One of the most common issues we encounter as neurological therapists is an impaired ability to move around in day to day life, whether it be getting to the bathroom, going shopping, or heading out and about with the family. Mobility is an important part of life, but for some clients walking isn’t necessarily practical or realistic, especially over long distances. In these situations, is there an alternative?
The simple answer is yes! Mobility aids such as wheelchairs and scooters can offer a great solution to mobility over short, medium or long distances, and lots of types of terrain. They can promote independence and improve quality of life by allowing access to a lot of aspects of life we simply can’t achieve without being mobile. An appropriate seating system can also be really beneficial towards therapy goals too. I see many clients in nursing homes who spend their days either in bed or in a water chair. As a rule, we physiotherapists aren’t a huge fan of the water chair – they’re basically like a big bucket chair that pretty much any person can be sat out in, but for most it’s very much like being in a mobile bed, and doesn’t really offer any benefit over being in bed. For anyone who has tried to manoeuvre them, they’re hard work to move about, so aren’t practical to further than from one room to another. All in all, not ideal.
Sitting out can offer so much more – a chance for a change of scenery, the ability to be more upright (which has additional benefits for those with swallowing or respiratory problems), more sensory stimulation and above all, the chance to be in a normal position or setting for interactions with others. It can also enable access to work, social and sporting activities.
There are wide range of seating options available, from lightweight, folding manual wheelchairs to purpose built sports chairs to power standing wheelchairs (yes, that’s right, a wheelchair that can stand you up!).
Technology is constantly improving and lighter, stronger, and more adaptable solutions are constantly evolving. Finding the most appropriate seating solution needs careful assessment, and I generally recommend to client’s to try it for more than just an hour to make sure it really meets all of their needs – take it for a test drive and see how it feels! If you’re not sure, try different options to see what works best for your needs. Adaptations to wheelchairs can often be made in the form of supports to stop a person leaning to one side, alternative back rests, alternative cushions for different pressure relief needs, different types of headrests, foot plates that can elevate, different types of brakes, special arm rests to keep an arm in position…the list is endless! One of the most useful features in a wheelchair, particularly for those with very limited mobility or ability to sit is a feature called tilt and space. This means instead of the backrest reclining the whole chair tilts backwards, which is great for a rest and even better for redistributing pressure off the bottom for those who may sit for longer periods of time.
Some chair designs work better indoors, some are better for outdoors, some are great for putting in the car, others offer more support. The most important thing when looking at any type of wheelchair is thinking about how, where and for what you want to be able to use it for. As with most medical equipment, prices can cover an enormous range, so it’s really important to find the right chair for you. At ARC we have great relationships with a number of providers of wheelchairs and often refer on with recommendations of specific features to meet an individual’s needs, and frequently perform joint assessments with these providers.