# Exploring the Influence of a Novel App for Training and Evaluating Walking Aid Skills in Walking Aid Users: Protocol for a Pragmatic Single-Blind Randomized Controlled Trial

## TL;DR

This study tests a new app to train people how to safely use walking aids, aiming to improve balance confidence and mobility.

## Contribution

The novel ICanWALK app uses interactive video feedback to train walking aid users, with a focus on balance confidence and mobility outcomes.

## Key findings

- The study will assess whether the ICanWALK app improves balance confidence in walking aid users.
- Mobility and knowledge of walking aid use will be evaluated as secondary outcomes.
- A feasibility study has already enrolled 26 participants who completed all assessment time points.

## Abstract

More than 12% of the world’s population and more than 1 million Canadians use walking aids to support mobility. Unsafe use of walking aids due to a lack of training may lead to injuries and an increased risk of falls. A novel interactive video-based feedback mobile app to train walking aid fitting and safe use, called ICanWALK (Improving Canadians’ Walking Aid Skills, Learning, and Knowledge), was recently developed.

The primary objective of this study is to explore the efficacy of the walking aid skills training app on the balance confidence of walking aid users. The secondary objective is to explore the influence of the mobile app on mobility and knowledge of walking aid users.

A 2-site single-blind pragmatic randomized controlled trial is proposed. A total of 52 adults who use walking aids will be recruited through clinical and community organizations. Participants will complete measures of balance confidence (Activities-specific Balance Confidence scale; the primary outcome), mobility (6-Minute Walk Test and Timed Up and Go test), walking aid skills (Walking Aids Skills Test, WAST), and knowledge of and confidence in walking aid fit and use (self-reported questionnaire) at baseline (T1). 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 2 to 4 days after the intervention (T2) and again 4 weeks later (T3). Analysis of covariance will be performed for primary and secondary outcomes by using SPSS software.

The study protocols were approved by the institutional review boards of both recruitment sites in 2023 and 2024. A feasibility study was conducted from 2023 to 2024 across the 2 sites. As of November 2025, participant recruitment is ongoing and expected to conclude in December 2026. To date, 26 individuals have been enrolled and have successfully completed all 3 assessment time points: T1, T2, and T3.

Using a video-based feedback training approach, a novel app is hypothesized to improve balance confidence, mobility, and knowledge of and confidence in walking aid fitting and use. This structured educational program for fitting and training of walking aids may improve balance confidence. Better walking aid fitting and use may improve mobility, especially for older adults, thereby increasing independence and social participation. Establishing efficacy is an important first step before exploring how the ICanWALK app may be used by walking aid users and clinicians in clinical and community settings.

ClinicalTrials.gov NCT05347875; https://clinicaltrials.gov/study/NCT05347875

DERR1-10.2196/71060