## 4 Discussion  
In this study, we developed and tested a smart walker prototype for monitoring gait along with providing support to users with walking disabilities. We found statistical differences in spatiotemporal gait parameters comparing people in Karachi, Pakistan, aged 50 to 90 years with and without osteoporosis. The smart walker does not need specific clothes, infrastructure, treadmills, or wearable devices. It can be used daily to assess the efficacy of therapeutic interventions provided by a physical therapist during rehabilitation process at home through self-monitoring of the number of force peaks recorded at a fixed distance. As the user's gait improves, the number of steps taken will decrease while the length of their stride will increase. The recorded data can be electronically shared with the therapist for evaluation to guide future follow-up sessions. Figure 10: Average walking speed of people with and without osteoporosis. Figure 9: Graphical representation of spatiotemporal gait parameters of people with and without osteoporosis. (**a**) Average right step length, (**b**) average left step length, (**c**) average stride length, and (**d**) average cadence. The gait parameters were highly affected in participants with osteoporosis compared with healthy users. It was seen that healthy adults in the age range of 50 to 90 years who do not have any significant chronic health conditions have a greater stride length, step length, cadence, and walking velocity; moreover, the stride time and average step time were lower compared with those of the osteopororotic participants because a healthy adult participant would have little or no fear of falling [35]. Thereby, people without osteoporosis took longer and a smaller number of steps to cover the 10 m marked distance compared with people with osteoporosis. The data acquired by our prototype are in accordance with the previous literature. For example, short maximal step length and slow 10 m walking speed are associated with osteoporosis in elderly women [36]. Pain due to osteoporosis may also be a factor affecting in altering spatiotemporal gait parameters. Most of our participants with osteoporosis expressed that they have trouble walking at a brisk pace and take short strides due to pain in their lower limbs while walking. Out of these patients, 16 were unable to provide us with three consecutive walk tests on the same day for the purpose of obtaining an average reading. As a result, we allocated three days to each of these patients, conducting one test per day. A primary purpose of a standard walker is partial weight bearing of the user [37]. It was observed that the people with osteoporosis put more force on the walker while walking, in comparison to the people without osteoporosis. Since the metabolic cost of using a four-footed walker is already high [38], in the absence of any preliminary data, we cannot make a conclusive deduction. It is possible that the damage done to the bones and joints by osteoporosis increases the overall metabolic cost of walking and thus increases the force applied on our smart walker even higher [16]. Further research can explore if any correlation exists between osteoporosis and increased weight bearing. The advantages of our proposed system include that it is portable, can be used anywhere at any time, and is economical. It has been validated with both healthy and unhealthy participants, and tests have successfully shown that the resulting gait parameters are consistent with those obtained from clinical studies. The results of our methodology are relevant to the diagnosis of people with osteoporosis by therapists. The system is easy to operate at home, allowing the user to avoid daily trips to the clinic for monitoring and enabling the recorded data to be saved according to date. By daily monitoring of the user's gait parameters, a clinician can assess the effectiveness of recommended treatment plans on a daily and weekly basis and make informed decisions about the best course of treatment for people with osteoporosis.