U-Step: A Crucial Step in Rehabilitation


Jonathan Miller and Sari Steinberg

For patients recovering from traumatic brain injuries, walkers are often not stable enough.  In addition, most walkers are made of aluminum, which can fracture, and the bolts that secure the walker frame tend to loosen, which compromises the integrity of the frame.  The U-Step Walking Stabilizer, an advanced walking aid named for its strategically-designed U-shaped frame, is made of light-gauge steel tubing.  The tubing is strong, light, and durable, and its parts are welded together.  This gives the U-Step's frame outstanding integrity and a very solid feel. 

The U-Step can aide in addressing balance problems associated with acquired brain injury.  An internal study among U-Step customers found that over 95 percent of individuals who had falling problems prior to using the product found the U-Step to dramatically reduce their incidence of falling.  The U-Step's innovative U shape surrounds the individual and prevents falling.  For added stability, most of the U-Step's weight -- approximately fifteen of its twenty pounds -- are concentrated in its base.  Its small casters help, too, by allowing the U-Step's frame to be low to the ground.  The consequent lower center of gravity improves the patients' balance and base of support.  Another key to the U-Step's effectiveness is its unique braking system.  Unlike other rolling walkers that stop when the brake handles are squeezed, the U-Step's brakes are engaged at the outset and are released when the patient squeezes the brake handles.

"Patients have excellent control of their movement by squeezing the handbrakes when they are ready to walk, and releasing the handbrakes when they need to stop," said Jonathan Miller, chief design engineer at In-Step Mobility Products Corporation.  "Also, this type of braking provides individuals with much more control as they are getting up."  Ideal for immediate braking, the U-Step's brake pads are made of pure rubber, which meshes with that of the main turning wheels.  The wheels are made of solid soft rubber that grips all surfaces well, for optimal control.  The advanced cabling design resists stretching, which translates into a braking system that does not need to be adjusted often.  To facilitate different patients' needs, Miller included two different types of brake controls in each walker.  One option is to squeeze either or both handbrakes, thereby making it possible to operate the brakes with one hand if necessary.  The second set-up is achieved by flipping the middle bar toward the patient, who then can release the brakes easily by leaning on the bar.  The braking system is extremely responsive and reliable -- which is critical for good control.

Another feature that works well for patients with acquired brain injuries is the tension control, which can be adjusted for each side independently.  Rolling resistance can be different for the left and right wheels and can be preset for various surfaces.  A patented, spring-loaded front wheel helps patients roll over molding strips, cracks in the sidewalk, and other surface transitions such as those encountered when entering elevators.  For indoor use, the U-Step's small casters enable it to turn in any direction with little resistance.  The U-Step's turning radius is 29 inches, which is approximately forty percent smaller than those of other advanced walkers.  This is achieved thanks to the U-Step's special wheel configuration, which places the main turning wheels toward the center of the walker.  The U-Step's width also makes it perfect for indoor use.  At 22 inches wide, the U-Step easily fits through standard doorways.  An AARP study is the basis of the U-Step's ergonomic handlebar design. The height-adjustable handlebars are flared out seven degrees and bent down seven degrees, improving posture and reducing stress on joints in the arms, shoulders, and back.

Besides the basket, seat, and foldable frame that are standard features of every unit, the U-Step comes with an optional laser module, offered exclusively by In-Step Mobility.  A 2004 pilot study conducted at the Philadelphia Department of Veterans Affairs showed the efficacy of the laser module in combating Parkinsonian freezing episodes. "The laser module was originally created to address the hesitation and freezing common in many individuals with Parkinson's," Miller said, adding that over three thousand people with Parkinson's Disease currently use this visual cue to assist them in walking.  But it also offers benefits to those with other conditions.  The laser line that the module projects can be used in walking therapy, to provide a goal or a line to step toward.  Therapists can easily adjust the placement of the line.  The laser feature has been helpful in stroke rehabilitation, as well as in certain forms of ataxia.

In spite of its light weight, the U-Step can support patients who weigh up to 375 pounds.  The standard model is height adjustable for customers from five feet to six feet, one inch tall.  In-Step Mobility will customize U-Steps for individuals who fall outside of those height parameters.  The U-Step is available currently in the United States, Canada, the United Kingdom, the Netherlands, and Israel.  In-Step Mobility also offers canes, with a laser module.  More information is available at www.ustep.com or by e-mailing walkers@ustep.com.