Accepted for/Published in: JMIR Research Protocols
Date Submitted: Jan 10, 2025
Date Accepted: Jul 8, 2025
Exploring the influence of a novel application for training and evaluating walking aid skills in walking aid users: A protocol for a pragmatic single-blind randomized controlled trial
ABSTRACT
Background:
Over 12% of the world's population and over 1 million Canadians use Walking Aids (WA) to assist mobility. Unsafe use of WA due to lack of training may lead to injury and risk of falls. A novel interactive video-based feedback mobile application to train WA fitting and safe use, called ICanWALK©, was recently developed.
Objective:
The primary objective is to explore the efficacy of the WA skills training application on balance confidence of WA users. Secondary objectives are to explore the influence of the mobile application on mobility and knowledge of WA users.
Methods:
A two-site single-blind pragmatic randomized controlled trial (RCT) is proposed. Fifty-two adults who use WA will be recruited through clinical and community organizations. Participants will complete the measures of balance confidence (Activities-specific Balance Confidence Scale (ABC, primary outcome), mobility (6-Minute Walk test (6MWT), Timed up and Go (TUG) and knowledge and confidence of WA fit and use (self-reported questionnaire) at baseline. Participants will then be randomly assigned to the experimental (ICanWALK© app) or attention-matched control group (breathing activity app), and will complete two 20-minute sessions interacting with the assigned app. Participants will be reassessed at least 1-2 days later after the intervention and 4-weeks later. Analysis of covariance (ANCOVA) will be performed for primary and secondary outcomes using SPSS software.
Results:
The protocol for the second recruitment site was approved by the institutional review board on June 10, 2024. A feasibility study was conducted from 2023 to 2024 and included 27 participants across the two sites. At the time of submitting the manuscript, recruitment is in progress and 12 participants have already been recruited.
Conclusions:
Using a video-based feedback training approach, a novel app is hypothesized to improve balance confidence, mobility, and knowledge and confidence in WA fitting and use. This structured educational program for fitting and training of WA would improve confidence in balance, and thus the user's perception of safety. Better fitting and WA use should improve mobility, especially for older adults, which may increase independence and social participation. Establishing efficacy is an important first step before exploring how ICanWALK© app may be used by WA users and clinicians in clinical and community settings. Clinical Trial: ClinicalTrials.gov NCT05347875
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