Thursday, January 18, 2018

Rollators - I have to admit that ...


I have to admit that I hate rollators, though there might be good reasons to prescribe rollators. But in recent years I’ve seen a proliferation of people using rollators. I’ve seen rollators at a supermarket (discounter) for sale for about € 50. Normally you pay €200-500 for a rollator in a medical store (prices apply for Germany). I think this situation is alarming.

For instance in patients suffering from COPD [chronic obstructive pulmonary disease] there is a rational for using rollators [1]. “Rollator use resulted in improvements in performance in the 6MW [6-minute walk], which were consistent over time among individuals with moderate to severe chronic obstructive pulmonary disease who walk less than 375 m during an unaided 6MW.”
You will find a large set of different diseases, in which rollators are helpful. And you will be able to find research data on useful appliance of a rollator as a therapeutic appliance. I won’t put this to doubt!

But if you try to find studies on the usefulness in other conditions you’ll look in vain. I’ve searched in PubMed:
    "Low Back Pain"[Mesh] AND "rollator"
    "Back Pain"[Mesh] AND "rollator"
"Somatoform Disorders"[Mesh] AND "rollator"
All these searches resulted in:
    “No documents match your search terms”

I doubt that rollators in patients with chronic back or low back pain without red flags or in patients suffering from somatoform disorders or fibromyalgia do any good. Patients are fixed in a state of disease and helplessness instead of recovering.
And I see, at least in Germany, quite a lot of people on welfare benefits using rollators. Maybe they want to express that they suffer from a disease that keeps them from working. It’s a bad sign, if people need to rely on a rollator to be accepted by society.

The percentage of people using rollators in a wrong way is very high, if you look at them downtown. They bend over the rollator, which is ruinous for the back – if they didn’t have back pain before, now back pain will follow. You can see such people also bending over shopping carts.

What would I change?
A rollator is a therapeutic appliance that has indications and contra-indications. We should be very critical in whom we prescribe a rollator, so that patients aren’t harmed by its use. We shouldn’t aggravate learned helplessness but promote self-reliance. And if we prescribe rollators, patients need to be instructed in its use by a physical therapist. A rollator should not be sold at a supermarket!


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4 comments:

  1. Replies
    1. Walking frame (German - Gehbock) is used in hospitals and at home, mostly in elderly patients after surgery (post-traumatic).

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    2. Thank you for the explanation.
      (das nächste Mal aber auf Deutsch, ja?)

      Viele Grüße
      Heike

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    3. Na gut! :)
      Mehr dazu mündlich.
      Liebe Grüße! Lothar

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