Japanese Silver Cars vs. Swedish Rollators | A PT's Perspective on the Differences in Walking Aids
One common sight in Japan is
an elderly woman with a hunched back
walking while pushing a 'silver car' (shopping cart walker).
I see them often on the streets and in hospitals.
However, in Sweden,
you rarely see these silver cars.
What you see instead is
a 'rollator,' which you walk with
by placing your body inside the frame.
This walking aid, also known in Japan by the product name 'Happy',
is generally called
a 'Rollator'in Sweden.
Why is this the mainstream choice in Sweden?
Actually, it was born in Sweden
Surprisingly,
the modern rollator originated in Sweden.
It was invented in 1978 by Aina Wifalk, a Swedish woman who suffered from polio.
It has been rooted in daily life in her home country for over 40 years,
and the recognition that 'a tool to assist walking = a rollator'
is completely established in Sweden.
What is the difference between a silver car and a rollator?
Although they look similar,
their purpose and structure are fundamentally different.
The silver car
is primarily intended for carrying luggage,
with walking assistance being a secondary role.
Because of its structure, which you push in front of your body,
it naturally tends to cause a forward-leaning posture (hunchback).
Since you barely use your core muscles,
continued use leads to muscle weakness,
creating a vicious cycle where the back becomes even more hunched.
On the other hand, the rollator
is designed for you to place your body inside the frame
and walk with your back straight.
Because you can walk while properly using your core and leg muscles,
it leads to the maintenance of walking function.
From a PT's perspective,
I feel that the rollator is overwhelmingly superior
for maintaining walking function and core strength.
Is it 'I use a silver car because my back is hunched' or
'My back is hunched because I use a silver car'?
The answer is that 'both are true'.
People who originally started to hunch due to osteoporosis, compression fractures, or lumbar spinal stenosis begin using a silver car,
and as a result, their core function declines further,
causing the hunching to progress...
a negative spiral is occurring.
While silver cars
are convenient for temporary relief or carrying luggage,
relying on them too much accelerates the decline of core function.
Actually, Japanese people are an ethnic group whose backs tend to hunch easily
Speaking from a slightly more professional PT perspective here,
due to the characteristics of their skeletal structure,
Japanese people are an ethnic group that tends to hunch easily compared to the rest of the world.
There are three main reasons for this.
One ispelvic orientation.
While Westerners tend to have an anterior pelvic tilt,
which makes it easier to maintain a posture with the buttocks lifted,
Japanese people tend to have a posterior pelvic tilt,
which causes the back to hunch and the head to protrude forward.
The second isback muscle mass.
Compared to Westerners, Japanese people have thinner bodies
and tend to have less muscle mass on the back.
They cannot support the weight of the head, which is about 5kg, with their back muscles,
and the back tends to hunch over time.
The third isthe DNA of an agrarian people.
While Western hunter-gatherer peoples focused on movements that used back muscles, such as drawing bows or throwing spears,
Japanese people spent hundreds of years doing tasks that required bending forward at the waist, such as rice planting and weeding.
It is said that the habit of a posture where the front muscles easily tense up
is easily established at the DNA level.
Floor-based living and floor chairs accelerate hunching
Furthermore, unique Japanese lifestyle habits have a significant impact.
Living on the floor and using floor chairs are factors that
accelerate pelvic posterior tilt and hunched posture.
Sitting directly on the floor—whether cross-legged, sitting on one's heels, or with legs sprawled—
structurally makes it very easy for the pelvis to tilt backward.
The only exception is formal kneeling (seiza), but
for modern elderly people, it places a heavy burden on the knees and ankles,
so in the end, most people end up sitting cross-legged or with their legs to the side.
Floor chairs and low-profile sofas are actually something to watch out for as well.
You might think, 'It's safe because it has a backrest,' but
it is easy to slip forward and lean back with a rounded spine,
resulting in a 'slumped sitting' posture,
and seats that are too soft cause the hips to sink in,
locking the pelvis in place.
If this state continues,
you will find that you cannot straighten your lower back even when you stand up.
In Sweden, life revolves around using chairs.
Living daily life with the pelvis in a naturally upright position
may be one of the reasons why they can maintain an upright posture
even in old age.
When 'Japanese people, whose backs are already prone to rounding,'
use a silver car (Japanese-style walker) daily
while also dealing with age-related muscle weakness,
it only further accelerates the rounding of the back.
Rollators are actually better for those with pelvic posterior tilt
There are three major benefits for people with a posteriorly tilted pelvis
to use a rollator.
Maintain a beautiful standing posture
A rollator has a U-shaped frame that
allows the body to fit inside,
positioning your pelvis directly above the wheels.
Because of this, you can walk
while keeping your pelvis in a neutral position as much as possible
without letting it tilt backward.
Since you don't have to push it in front of your body like a silver car,
you can prevent your pelvis from tilting further backward.
Reduces neck and shoulder pain
When the pelvis tilts backward, the head juts forward,
concentrating the entire weight of the head—about 5kg—on the neck and back.
Using a rollator places the grips right beside your body,
allowing you to bend your elbows slightly and rest your weight straight down.
This makes it easier to align the pelvis, spine, and head along a single axis,
relieving tension in the neck and back muscles,
and significantly reducing fatigue while walking.
Lowers the risk of tripping and falling
When the pelvis tilts backward, the hip joints become harder to extend,
leading to a shuffling, short-stepped gait.
This is a major cause of falls.
Using a rollator helps the pelvis rise up,
naturally directing your gaze forward.
Because your field of vision widens, you can notice obstacles and steps sooner,
dramatically increasing safety.
Why are rollators so common in Sweden?
There are several reasons.
First, they are loaned out for free.In Sweden,
rollators are positioned as medical and rehabilitation assistive devices,
and when walking becomes slightly unstable,
they are basically loaned out for free
after a fitting by a physical therapist or similar professional.
There is no need to go out and purchase a silver car individually.
Next is the issue of road conditions and physique.On cobblestone streets or roads covered in snow and ice during winter,
the small wheels of a silver car would get stuck.
The large rubber wheels of a rollator can navigate these safely.
Also, there is the reason that
lightweight frames like those of silver cars lack the strength
to support the larger-framed elderly people in Northern Europe.
And above all,
**the welfare philosophy that prioritizes 'independence'**
In Sweden,
the highest priority is placed on elderly people continuing to live on their own power as much as possible. Rollators are actively recommended by professionals as medical welfare equipment to prevent bedridden states and help people keep walking on their own feet.
In Sweden, rollators are seen as positive tools
In Japan, the word 'rollator' might give some people the image of
'I can no longer walk on my own.'
But in Sweden,
it is not viewed as a negative tool one step away from a wheelchair, but rather
**'a partner for walking freely, like a bicycle'**
and is perceived positively.
In Sweden, there are many elderly people who walk briskly
with their backs straight.
I feel that behind that is a culture that values 'independence'
even in the choice of tools.
This time, I ended up talking only from a PT's perspective, didn't I?
Thank you for reading until the end.
KANAKO