A Smart Wheeled Walker With Integrated Physiological Monitoring to Improve Mobility in Older Adults: Randomized Crossover Trial

Vollständiger Abstract

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Abstract Background Mobility limitations in older adults are associated with an increased physiological cost of walking, reduced functional independence, and elevated fall risk. Conventional wheeled walkers improve stability but lack real-time physiological monitoring and safety feedback. Digital health–enabled assistive devices integrating physiological monitoring and fall detection may enhance mobility performance and safety. Objective This study aimed to evaluate the short-term effects of a smart wheeled walker equipped with real-time physiological monitoring and fall detection compared with a standard wheeled walker in improving walking efficiency, dynamic balance, and fear of falling among community-dwelling older adults. Methods A single-blind randomized crossover trial was conducted in 30 community-dwelling older adults aged 65 to 80 years with mild balance impairment (Timed Up and Go >13.5 seconds). Participants completed walking trials using both a standard wheeled walker and a smart wheeled walker in a randomized order, with a 30-minute washout period. The smart walker integrated photoplethysmography-based heart rate (HR) monitoring, pulse oximetry (oxygen saturation [SpO ₂ ]), and a tilt-based fall detection system with mobile alert functionality. The primary outcome was walking efficiency assessed using the Physiological Cost Index (PCI). Secondary outcomes included dynamic balance (Expanded Timed Up and Go [ETUG]) and fear of falling (Falls Efficacy Scale-International). Statistical analysis was performed using paired comparisons with a significance level of P