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How to Choose the Mobility Device That Is Right for You (MS Society)

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How to Choose the Mobility Device That Is Right for You (MS Society) How to Choose the Mobility Device that is Right for You A guide for people with ms MANAGING MAJOR chANGES Jason (cover photo), diagnosed in 2005. Kim (top), diagnosed in 1986. John (second from top), diagnosed in 2001. ray (middle), diagnosed in 2003. michael (second from bottom), diagnosed in 2004. ginny (bottom), diagnosed in 1990. How to Choose the Mobility Device that is Right for You A guide for people with ms MANAGING MAJOR chANGES Consumer Guideline Panel Members Ana Souza, MS human engineering research laboratories, department of Veterans Affairs, pittsburgh pA rehabilitation science and technology department, university of pittsburgh, pittsburgh pA Annmarie Kelleher, OTR/L, MS human engineering research laboratories, department of Veterans Affairs, pittsburgh pA rehabilitation science and technology department, university of pittsburgh, pittsburgh pA Rosemarie Cooper, MPT human engineering research laboratories, department of Veterans Affairs, pittsburgh pA rehabilitation science and technology department, university of pittsburgh, pittsburgh pA Lisa I Iezzoni, MD, MSc harvard medical school, Boston, mA institute for health policy, massachusetts general hospital, Boston, mA Rory A. Cooper, PhD human engineering research laboratories, department of Veterans Affairs, pittsburgh pA rehabilitation science and technology department, university of pittsburgh, pittsburgh pA this publication is supported by contributions to the National ms society from its members and friends. reviewed by members of the Client education Committee of the National multiple sclerosis society’s Clinical Advisory Board. © 2013 NAtional MS soCiety. All rights reser Ved. Contents who should read this guide? ............................................................................................................................2 why is this guide valuable? ...............................................................................................................................2 what is multiple sclerosis? ................................................................................................................................2 what are common ms symptoms that affect mobility? ................................................................................3 what common ms symptoms can increase your risk for falls & decrease your independence in activities of daily living (Adls)? ................................................................3 what types of assistive & mobility devices are available? .............................................................................4 orthoses (braces) ........................................................................................................................................5 functional electrical stimulation (fes) .....................................................................................................6 Canes .............................................................................................................................................................7 Crutches ........................................................................................................................................................8 walkers and wheeled walkers (rollators) ................................................................................................10 manual wheelchairs ...................................................................................................................................11 pushrim-activated power-assist wheelchairs (pApAw) ........................................................................14 motorized scooters....................................................................................................................................15 power wheelchairs .....................................................................................................................................17 what is involved in assistive technology service delivery? ..........................................................................22 who are assistive technology professionals? ..........................................................................................22 what does a typical evaluation for a wheeled mobility device include? .............................................23 where can i find an assistive technology professional? .........................................................................24 what can i do to prepare for a mobility device evaluation? .................................................................25 final remarks ....................................................................................................................................................26 Notes .................................................................................................................................................................27 1 | How to Choose the Mobility Device that is Right for You The purpose of this guide is to help Who should you become familiar with the types of read this guide? equipment (assistive and mobility devices) that are currently available to enhance your n People with multiple sclerosis (ms) mobility, and the potential benefits and n Family, friends, personal care attendants, and limitations of each one. The guide serves others who help you with your personal care as a resource for you and your healthcare provider to assist you in choosing the right n Medical and rehabilitation providers with whom you come in contact, including mobility device for you. We recommend physicians, nurses, occupational therapists, that you take this guide with you to your physical therapists, rehabilitation engineers, appointment with your healthcare providers and assistive technology suppliers when looking for the mobility device that n Anyone who is interested in learning more best meets your needs. about mobility options for people with ms What is Why is this multiple sclerosis? guide valuable? Multiple sclerosis (or MS) is a chronic, often n Eighty percent of people with ms experience disabling disease that attacks the central problems with walking within 10–15 years of nervous system (CNS), which is made up disease onset. of the brain, spinal cord, and optic nerves. n Common symptoms of ms, including weakness People with MS typically experience one of (decreased strength), poor balance, spasticity four disease courses — relapsing-remitting, (increased muscle stiffness or tone), and primary-progressive, secondary-progressive, or fatigue (feeling of tiredness), can increase progressive relapsing — each of which might your risk for falls. be mild, moderate, or severe. Depending on n Many falls can be prevented with the use of the disease course a person has, symptoms the appropriate mobility device. can come and go, come and stay, or progress n Safety and independence can be enhanced more steadily over time. The progress, severity, with the use of the right mobility device. and specific symptoms of SM are unpredictable n Mobility devices can help to conserve energy and vary from one person to another. and increase activity levels. Managing Major Changes | 2 The National MS Society can help you find month. The progressive nature of SM — a physician and other healthcare providers with exacerbations (also called attacks or with MS expertise in your area, answer your relapses that cause a sudden onset of new questions, and direct you to resources in symptoms or worsening of old symptoms) your community. Call 1-800-344-4867 or and remissions (in which symptoms return email [email protected] to connect to their previous level or stabilize) — may with an MS Navigator®. make it difficult to adjust to changes in your mobility. However adjusting to these changes is essential for your safety and comfort. What are common MS symptoms that What common affect mobility? MS symptoms can Common symptoms of MS that can affect increase your risk your ability to walk safely, independently, and efficiently include: for falls & decrease n Muscle weakness your independence n Pain in activities of daily n Loss of balance n Poor coordination living (ADLs)? n Numbness/tingling in your feet and legs All of the symptoms listed above can increase n Extreme fatigue or feelings of tiredness your risk of falls. Fatigue is one of the most n Increased muscle tone or stiffness (spasticity) common and disabling symptoms of MS. MS n Impaired vision fatigue — also referred to as lassitude — is n Cognitive difficulties a feeling of extreme tiredness or exhaustion that can affect your physical and mental The course of SM is unpredictable and functioning. Approximately 80% of people the severity of symptoms and the rate with MS report having fatigue on a regular of progression vary from one person basis — and this fatigue can directly affect to another. For any given individual, your ability to walk and increase your risk symptoms can vary over the course of a of falls. day and from week to week or month to 3 | How to Choose the Mobility Device that is Right for You Falls can cause secondary problems such as Without the proper devices, your mobility bone fractures, hospitalization, and possibly problems are likely to interfere with your increase your dependency on others. Having participation in home, work, family, social a fear of falling can limit your willingness and leisure activities. to go out in the community independently, A large number of assistive and mobility which can increase your frustration level and devices
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