Mobility Independence and Safety
Written by Patricia G. Provance, PT, MSCS
Part III: Wheeled Mobility
Part I of this series focused on ambulation issues and Part II outlined the importance of exercise. These appeared in the Fall 2008 and Winter/Spring 2009 issues of The Motivator, respectively. In this third and final segment, we will discuss the many complex considerations related to wheeled mobility.
It is not possible to include all of the options in a short article, so the emphasis here will be on outlining the many factors to be considered, the pros and cons of each type of equipment, and resources to further your education. Individuals with MS who require wheeled mobility most or all of the time should be evaluated by a seating specialist, usually a physical therapist (PT) or occupational therapist (OT) with extensive training in this area. Preferably, this should be done in a "seating clinic," also attended by a family member and/or care partner, along with a rehabilitation technology supplier (RTS) representing a durable medical equipment company. This will help ensure that the most appropriate device is prescribed for each individual situation. It is also important to keep in mind the often progressive nature of MS, and the fact that funding sources usually dictate that a chair last for five to seven years.
Factors that need to be considered are:
Standard - Lower-end, basic wheelchairs with folding frames, but limited adjustability. Not recommended for a full-time wheelchair user, but can be used as a back-up chair for easier transport in a car or van.
Power Mobility Devices
Folding Power Wheelchairs - Heavy models have some seating options but are difficult to transport. Lighter models give less support.
Power-Assist and Conversion Units - These are devices that can be added on to manual wheelchairs to augment a person's ability to propel the chair. Portable by car, but expensive and do not have power seating options.
Standing Wheelchairs - Provides the psychological benefit of being upright. Allows weight bearing through the legs, pressure relief, and muscle stretch, while building endurance. Also improves circulation, digestion, elimination, and respiratory function. However, these are very expensive and funding is difficult.
Environment and Lifestyle
Although we expect that the need for wheelchairs will diminish in the coming years since the introduction of disease-modifying therapies, historically, it has been estimated that 25 percent of people with MS will eventually need to use a wheelchair (usually power) full time for mobility, while 60 percent will be part-time users of wheelchairs (usually manual) or scooters for travel, shopping, and outdoor activities.
Proper planning is essential to avoid a poor match, so it's important to resist the temptation of easy access via television and internet offers - some sounding "too good to be true!"
Take the time to consider:
Wheeled mobility, whether full or part time, can broaden horizons and provide a huge boost to functional independence and quality of life. Hopefully this overview will be helpful in the important planning process that is essential for a positive outcome. Resources on the next page should help provide additional references, but should not take the place of an evaluation by a seating specialist. A world on wheels is indeed a bigger world!
Please note that MSAA does not endorse or recommend any specific product or brand mentioned in our articles or advertising.
21st Century Scientific, Inc.
Abbey Home Elevator
Able to Travel
Accessible Design and Consulting
American Ramp Systems
Bruno Independent Living Aids, Inc
Frank Mobility Systems
LifeStand (A Permobil Inc. Company)
Pride Mobility Products Corp.
Redman Power Chair
Rehabilitation Engineering and Assistive Technology Society of North America
The Home Wheelchair Ramp Project
United States Access Board
Wheelchair Getaways(Accessible Van Rentals)
Reference: International Journal of MS Care
This article is one of a series of three that have been written and generously provided to MSAA by Patricia G. Provance, PT, MSCS. Pat is an esteemed member of MSAA's Healthcare Advisory Council. Pat has 37 years of experience in physical rehabilitation, having been in clinical practice since 1971. In 1982, she started the first MS Rehabilitation Program in Maryland at The Union Memorial Hospital, in addition to her orthopedic caseload. In 2000, Pat joined the University of Maryland Medical System at Kernan Hospital to dedicate her practice to MS, and continued as a clinical consultant with the Maryland Center for MS until her semi-retirement in December 2006. She became an MS Certified Specialist in 2005 and continues as a clinical consultant with the National Multiple Sclerosis Society. Pat is also an active member of The Consortium of Multiple Sclerosis Centers. She currently is teaching and consulting on MS care to patients and professionals throughout the country. Publications include the clinical bulletin, "Physical Therapy in Multiple Sclerosis Rehabilitation," and co-authorship of the textbook, Muscles, Testing and Function with Posture and Pain, 4th and 5th editions.
MSAA expresses sincere appreciation to Pat for her many contributions of her time and expertise to our organization and the individuals we serve, including this valuable series of articles on mobility independence and safety.
Gratitude is also extended to 21st Century Scientific, Inc. for providing some of the photographs used in this article.Back
|Last Updated on Monday, 25 March 2013 11:51|