wileyonlinelibrary.com/journal/ane Acta Neurol Scand. 2018;138:70–7 7.
© 2018 John Wiley & Sons A/S.
Published by John Wiley & Sons Ltd
1 | INTRODUCTION
Parkinson’s disease (PD) is a chronic progressive neurodegenerative
disease, which results in functional loss and disability due to motor
symptoms (eg, bradykinesia, tremor, postural instability) and non-
motor symptoms (e.g, fatigue, depression, cognitive dysfunction).
As PD progresses, gait and balance problems become more prev-
Mobility devices (MDs) can compensate for such problems
and facilitate activity performance.
This implies that it is important
to increase the understanding of how the use and perceived unmet
need of MDs evolve over time. To the best of our knowledge, no
study has yet addressed such matters in people with PD.
According to the International Classification of Functioning,
Disability and Health (ICF), MDs are part of environmental factors,
which can act as a facilitator or a barrier for activity performance.
Various types of MDs with different levels of support may be required
depending on the person′s functioning, level of independence in activ-
ities of daily living (ADL), his/her activity repertoire, and environmental
Commonly used MDs in people with PD include canes (ie,
walking sticks), wheeled walkers (ie, rollators) as well as manual and
Accepted: 21 March 2018
Mobility device use in people with Parkinson’s disease:
A 3- year follow- up study
| S. B. Jonasson
| S. Iwarsson
| P. Odin
| M. H. Nilsson
Department of Health Sciences, Lund
University, Lund, Sweden
Department of Neurology and
Rehabilitation, Skåne University Hospital,
Section for Neurology, Department of
Clinical Sciences, Skåne University Hospital,
Department of Neurology, Central Hospital,
Memory Clinic, Skåne University Hospital,
M. Kader, Department of Health Sciences,
Lund University, Lund, Sweden.
The Swedish Research Council;
Strategic Research Area in neuroscience
(MultiPark); NEURO Sweden; Norrbacka-
Eugeniastiftelsen; Ribbingska Foundation
in Lund; Greta och Johan Kocks stiftelser;
Swedish Parkinson Foundation; The Swedish
Association of Persons with Neurological
Objectives: This study aimed to investigate how the use and perceived unmet need
of mobility devices (MD) in people with Parkinson’s disease (PD) evolve over a 3- year
Methods: The study reports baseline assessments (n = 255) and comparisons for par-
ticipants with complete data at baseline and the 3- year follow- up (n = 165). Structured
questions addressed the use and perceived unmet need of various MDs indoor and
outdoor (eg, canes, wheeled walkers, and manual and powered wheelchairs).
McNemar tests were used to investigate differences over time.
Results: In the total sample at baseline, 30% and 52% of the participants reported
using MDs indoors and outdoors, respectively. Among those with complete data also
at the 3- year follow- up, the proportion of participants using MDs increased signifi-
cantly (P < .001) from 22% to 40% for indoors and from 48% to 66% for outdoors,
with transition of MD toward more assistive potential (ie, wheeled walker and manual
wheelchair). Wheeled walkers were the most commonly used MD indoors as well as
outdoors on both occasions. Among the users of multiple MDs, the most common
combination was cane and wheeled walker on both occasions. The proportion of
participants who reported a perceived unmet need of MDs was 5% at baseline,
whereas it was 21%, 3 years later.
Conclusions: The use and perceived unmet need of MDs in people with PD increase
over time. There is a need for addressing MDs at clinical follow- ups of people with
PD, with continuous attention in primary health care and municipality contexts.
assistive devices, canes, mobility, Parkinson’s disease, walking aids, wheelchairs, wheeled