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At least 19 recordsLinked to original sources
PubMed1992

A comparison of a two-wheeled walker and a three-wheeled walker in a geriatric population.

OBJECTIVE: There are few data on the effect of walkers on gait and mobility or on comparisons of different walker types. We compared a commonly used 4-legged, 2-wheeled walker and a newer 3-legged, 3-wheeled walker in measures of gait, mobility, and patient satisfaction. DESIGN: Cross-over controlled trial. SETTING: In the Physical Therapy Department of a Veterans Affairs hospital. PARTICIPANTS: Subjects were 15 male and female frail elderly veterans (mean age, 82 years), both inpatients and outpatients, consecutively enrolled from a sample of 35 patients referred to the Physical Therapy Department for mobility problems. Subjects met the following criteria: age 65 or over, ambulatory, no prior use of a wheeled walker, stable medical condition, and informed consent. INTERVENTION: Subjects were evaluated without either walker and with each of the two walkers on a 15-foot walkway and a 60-foot obstacle course. Subjects were asked which walker they preferred. OUTCOME MEASURE: Outcome measures were stride length on the walkway, time on an obstacle course, and walker preference. RESULTS: Stride length was 1.4 inches (3.6 cm) greater with the 3-wheeled walker than with the 2-wheeled walker (P = 0.016 by Wilcoxon signed-rank test). Time on the obstacle course was 16.0 seconds less with the 3-wheeled walker than the 2-wheeled walker (P = 0.002). The 3-wheeled walker was subjectively preferred. CONCLUSIONS: The 3-wheeled walker appears to have a greater positive impact on gait and mobility than the 2-wheeled walker.

Activities of Daily Living↗
PubMed1986

Patterns of walker use and walker injury.

Infant walkers have been described as a cause of unexpected trauma in the first year of life. We conducted a prospective study to determine the mechanism and pattern of walker injuries presenting to an urban pediatric teaching hospital. We also studied the patterns of walker use. All injuries sustained by infants in baby walkers during a 1-year period were reviewed. The 139 injuries included 29 fractures. The most severe injuries were caused by falls down stairs; these falls accounted for 123 of the injuries. Stair gates were present in one third of all falls. At follow-up 2 months later, two thirds of the children had been in the walker subsequent to the injury. One third were still in the walker at 2 months after their initial injury. Less than half of the homes that had not had stair gates in place had acquired them at the time of follow-up. Baby walkers represent a cause of significant injury in the infant population; studies of warning labels and anticipatory guidance are needed.

Accidents, Home↗
PubMed1993

Walker user risk index. A method for quantifying stability in walker users.

A method for quantifying the stability of a patient using a walking frame is presented. Data collected from a walker-dependent patient recovering from surgical amputation of his right leg were used to demonstrate the derivation and interpretation of a proposed walker user risk index (WURI). WURI curves express risk to the walker user in terms of how much the upper extremities contribute to overall patient support. The WURI analysis of the walker stride presented here quantified the expected clinical impression that this patient was least reliant on the walker immediately after the advance of his prosthetic leg and most reliant when standing on his prosthesis and swinging his nonamputated leg. The analysis also revealed unexpectedly high upper body loads and specific phases in the gait cycle where the patient's balance was at risk.

Accidental Falls↗
PubMed2000

The sonographic diagnosis of Dandy-Walker and Dandy-Walker variant: associated findings and outcomes.

Outcomes of pregnancies with sonographically diagnosed Dandy-Walker (DW) or Dandy-Walker variant (DWV) syndromes vary widely. We examined our own experience with these diagnoses in an effort to identify those sonographic features that best predicted neonatal outcome. We identified 50 fetuses with DW and 49 with DWV diagnosed sonographically. Eighty-six per cent of fetuses with DW and 85% of fetuses with DWV had other sonographically identifiable anomalies, the most common being ventriculomegaly (DW: 32%; DWV: 27%) and cardiac defects (DW:38%; DWV: 41%). Forty-six per cent and 36% of available karyotypes in cases of DW and DWV, respectively, were abnormal. 50 out of 99 women in our series elected pregnancy termination. Only three pregnancies with DW resulted in a living infant, and only one of these had a normal paediatric examination at six-week follow-up. Thirteen out of 49 infants with DWV survived the neonatal period and 7 of 13 were reported initially as normal infants, including six with an isolated finding of DWV. We conclude that overall, the prognosis for these posterior fossa defects is grim but not uniformly fatal. The presence of other anomalies is associated with the worst prognosis. Isolated Dandy-Walker variant has the highest chance of leading to a normal neonate.

Abortion, Induced↗
PubMed2006

Basic walker-assisted gait characteristics derived from forces and moments exerted on the walker's handles: results on normal subjects.

This paper describes a method that passively assesses basic walker-assisted gait characteristics using only force-moment measurements from the walker's handles. The passively derived gait characteristics of 22 subjects were validated against motion capture gait analysis. The force-moment based heel initial contact detection algorithm have produced a high level of concordance with heel initial contacts detected by a human inspecting the heel marker data sets of the Vicon video capture system. The algorithm has demonstrated 97% sensitivity and 98% specificity with a narrow 95% confidence interval of +/-1% during all experiments, which included five navigational scenarios. Temporal error in detecting the instances of heel initial contacts were within 5.27+/-3.66% of the overall stride time obtained from Vicon when the subjects walked in a straight line, whereas the toe-off instance estimates were within 5.18+/-2.75% of the gait cycle. The errors in determining the duration of stride time, single support, and double support were within 5.86+/-2.49%, 5.24+/-2.29%, and 4.34+/-2.13% of the gait cycle respectively. The stride time estimated, using the method presented here, correlated well with stride time computations based on visual inspection of Vicon's data, Pearson correlation coefficient r=0.86 for straight line segments. However, absolute errors were too high to estimate the single and double support phases with acceptable accuracy. The potential application of the instrumented walker and the method presented here is longitudinal basic gait assessment that can be performed outside of the conventional gait labs.

Algorithms↗
PubMed1983

Interaction of 99mTc-labeled liposomes with Walker tumour cells in vitro. Liposome-mediated introduction of thaliblastine into resistant Walker tumour cells.

A method for labeling phospholipid vesicles (liposomes) with 99mTc-pertechnetate is described. The labeling methodology involves the chemical reduction of sodium 99mTc-pertechnetate by stannous chloride, which produces a 99mTc-SnCl2 complex with high binding capacity to phospholipids. Binding studies in vitro showed that Walker tumour cells can incorporate large amounts of 99mTc-labeled liposomes without cytotoxic effects. Fusion of liposomes with the cell plasma membrane may represent an important pathway for lipid incorporation. A Walker cell line resistant to thaliblastine, on treatment with the antitumour alkaloid thaliblastine entrapped in liposomes, showed a marked growth inhibition at concentrations that had little effect when used as free drug. The usefulness of 99mTc-labeled liposomes for kinetic binding studies with tumour cells in cultures and their possible use as carriers of cytotoxic agents in selective cancer chemotherapy, are discussed.

Animals↗
PubMed1995

A case of Marden-Walker syndrome with Dandy-Walker malformation.

A 5-month-old girl with Marden-Walker syndrome is presented. This is a rare autosomal recessive syndrome. So far, approximately 20 cases have been described in the literature. The patient was hospitalized because of difficulty in feeding and slow spontaneous movements. Her parents were first cousins. She was diagnosed with clinical findings of growth and motor retardation, typical facial appearance, congenital heart disease, arachnodactyly, joint contractures, and a Dandy-Walker malformation on magnetic resonance imaging.

Brain↗
PubMed1978

The retention of circulating Walker-256 cells by Walker-256 tumours.

When Walker-256 cancer cells are injected into the portal veins of rats bearing Walker-256 tumours in their livers, the retention of the injected cancer cells by the tumours is considerably less than in the surrounding liver. After applying defined general criteria for "homing" phenomena to the data, it is concluded that compared with the liver, they demonstrate "antihoming". The observations are explained in terms of a deficient arrest process within the tumours.

Animals↗
PubMed1999

Role of walker motif A of RuvB protein in promoting branch migration of holliday junctions. Walker motif a mutations affect Atp binding, Atp hydrolyzing, and DNA binding activities of Ruvb.

Escherichia coli RuvB protein, an ATP-dependent hexameric DNA helicase, acts together with RuvA protein to promote branch migration of Holliday junctions during homologous recombination and recombinational repair. To elucidate the role of the Walker motif A of RuvB (GXGKT; X indicates a nonconserved residue) in ATP hydrolysis and branch migration activities, we constructed four ruvB mutant genes by site-directed mutagenesis, altering the highly conserved Lys(68) and Thr(69). K68R, K68A, and T69A mutants except T69S failed to complement UV-sensitive phenotype of the ruvB strain. These three mutant proteins, when overexpressed, made the wild-type strain UV-sensitive to varying degrees. K68R, K68A, and T69A were defective in ATP hydrolysis and branch migration activities in vitro. In the presence of Mg(2+), K68R showed markedly reduced affinity for ATP, while K68A and T69A showed only mild reduction. K68A and T69A could form hexamers in the presence of Mg(2+) and ATP, while K68R failed to form hexamers and existed instead as a higher oligomer, probably a dodecamer. In contrast to wild-type RuvB, K68R, K68A, and T69A by themselves were defective in DNA binding. However, RuvA could facilitate binding of K68A and T69A to DNA, whereas it could not promote binding of K68R to DNA. All of the three mutant RuvBs could physically interact with RuvA. These results indicate the direct involvement in ATP binding and ATP hydrolysis of the invariant Lys(68) and Thr(69) residues of Walker motif A of RuvB and suggest that these residues play key roles in interrelating these activities with the conformational change of RuvB, which is required for the branch migration activity.

Adenosine Triphosphate↗
PubMedDate not supplied

Intelligent walkers for the elderly: performance and safety testing of VA-PAMAID robotic walker.

A walker that could help navigate and avoid collisions with obstacles could help reduce health costs and increase the quality of care and independence of thousands of people. This study evaluated the safety and performance of the Veterans Affairs Personal Adaptive Mobility Aid (VA-PAMAID). We performed engineering tests on the VA-PAMAID to determine safety factors, including stability, energy consumption, fatigue life, and sensor and control malfunctions. The VA-PAMAID traveled 10.9 km on a full charge and avoided obstacles while traveling at a speed of up to 1.2 m/s. No failures occurred during static stability, climatic, or fatigue testing. Some problems were encountered during obstacle climbing and sensor and control testing. The VA-PAMAID has good range, has adequate reaction time, and is structurally sound. Clinical trials are planned to compare the device to other low-technical adaptive mobility devices.

Equipment Design↗
PubMed1999

Large scale purification of detergent-soluble P-glycoprotein from Pichia pastoris cells and characterization of nucleotide binding properties of wild-type, Walker A, and Walker B mutant proteins.

P-glycoprotein (Pgp; mouse MDR3) was expressed in Pichia pastoris, grown in fermentor culture, and purified. The final pure product is of high specific ATPase activity and is soluble at low detergent concentration. 120 g of cells yielded 6 mg of pure Pgp; >4 kg of cells were obtained from a single fermentor run. Properties of the pure protein were similar to those of previous preparations, except there was significant ATPase activity in absence of added lipid. Mutant mouse MDR3 P-glycoproteins were purified by the same procedure after growth of cells in flask culture, with similar yields and purity. This procedure should open up new avenues of structural, biophysical, and biochemical studies of Pgp. Equilibrium nucleotide-binding parameters of wild-type mouse MDR3 Pgp were studied using 2'-(3')-O-(2,4,6-trinitrophenyl)adenosine tri- and diphosphate. Both analogs were found to bind with K(d) in the low micromolar range, to a single class of site, with no evidence of cooperativity. ATP displacement of the analogs was seen. Similar binding was seen with K429R/K1072R and D551N/D1196N mutant mouse MDR3 Pgp, showing that these Walker A and B mutations had no significant effect on affinity or stoichiometry of nucleotide binding. These residues, known to be critical for catalysis, are concluded to be involved primarily in stabilization of the catalytic transition state in Pgp.

ATP Binding Cassette Transporter, Subfamily B↗
PubMed2003

Baby walkers--health visitors' current practice, attitudes and knowledge.

BACKGROUND: Baby walkers are a commonly used item of nursery equipment. Between 12% and 50% of parents whose infant uses a walker report that their child has suffered a walker-related injury. Health visitors' knowledge, attitudes and practice with regard to walkers and related health education has not been explored so far. AIM: The aim of the study was to describe health visitors' knowledge of walkers and walker-related injuries, their attitudes towards walkers and current practice with regard to walker health education, and to examine the relationship between knowledge and attitudes and knowledge and practice. METHOD: A survey was carried out with 64 health visitors prior to participation in a randomized controlled trial assessing the effectiveness of an educational package in reducing baby walker use. RESULTS: The response rate was 95%. Half of the health visitors always discussed walkers postnatally, most frequently at the 6-9 month check. Most did not usually discuss the frequency of walker-related injuries. Most had negative attitudes towards walkers, but believed that parents hold positive attitudes to them and that it is hard to persuade parents not to use them. Health visitors had a limited knowledge of walker use and walker-related injuries. Those giving advice on walkers most often had higher knowledge scores than those giving advice less often (P = 0.03). Those with higher knowledge scores held more negative attitudes towards walkers (rs = 0.29, P = 0.023) and believed parents to have more positive attitudes towards walkers (rs = -0.49, P < 0.001). Few health visitors had resources to discuss walkers. CONCLUSIONS: Health visitor advice regarding walkers needs to be given earlier in the postnatal period than is currently common practice, and they need more knowledge about walker use and related injuries. Education about baby walkers needs to be incorporated into undergraduate and in-service education, which may need to include the development of skills in exploring reasons why parents use walkers and in negotiating alternatives to their use. The provision of audio-visual aids for discussing walkers might also be helpful.

Accident Prevention↗
PubMed2004

[Infant walkers: the prevalence of use].

UNLABELLED: Infant walkers are mobile wheeled seats that allow infants to move around with their feet on the floor. They enable precocious locomotion in very young, otherwise prelocomotor infants. Prelocomotor walker experience prevents visual access to the moving limbs. Infant walker use can be associated with delay in achievement of normal locomotor milestones. Besides delayed motor development, contractures of the calf muscles and motor development mimicking spastic diparesis may appear. In the case of infant walker's use for the infants at risk for development of cerebral palsy, multiple side effects can be produced: the persistence of positive support reflex, heel cord contractures, subluxation and dislocation of the hips or pronation contractures of the upper extremities. The use of infant walkers increases the risk of injuries. The study has enrolled 150 children and their mothers, from three big cities in Bosnia and Herzegovina (Sarajevo, Bihać, Zenica). All relevant data have been collected through the questionnaires. 130 children (86.6%) have used infant walkers. The mean age when the use of infant walker has started was 7 months. The mean time of daily use of infant walker was 1 hour 49 minutes. Twenty three children had various motor disturbances, 13 out of them (56.5%) have used infant walker. The mild injuries caused by using the infant walkers have been registered in 17 cases (11.3%). 83 mothers (55.3%) were aware of infant walker's nocuous effects. CONCLUSION: The use of infant walkers has been spread widely under our circumstances. There is significant discrepancy between mothers' knowledge about nocuous effects of infant walkers and their practice. The use of infant walkers for infants with motor disturbances is especially harmful. The main reason for using infant walker, despite of its harmfulness, was mother's preoccupation with everyday household activities. It is necessary to engage health professionals to support antiwalker campaign (warning labels on the infant walkers, public education programs, etc). We recommend safer alternatives for child daycare, like stationary activity centers (so called "fenced play gardens".

Bosnia and Herzegovina↗
PubMed2003

Wheeled and standard walkers in Parkinson's disease patients with gait freezing.

OBJECTIVES: Compare the efficacy of two walking assistance devices (wheeled walker and standard walker) to unassisted walking for patients with PD and gait freezing. BACKGROUND: Although numerous walking devices are used clinically, their relative effects on freezing and walking speed have never been systematically tested. METHODS: Nineteen PD patients (14 non-demented) walked under three conditions in randomized order: unassisted walking, standard walker, and wheeled walker. Patients walked up to three times in each condition through a standard course that included rising from a chair, walking through a doorway, straightway walking, pivoting, and return. Total walking time, freezing time and number of freezes were compared for the three conditions using mixed models (walking time) and Friedman's test (freezing). The wheeled walker was further studied by comparing the effect of an attached laser that projected a bar of light on the floor as a visual walking cue. RESULTS: Use of either type of device significantly slowed walking compared to unassisted walking. Neither walker reduced any index of freezing, nor the laser attachment offered any advantage to the wheeled walker. The standard walker increased freezing, and the wheeled walker had no effect on freezing. Among the non-demented subjects (n=14), the same patterns occurred, although the walking speed was less impaired by the wheeled walker than the standard walker in this group. CONCLUSIONS: Though walkers may stabilize patients and increase confidence, PD patients walk more slowly when using them, without reducing freezing. Because the wheeled walker was intermediate for walking time and does not aggravate freezing, if walkers are used for these subjects, this type of walker should be favored.

Aged↗