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Gait and Post-Polio Similarly, problems in the arms may make using two-sided devices Marianne Weiss, MS, PT such as walkers, two crutches, or Wheeling Jesuit University, Wheeling, West Virginia two canes difficult, if not impossi- ble. The trick is to find the device -that provides enough assistance Falls are a chief cause of death Some signs that can help you to compensate for the physical and increased disability in this answer those questions are these: abnormality without causing other country. Among the physical lessening endurance for walking physical problems. problems leading to falls are loss due to muscle fatigue, worsening Sometimes the evaluation reveals of balance, overall fatigue, repeti- of a limp, pain in the legs during too much disability for the sur- tive motion leading to individual walking, a history of falls, or the vivor to benefit from an assistive muscle fatigue, weak muscles, recent occurrence of new falls.* gait device. This finding can free and abnormalities in gait.' Many If you suspect that you need an the survivor to make the decision polio survivors exhibit one or assistive device in walking or a to walk only in the home and to more of these problems. Using new type, discuss the matter with use motorized conveyances to assistive devices for walking can your doctor, who will probably move about in the community. reduce the severity of these refer you to a physical therapist Many who become motorized are abnormalities or reduce the effect for an evaluation. pleasantly surprised to find how that they have on the lives of The therapist will then assess: easily they can participate in com- polio survivors. how your strength and flexibility munity activities again and how Some survivors have used assistive affect your ability to walk and to much more energy they have gait devices for many years. get up and down from a seated after they make the decision to Others used them only in the position; whether you have ride rather than walk outside acute stage of recovery after enough upper body strength and their homes. polio, while others never used flexibility to safely and effectively If the evaluation reveals that an them. How do you know if you use an assistive device; how good assistive device would improve need an assistive device for walk- your balance is3; and how your your gait, the therapist will recom- ing or if you need to change the heart and lungs react to walking. mend a specific device, assist you one you have? In many cases, the use of an assis- in obtaining it, fit it to you, teach tive device reduces the strain on you how to use it, and assess its the heart and lungs because the effectiveness in meeting the goal MARlANNE T. WEISS, MS, PT device uses less energy than, for for which it was recommended. has been practicing physical thera- example, the limp it corrects. Frequently the therapist may also py for 20 years. She hold a BS in However, in some cases, using an recommend a gen t le exercise assistive device may be more tax- Allied Health Professions (physical program of strengthening and ing on the heart and lungs than therapy) from The Ohio State stretching to further assist your walking without a de~ice.~If this University and a post-professional walking efforts. Certain types is the case, the assistive device of braces or splints may also be MS in physical therapy from the that the therapist recommends recommended. 5,6 University of Indianapolis. She has may be an electric scooter or experience working in many set- motorized wheelchair. In working with polio survivors for the last 15 years, I have seen tings including hospitals, nursing Finding an appropriate assistive many of them helped significantly homes, home health agencies, and device for walking for polio sur- by their using appropriate assis- private practices. She has directed vivors can be a challenge. If a tive devices for walking. The person has a one-sided problem a physical therapist assistant devices can help reduce pain and in the legs, usually a one-sided educational program, and she fatigue and reduce limping. And, device, such as a cane or a single currently is an assistant professor of course, all of this leads to a crutch, is indicated (most often of physical therapy at Wheeling reduction in the incidence of falls used in the hand opposite the - resulting in less chance of Jesuit University in Wheeling, West affected leg). However, abnormali- more serious disability or even Virginia. She has treated polio ties of strength, pain, or flexibility premature death. survivors since 1982. in the arms may make using a one-sided device impossible.

8 POLIO NETWORKNEWS H WINTERI 998, VOL. I 4, NO. I So, what are you waiting for? If "As of 1996, the only ones that you think an assistive device might have that option are GM cars. For 'designerwarm ad make your life easier, start the Call your GM dealer or the GM ualking sticks, contact: process described above by obtain- Mobility Assistance Hotline at ing your physician's opinion. 800/323-9935. The Harrls Company . "Another option is to buy a four-door Penny and Bob Harris References car with a bench or split front seat 29 Dennison Avenue, 1. Shumway-Cook A. and Woolacott M. and put the chair in a car-top carrier Swam pscott, MA (Massachusetts) (1995).Motor control, theory and on the roof. Whoever installs hand 01 907 (Jan-May) or applications. Philadelphia: Williams controls, etc. in your area would have (May-Dec) 16040 Loch Katrine Trail, and Wilkins. that information." #7805, Delray Beach, FL (Florida) 2. Pierson F. (1994). Principles and Alice, Ohio 33446 techniques of patient care. Philadelphia: Williams and Wilkins. Resources Contact them at 8001943-5646, access 3. Minor MA and Minor SD. (1995). 41 or www.wal kingstickcom. Patient care skills. Norwalk, CT: For a free, state-specific information Appleton and Lange. packet and details about the GM Prompted by his wife's wish to have more fashionable crutches during her 4. Perry J. (1992).Gait analysis. Mobility reimbursement program, Thorofare, NJ: Slack, Inc. contact: GM Mobility Assistance recuperation from hip surgery, "retired" Center, P.O. Box 9011, Detroit, MI women's shoe designer Bob Harris deco- 5. Smith LK and Mabry M. (1995).Polio- rated a pair with red-white-and-blue myelitis and the post polio syndrome. In (Michigan) 48202 (800/323-9935 bunting. When then First Lady Barbara Umphred D (Ed.),Neurological rehabilita- voice, 800/833-9935 TTY, or Bush broke her leg, Bob sent a decorated tion. 3rd ed. Philadelphia: Mosby. 313/974-4383 fax). 6. O'Sullivan SB and Schmitz TJ. (1995). pair to her, which resulted in a story Physical rehabilitation: assessment According to the GM literature, sever- printed in The Boston Globe. Thus began and treatment. 3rd ed. Philadelphia: al two-door models of Chevrolet a new career for the designer, who now FA Davis. and Pontiac and a fewer number of creates handcrafted canes of selected two-door models of Buick, Geo, woods and finishes, also available in a Oldsmobile, and Cadillac can accom- wide variety of scotch-guarded fabrics modate a typical adult folding wheel- and coverings. chair in either the back seat or trunk. readers respalrd Numerous four-door models can nuusti ur unms From Polio Network News, accommodate the wheelchair in the Mailing Address: P.O. Box 574, Volume 13, No. 3: trunk only. They also provide a listing Shipping Address: 767 Old Onion Mt. of vans and light trucks which are "Can anyone offer suggestions as Road, Wilderville, OR (Oregon) 97543 wheelchair and electric scooter (5411476-4094,5411955-8820 fax, or to which is the best car to purchase compatible. for putting a wheelchair in the [email protected]) back seat?" The GM Mobility Assistance Program Mark Fontaine has made over 18,000 Ed, Missouri offers financial reimbursement (up to canes in 18 years. The single point wnndon ran0 with tho nff-cot T nr norhv $1,000) towards adaptations on new ..VVIb.. -... .b .. ... I .. .b VI I a-. I "I --I Y, "We like our '93 Plymouth Vista and unused vehicles. Contact them handle is his specialty, but other shaped made by Mitsubishi, sold by Plymouth for details including mobility equip- handles and even ready-made canes dealers as Vista and Eagle Summit. ment installers, driver assessment are available. It is a mini mini-van looking vehicle facilities, state rehabilitation services, with all-wheel drive and a low loading and driver licensing offices, etc. For "designerwcrutches and height. The wheelchair stands upright For similar information, contact behind the rear seat. Unfortunately, other uama#s, contact: Ford Mobility Motoring Program the last year of importation was Headquarters, P.O. Box 529, 1996. You may be able to find an Walk Easy, Inc. Bloomfield Hills, MI (Michigan) older model still with the guarantee." 291 5 South Congress Avenue, 48303-9857 (800/952-2248), or Delray Beach, FL (Florida) 33445 Paul, New York Chrysler Corporation's Auto- (8001441-2904) mobility Program Headquarters, "Most people think that they should P.O. Box 3 124, Bloomfield Hills, MI Walk Easy carries a full line of modern, buy a four-door car, however, a two- (Michigan) 48302-3124 (800/255- lightweight walking aids including door works much better because the 9877 voice, 800/922-3826 TTY, forearm and underarm crutches. door opens wider and is 'out of the or www.automobility. chrysler. com). Colors include blue, bronze, green, way' as you put your wheelchair in -- . . black, purple, white, yellow, several the back seat. " "neons," and several pastels. Carolyn, Florida