Designing Factors for Walking Aid Equipment in Thai Older Adults

Last reviewed: March 2026

Summary

This study investigated the design factors considered most important by Thai older adults when selecting and using walking aid equipment. As Thailand faces rapid population ageing — with projections indicating that over 20% of the population will be aged 60 years or above by 2030 — the demand for well-designed assistive devices including walking aids is increasing. The research combined user-centred design methodologies with ergonomic assessment to identify key design parameters for walking aids suitable for the Thai elderly population.

Background

Falls represent one of the most significant public health risks for older adults globally. The World Health Organization estimates that approximately 684,000 people die annually from falls worldwide, with adults over 60 years accounting for the majority of fatal falls. Non-fatal falls also carry enormous costs, including injuries, disability, loss of independence, institutionalisation, and reduced quality of life. Walking aids — including canes, crutches, walkers, and rollators — are among the most widely used assistive devices for fall prevention, prescribed to maintain mobility, improve balance, and reduce fall risk in older adults with gait or stability impairments.

However, the effectiveness of walking aids is critically dependent on their design, fit, and user acceptability. Research consistently identifies high abandonment rates for assistive devices, with estimates suggesting that one-third to one-half of all assistive devices are not used as intended or are abandoned entirely. Poor fit, discomfort, social stigma, difficulty of use, and unsuitability for the user’s living environment are commonly cited reasons for non-use. These challenges highlight the importance of designing walking aids with direct input from the end users — older adults themselves — and with attention to population-specific anthropometric and cultural factors.

Thailand’s older adult population presents specific considerations for walking aid design. Thai elderly individuals tend to have smaller stature and different body proportions compared to Western populations for whom most commercial walking aids are primarily designed. Furthermore, Thai living environments, which may include uneven surfaces, wet conditions during the monsoon season, frequent use of stairs, and smaller interior spaces, impose additional functional requirements on walking aids.

Methods

The study employed a mixed-methods approach combining quantitative anthropometric measurement with qualitative user preference research. A sample of Thai adults aged 60 years and above who used or had been prescribed walking aids was recruited from healthcare facilities and community settings in Bangkok. Anthropometric measurements relevant to walking aid design were collected, including standing height, elbow height, hand grip span, and shoulder width.

User preferences were assessed through structured interviews and questionnaire surveys that asked participants to rate the importance of various walking aid design attributes, report difficulties encountered with their current walking aids, and describe features they would like to see in improved designs. Participants were also asked to evaluate physical prototypes representing different design configurations.

Key Results

The analysis of user preferences revealed a clear hierarchy of design priorities. Safety-related features ranked highest, with stability during use, non-slip base materials, and sturdy construction identified as essential requirements. Ease of use was the second priority, encompassing factors such as intuitive operation, minimal physical effort required, and simple height adjustment mechanisms. Lightweight construction ranked third, reflecting the practical concern that many older adults have limited upper body strength and may need to lift or carry their walking aid at times.

Anthropometric analysis revealed that the dimensions of commercially available walking aids did not optimally fit the Thai elderly population. Handle heights, grip diameters, and overall frame dimensions were frequently either too large or not adjustable within the appropriate range for Thai users. These mismatches can lead to compensatory postures that increase energy expenditure, reduce stability, and potentially contribute to musculoskeletal pain.

Additional design factors that emerged from the user research included foldability (for storage in compact Thai homes and for transport in vehicles or on public transport), aesthetic acceptability (older adults expressed preferences for designs that looked less medical and more like everyday accessories), durability in humid tropical conditions, and compatibility with common Thai footwear including sandals and slip-on shoes.

Discussion

The findings reinforce the importance of user-centred design approaches in assistive device development, particularly for populations whose physical characteristics and living contexts differ from the primary design targets of commercial products. The documented mismatches between Thai elderly anthropometry and standard walking aid dimensions suggest that manufacturing specifications should be adapted for different regional markets rather than applying a universal design approach.

The emphasis on safety and stability aligns with the primary clinical purpose of walking aids — fall prevention — and suggests that older adults are pragmatic about their device requirements. However, the importance placed on aesthetics, foldability, and lightweight design reflects the broader social and practical context in which walking aids are used and underscores the need for designs that balance clinical function with user acceptability and lifestyle compatibility.

Limitations

The study was conducted primarily in urban Bangkok, and findings may not fully represent the needs and preferences of rural Thai older adults who may face different environmental challenges and have different cultural expectations. The sample size, while adequate for identifying major design themes, may not capture the full diversity of needs within the older adult population. The study focused on user preferences rather than objective biomechanical outcomes, so the relationship between preferred design features and actual fall prevention effectiveness was not assessed.

Implications

The research provides an evidence base for manufacturers, healthcare providers, and policymakers seeking to improve walking aid design for the Thai elderly population. The design guidelines derived from this study can inform product development, procurement specifications for healthcare institutions, and clinical prescription practices. As Thailand and other ASEAN nations invest in healthy ageing infrastructure, ensuring that assistive devices are designed for their intended populations is essential for maximising their public health impact.