Push Carts and Your Back: What’s the Difference Between a “Silver Car” and a Walker?
Written by: 栗原 俊介 (Welfare Equipment Planner and Welfare Equipment Specialist Advisor)
Look around any town in Japan and you’re sure to see older people walking along pushing a cart. In fact, these push carts fall broadly into two types: the “silver car” (a wheeled shopping cart for seniors) and the walker (a wheeled walker, also known as a rollator).
They look almost the same, but surprisingly few people know that they differ in purpose, in who they are for, and in how they affect the body. That is why silver cars are not covered by Japan’s long-term care insurance; only walkers are. In this column, I’ll introduce these two tools, which look alike but are completely different.
A silver car is for people who can walk independently
Silver cars are intended for “people who can walk independently.” A silver car helps such people walk more steadily by letting them carry belongings and sit down when they need a rest. Put crudely, a silver car is a close relative of the hand cart.
How would you feel if you saw someone who is unsteady on their feet walking while pushing a hand cart? It would make you nervous just to watch, wouldn’t it? In other words, people who cannot walk without a silver car are no longer the people silver cars are meant for.
A walker is welfare equipment built to support body weight
The welfare equipment intended for people who are unsteady on their feet is the walker. Part of the official definition of a walker in Japan reads: “equipment that supplements the walking function of people who have difficulty walking and is built to support body weight during movement.” In other words, it must be built to bear the weight of someone who is unsteady and likely to fall, in place of their own body.
Put the other way around, a silver car has no such function. Used correctly, a walker is built so that it is unlikely to tip over even if the user loses their balance sideways, but a silver car easily topples sideways along with the user. What’s more, falling together with a silver car is more likely to cause injury than falling on your own, so even more care is needed.
Choose tools by suitability, not by “good” or “bad”
Hearing this, some may say, “So silver cars are bad tools and walkers are good ones!”, but that is not the case at all. All tools, including welfare equipment and care products, need to be chosen not by whether they are good or bad, but by whether they are suitable.
Nobody uses scissors to peel potatoes, right? Scissors have blades, but if you tried to peel a potato with them, it would be awkward and you might hurt yourself. On the other hand, more and more people now use scissors to cut meat. With everyday tools, we unconsciously judge whether they suit the purpose before choosing them.
Silver cars and walkers are tools in just the same way. It is important to choose by considering what the tool will be used for and whether it suits the user’s condition. If you or your family can’t decide, consult your local Community General Support Center (the name varies by municipality) or a qualified professional such as a welfare equipment specialist advisor.
How to tell them apart: the handle
Next, let me explain how to tell the two apart and what characterizes each. The easiest point to spot is the handle: whether it is a single crosswise bar, like on a hand cart, or a pair of grips on either side, like on a bicycle. Products with a crosswise bar are silver cars, and those with side grips are walkers (though not in every case).
A different handle changes where the user’s hands go. In other words, it changes the user’s walking posture. This is one of the factors that determine whether a product is covered by long-term care insurance.
A crosswise handle (silver car) encourages a hunched back
Holding a crosswise handle draws the shoulders inward and rounds the back into a hunch. Picture your posture when pushing a hand cart. Because a silver car has the same structure as a hand cart, the user’s posture ends up the same.
We sometimes get requests to raise the handle of a silver car “because walking hunched over is bad.” But even if the handle is raised, the arms still reach forward and the shoulders draw inward when walking, so the structure inevitably leads to a hunched posture.
Side grips (walker) let you walk with a straight back
A walker with side grips, on the other hand, lets you keep your hands at your sides. Walking with your hands in that position lets you open your chest and walk with your back straight.
In this position, the body’s center of gravity also falls within the walker’s “base of support,” so you can walk steadily. The base of support is the area formed by connecting the wheels or legs of a walker or silver car with lines; when the user’s center of gravity is inside it, the device is less likely to tip over and stays stable. Silver cars and hand carts are built so that the user’s center of gravity cannot fall inside the base of support, which is why they topple over together with the user.
In short, a walker is built so that, used correctly, it lets you walk safely with good posture. However, having the walker on both sides of your body also means it is at least a size bigger than your body. It can never be compact and lightweight. That makes it unsuitable if you want to use it in narrow places with many steps, so in addition to the purpose and the user’s physical condition, where it will be used is also an important consideration.
Round your back, straighten your back: vary your posture
How we spend our days affects the body in many ways. If you spend your days hunched over, your back stiffens in a rounded shape, a condition called kyphosis (a rounded upper back). A kyphotic posture contributes to many problems, such as falls, aspiration pneumonia and pressure sores.
Preventing kyphosis through how you spend your days helps prevent problems that might occur in the future. If you often walk somewhat hunched over with a silver car, I hope you will consciously take on a variety of postures over the 24 hours of the day, rounding and straightening your back, for example by building back-stretching movements into your daily life.
Reference
About the author: 栗原 俊介 (Welfare Equipment Planner and Welfare Equipment Specialist Advisor)
This article is a contribution from a medical or care professional, re-edited by our editorial team. It provides general information as of the time of writing, and symptoms and circumstances differ from person to person. For specific decisions, please consult your doctor, dentist, pharmacist or another professional.
This is an English translation of a column originally published in Japanese by Next Co., Ltd.
About Next Co., Ltd. We are a Tokyo-based company working in Japan’s senior care and end-of-life planning field. Alongside these expert columns, we publish professional training textbooks and support businesses entering Japan’s eldercare market. More expert columns | Our English textbook | Contact us
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