Assistive devices are commonly prescribed to compensate for gait impairments in individuals with neurological disorders. However, there are limited recommendations for prescribing these devices, and the effects of their use are poorly understood.

To investigate the immediate, short, and long-term effects of using conventional assistive devices on gait parameters in adults with neurological disorders.

This is an ongoing systematic review including experimental studies that investigated the effects of using conventional assistive devices (e.g., canes, crutches, and walkers) on the gait parameters (speed, cadence, step length and distance) of individuals with neurological disorders. Electronic searches were conducted in MEDLINE, Embase Ovid, PEDro, Scielo, CINAHL Database, LILACS, and gray literature. Two trained independent reviewers selected the studies, extracted the data, and assessed the methodological quality of the included studies using the Cochrane Risk of Bias (RoB2) tools. A third independent reviewer resolved disagreements. Meta-analyses were conducted when at least two homogeneous studies were available. The quality of the evidence was assessed (GRADE).

Twenty-three studies involving 450 participants were included. The neurological conditions included Alzheimer's Disease (AD), Huntington's Disease, Neuromuscular Disorders, Multiple Sclerosis (MS), Parkinson's Disease (PD), Spinal Cord Injury, and Stroke. About half of the studies had a high risk of bias. Most studies (n = 21; 92%) evaluated immediate effects, one study evaluated short-term effects (4%), and one study evaluated long-term effects (4%) of assistive device use. Most studies compared the gait with and without assistive devices (n = 19; 83%). The mean difference (MD) between test conditions was calculated for all studies and meta-analyses were conducted including individuals with AD, PD and stroke. According to the meta-analysis, the immediate use of assistive devices worsened or made no difference in the gait parameters of individuals with AD, PD and stroke (0.001 = p = 0.410) compared with gait without assistive devices. In individuals with stroke the immediate use of a single-point cane improved both gait speed (MD: 0.017 m/s, 95% CI: 0.025 to 0.090; p = 0.001) and distance (MD: 20.33 meters, 95% CI: 4.49 to 38.19, p = 0.012) compared to the four-point cane. Data from a single study about the long-term effects showed that the gait speed with a cane was 0.14 m/s (95% CI 0.05–0.23) higher in individuals with stroke who used the device daily for 30 days, compared to control individuals who performed stretching sessions.

Current evidence on the effects of assistive devices is mainly based on studies investigating immediate effects, showing no benefit or a worsening of gait parameters compared to gait without the device. In the long-term, daily use of a single-point cane increased gait speed with the cane in individuals with stroke after four weeks of intervention. Additionally, the use of the single-point cane was superior to the use of the four-point cane.

The time of training and the type of device should be considered when prescribing assistive devices. Future research should investigate the effects of training and device use in both the short and long-term. Results should be interpreted with caution until the study is completed.