional exercise performance in patients with COPD.

The Netherlands National Trial Registry; No.: NTR1542; URL: www.trialregister.nl.