Selecting a Mobility Device
Author: Patricia Kennedy, RN, CNP, MSCN
Published: Jul 30, 2009 (Revised: Jan 16, 2010)
Abstract: More than 100000 people were treated in the US for injuries related to wheelchairs and other mobility devices last year alone.
Document Detail: In the past decade, the number of people injured while using a mobility device (cane, walker, wheelchair, scooter, etc.) has more than doubled. More than 100,000 people were treated in the US for injuries related to wheelchairs and other mobility devices last year alone, and the number of injuries is expected to increase in coming years.
In the past decade, the number of people injured while using a mobility device (cane, walker, wheelchair, scooter, etc.) has more than doubled. More than 100,000 people were treated in the US for injuries related to wheelchairs and other mobility devices last year alone, and the number of injuries is expected to increase in coming years. Often, the cause of these injuries is not malfunction of the device – but the fact that many people choose the wrong device for their needs or use them incorrectly.
Beth Bullard is an occupational therapist who volunteers her time to people living with multiple sclerosis (MS) at The Heuga Center for Multiple Sclerosis, a nationally-renowned organization that runs wellness programs to transform and improve the quality of life for people and families living with MS. Beth is also the Director of Case Management and Patient Assessment Information Coordinator at Northern Colorado Rehabilitation Hospital in Johnstown, CO. Bullard has worked with hundreds of patients with all kinds of disabilities, whether they are related to a degenerative disease like MS or injuries caused by accidents at the workplace. A primary focus of her job is to help people with walking impairment find and use the proper mobility device for their particular disability, placing a strong emphasis on device safety. In most cases, she finds that people with walking problems get injured because they do not seek advice about choosing a mobility device and, even making matters worse, do not learn how to use the device properly.
And that’s not the only problem that people living with MS face in their attempts to keep themselves mobile. Research has shown that many people who need the mobility devices don’t use them as much as they should, or even at all. A 2008 Harris Interactive survey of more than 1000 people with MS found that 37% were embarrassed to use their mobility device. Another 36% said they didn’t use their mobility device as often as they should. Without the use of mobility devices, people with disabilities face a much higher risk of getting injured through falls and other balance-related accidents.
These findings are especially troubling in light of the numbers of people with MS who experience mobility problems. Fully 64% of respondents in the survey reported that they have trouble walking at some point. The respondents overwhelmingly stated that the walking difficulties were very disruptive to their life as well.
To address some of these problems, Bullard has developed a special safety guide “checklist” for people to consider before choosing a mobility device. The guide covers how to select the right mobility device and how to care for and maintain the device. Her guidelines focus on the five issues in mobility devices that present the highest risks to users:
1) Use the right device.
In many cases, patients choose mobility devices on their own and without consulting with a doctor or other expert. Some people make purchasing decisions based on advertising or information on the Internet. Others may feel that they do not need any guidance when choosing the best mobility device for their needs. But such thinking can be dangerous. Using a device that is not appropriate (either because it provides too much or too little support) can cause a further decline in mobility for some patients.
“Everyone likes to maintain their independence, and choosing your own mobility device is a big part of that,” says Bullard. “But consulting a doctor or therapist is especially important for people affected by MS and other diseases and conditions where mobility can change from day to day.”
2) Train to use any mobility device correctly.
Before using a mobility device, patients should consider participating in a hospital or clinic based training course. Many home care companies are also able to provide instruction on the use of mobility devices. Recent advances in training techniques include the use of virtual reality technology as a tool to train people to properly use mobility devices.
“Whether they are using a cane or a motorized scooter, people need to take advantage of all the training they can get. Over the long run, it’s that training that will ensure a person’s safety and well-being,” says Bullard. “The best mobility device in the world isn’t going to help you at all if you don’t use it properly.”
3) Plan ahead.
While mobility devices can help you to remain independent, they often do require some changes to a normal routine. People with mobility devices should take time to think about the best route to use for their travel. They should try to travel during off-peak times and avoid areas of heavy traffic, busy roads, small sidewalks, construction sites and other areas where travel may be more challenging or risky.
“Sometimes all it takes is a crack in the sidewalk or a small pothole to cause someone with a mobility device to lose their balance and fall,” explains Bullard. “That’s why it’s so important for people with mobility devices to be aware of their environment and use careful planning to avoid travel problems.”
4) Avoid “Mobility under the Influence” (“MUI”).
Many medications can cause severe drowsiness and fatigue. Before operating a mobility device, patients should make sure that any meds they are using will not impair their ability to use a device safely.
“This is a big problem for mobility device users including seniors and people who are living with MS or other serious illnesses,” says Bullard. “Certain kinds of medications can cause drowsiness or a sudden drop in blood pressure that can lead to dizziness. That can cause further problems in judgment and other safety issues.”
5) Care for the mobility device.
For most mobility devices, routine maintenance and repairs can be completed at home by users and care providers. However, most mobility devices should have a professional service and maintenance check every six months or so, depending on rate of use.
“There are many simple adjustments or repairs that a patient or a caregiver can make to mobility devices,” says Bullard. “Little things like making sure all wheels are properly oiled and nuts and bolts are fully tightened can make a big difference in preventing falls or other accidents. But it is also very important to have professional maintenance service as needed to keep devices operating smoothly and safely.”