Evaluating mobility aids for the disabled, special needs and elderly
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If you use a wheelchair or walker, you already know how difficult movement can be without their assistance.
With the wide variety of mobility aids on the market today, you have more choice and options than ever before.
As you begin shopping for a mobility aid, consider your specific mobility requirements, size and how you plan to use it.
Then, evaluate and "test drive" a number of models and compare the level of comfort, function and features that the different mobility aids offer.
The following information is designed to provide an overview of your choices and help serve as a starting point in your decision-making process.
Some mobility aids that may help you keep your independence include: * Wheelchairs - rigid and collapsible* Powerchairs - These highly maneuverable and versatile machines are good alternatives to electric
wheelchairs. Some swivel or have seat lift options. These disabled mobility aids are designed for those with severe movement restrictions.
* Scooters - There are three– and four-wheeled models. Some have baskets and are useful for shopping. Others
are better for outdoor adventures.
* Walkers - These come with or without wheels and are helpful if you are not confined to a wheelchair.
Most fold for easy storage. Some come equipped with a seat or pockets. Others accommodate baskets, trays, or totes.
* Walking sticks or canes. These can be made of solid wood or folding aluminum and come in sizes to fit all
heights. Make sure the walking stick has a rubber tip to prevent sliding.
Smaller aids and equipment that might help you include light-weight and portable power lift cushions, which work like a lift recliner. There are also key turners with handles to help open doors and items to help with gardening or driving.
Mobility chairs fall into three primary categories: (1) Manual push wheelchairs, (2) Powered or electric wheelchairs, and (3) Motorized scooters. Following is a summary of each type.
Manual Wheelchairs
The most common type of manual wheelchair is designed for heavy use with strong steel construction and large rear wheels so it can be self-propelled. This standard model usually weighs more than 30 pounds and can support up to 250 pounds. Seat widths range from 16 inches to 22 inches.
Heavy-duty models are available for those who weigh in excess of 250 pounds and need a seat up to 30 inches wide. There is also a lighter version of the standard mode that is more portable but not as durable for extended use. Companion or transport wheelchairs are another manual option to consider. They are easily carried, folded and stored in vehicles for frequent outings. They weigh much less (around 15 to 20 pounds) and still have the ability to carry around 250 pounds of weight. These models are designed with small rear wheels and cannot be self-propelled so an individual must rely on a companion (hence the name) to push him or her. You can purchase models that recline as well as those for shower and bathroom use.
Did you ever notice that you never see disabled athletes competing in folding wheelchairs? The reason is increased performance of rigid wheelchairs. All athletes seek to optimize performance. But performance is not only important for sports wheelchairs, it is important for active everyday users as well.
A well designed rigid wheelchair becomes part of the body of a disabled user allowing easier access and freedom of movement. What are the features of a rigid wheelchair that give superior performance?
•Reduced Maintenance and Weight: Folding chairs have lots of movable parts that undergo strain. These parts must often be regularly adjusted or replaced to keep the chair in alignment. Because of this strain, thicker walled aluminum is required and therefore the wheelchairs are usually heavy. Rigid wheelchairs have fewer movable parts and fewer things to go wrong. They are generally more durable and age better than folding wheelchairs.
* Much of the energy from the push on the wheels is lost in the flexing parts of the folding wheelchair. Since the rigid chair has fewer movable parts, most of the energy from the push on the wheels is translated into forward motion. In short, the rigid wheelchair may be easier to push than a folding wheelchair.
•Due to the need to fold, the folding wheelchair design might not be optimized for performance. For example, the casters of the folding wheelchair are usually placed well behind the foot-rest, in order to allow the wheelchair to close properly. This design puts a lot of weight on the casters. With the rigid wheelchair, the distance between the footrest and casters is usually much shorter; placing more of the weight on the rear wheels. Less weight on the casters makes the rigid wheelchair easier to turn.
•Because rigid wheelchairs are lighter and more maneuverable than folding chairs they, perform better, that is, they are easier for the user to move in. But this is not an advantage only for athletes. Imagine a wheelchair user going up a wheelchair ramp without assistance. This can be more difficult in a heavy folding chair, than in a maneuverable, ultra-light, which can be lighter by 10kg or more.
•In summary, due to weight, design, and fewer moving parts, the performance of a rigid wheelchair is usually better than a folding wheelchair. This difference may become even more noticeable as the wheelchairs age.
Performance is only one of the advantages of a rigid wheelchair over folding wheelchairs. Below is a partial list of advantages of rigid over folding chairs.
Better Body Fit: The primary design of a rigid wheelchair is to fit the body of the user. The primary design of a folding wheelchair is to fold. Folding models are generally boxy, while rigid models conform to the shape of the body. For example, with a rigid chair, one can taper the design to conform to the body shape (large at the hips, narrow at the knees) which can hold the users’ body in place. Also the aluminum between the knees and footrest can be tapered (wider at the knees, narrow at the feet) holding the feet in place. With a folding chair, you can not taper it or it would not close completely.
Rigid wheelchairs generally have more configurations and adjustments than folding chairs. Most folding models have limits in their configurations and adjustments. For example, many folding chairs do not allow for adjusting the angle between the backrest and the seat.
Independence: Users can easily make transfers from rigid wheelchairs into some cars independently. With a folding wheelchair, the user usually requires a companion to fold the wheelchair and put it in the car trunk. With some forms of rigid wheelchairs, the user can transfer into the car and from the inside of the car, remove the two wheels, fold down the back rest and bring the wheelchair inside the car and place it either in the back seat or on the floor. An independent transfer would be more difficult in a folding wheelchair.
Esthetics: Some rigid wheelchairs are designed to be attractive. Folding chairs are rarely considered attractive, only functional
What is the advantage of a folding wheelchair? Mainly there is one advantage: a folding chair can be stored in a trunk of an automobile without removing the wheels. Rigid chairs are not for everyone, but many people who are now using folding models are better off in a rigid wheelchair.
Who is the right customer for a rigid wheelchair? Someone who:
•Has good upper body strength
•Wants to be independent
•Is young and active (5-50 years)
•Sees the wheelchair as part of his or her body and not just a piece of furniture
Who is the right customer for a folding chair? Someone who:
•Will never be independent or has no upper body strength
•Has minimal upper body strength or coordination
•Is very young (0-4) or older (60-90)
A rigid wheelchair is made for the users’ convenience. Folding models are made for companions’ convenience. Which would you prefer?
Wheelchairs have been developed for all kinds of people. As society has evolved, so have powered mobility chairs that enhance the quality of life for disabled or special needs individuals.
Sizing a wheelchair: When determining how to size a wheelchair to meet your needs, you need to consider fit, placement and overall comfort. In his book, Living
with Spinal Cord Injury
•Your thighs should be slightly spread apart.
•The normal curvatures of your spind should be preserved. Abnormal curvatures that cannot be corrected should be accommodated.
•Your head should be directly over the pelvis, the eyes looking directly ahead and level.
Special conditions may require special chairs such as a reclining or tilt-in-space wheelchair for those who cannot shift weight or have poor arm strength.
A power wheelchair may be best suited for those who cannot push a manual wheelchair, have poor trunk or torso control, or significant curvatures of the spine, such as Lordosis , Kyphosis, and Scoliosis.
A properly sized wheelchair must support and accommodate your entire body, including back, hips, legs, knees, ankles, and buttocks. Your weight should be evenly distributed and you should have a good seat pad designed to relieve pressure points that could potentially cause sores. In addition, your mobility chair needs to be comfortable, cool, and easy to push.
Powerchairs
Similar to manual wheelchair models, there are a wide variety of battery-powered models available for both indoor and outdoor use. As you evaluate each option based on your needs, be sure to consider each chair’s power, speed capacity, size, ease of steering, seating comfort, transport capability, and battery life.While they are significantly heavier than manual mobility chairs, electric models are helpful to those with limited upper body strength and who can’t use self-propelled chairs. Electric wheelchairs are easy to operate and provide independence from relying on a companion to push the chair. Models come in front, mid and rear wheel drive. Here are the features and benefits of each:
•Mid-wheel drive chairs are excellent for indoor maneuverability. The small models are good for use in apartments and nursing homes, while larger models do well in both indoors and outside. Mid-wheel drive wheelchairs normally have six wheels, two larger (powered) wheels affixed to the base and 4 smaller wheels surrounding them.
When it comes to deciding whether powered chairs are best for you, there are a few things you need to consider, including your lifestyle and activities of daily living.
Ideally, these electric mobility chairs are best for people who are unable to propel manual wheelchairs but require independent mobility.
When considering a power wheelchair, it is also necessary to take into account development and physical factors such as visual perception, posture and coordination, as well as the environment and living conditions.
Since powered chairs are heavier than manual chairs, they cannot be easily lifted on curbs and steps. In addition, it is important to have a living environment with wide doors and halls to accommodate the wheelchair.
Think carefully of how you will use the chair to make sure that it will hold up to your needs. Decide if you will be traveling a lot because power wheelchairs do not fold conveniently, making them difficult to transport.
Additionally, these kinds of chairs are run by electricity so you need to consider the batteries and charger.
Scooters
Scooters offer those with some degree of mobility the opportunity to cross rougher terrain and travel longer distances in stores, parks and neighborhoods.
Models have three or four wheels and typically feature front and rear lights, padded swivel seating, a host of accessories.
Scooters are battery-powered like electric wheelchairs and should be evaluated on similar characteristics including speed, maneuverability, steering, seating comfort, transport capability, etc.
Mobility scooters for people with disabilities or special needs offer greater maneuverability over motorized wheelchairs and provide the capability to make tight turns, navigate small spaces, and move over smooth and rough surfaces with ease.
As a result, those with limited walking ability can enjoy a richer quality of life by easily accomplishing daily activities such as grocery shopping, meeting friends at a nearby park, going out to dinner, navigating large shopping malls, and spending more time outside.
Selecting a disabled mobility scooter involves doing some research to make sure you get the features and functionality that best suit your needs. There are many decisions to make including size, weight, number of wheels, drive train, power system, battery life, seat style, steering, color, lighting, and storage capacity.
Wheels: Three-wheeled scooter models are lighter and the most maneuverable; while four-wheeled scooters are heavier and more stable. A test drive will help you determine which you prefer for your lifestyle.
Tires: Choose the type and size of wheels based on how you plan to use your scooter. Tire sizes range from six to 12 inches. Smaller tires are best for indoor use that requires sharp turns and navigating tight spaces. Larger, wider tires are better suited for rough terrain and stability needs.
Drive Train: Your disabled mobility scooter also comes with a choice of front or rear wheel drive. Front wheel drive models are lighter and designed for indoor use or traveling on level surfaces. They are smaller in size are more likely to be compatible with transport wheelchair lifts.
Front-wheel drive scooters do not have as much speed and duration as rear-wheel drive scooters that can traverse rougher terrain and handle more weight. With rear-wheel drive models, you can achieve speeds of five miles per hour or faster with a range of approximately 25 miles before needing to recharge your battery.
Seating: Choose a chair for your scooter based on your individual comfort and utilization requirements. Most manufacturers allow you to select seat covering, swivel options, extra padding, lumbar supports, and powered height adjustments. Armrests are another consideration and can be added, removed or changed to address your needs.
Steering: Most scooters have handle-bar style steering with thumb controls or levers that allow the user to manage speed and drive the scooter forward or in reverse. Other steering systems like joy sticks and loop handles can be adapted according to manufacturer specifications.
Additional Features: There are a wide variety of add-ons and accessories you can purchase to equip your disabled mobility scooter to match your lifestyle. These include portable battery chargers, baskets, headlights and taillights, oxygen carriers, walker and cane holders, storage compartments, horns, and canopies.
Batteries and chargers are usually considered add-ons and are not included in the base scooter price. Scooter power is most often generated from one or two 12-volt deep cycle batteries, depending on the model, that last up to 18 months before they need to be replaced. Gel cell batteries are recommended for their safety over other batteries types.
As you begin your search for a mobility scooter, there are many factors and features to consider, including how and where you will use your equipment and your specific transport requirements. The following information summarizes some of the basics to consider in your search.
Number of Wheels: A mobility scooter can be equipped with three or four wheels and both options have their benefits. A three wheeled model is typically more maneuverable and enables you to easily navigate in and out of tight spaces. It is usually lighter and best suited for indoor use.
A four-wheeled scooter is more stable but does not have as tight of a turning radius as three-wheeled models. It easily accommodates outside terrain and better handles curbs, bumps, and hills.
Drive Trains: Scooters come in both front-wheel and rear-wheel drive models. Front-wheel drive models are usually found on smaller scooters designed for indoor use. They cannot carry as much weight as rear-wheel drive models and are not built to handle rough surfaces or elevations.
In addition, a front-wheel drive mobility scooter typically has a smaller motor, which translates into less power, speed and range. Yet, these models are more adept at maneuvering in small spaces, around corners, and are lighter for transport.
Rear-wheel drive scooters are designed to push weight rather than pull it as in front-wheel drive models.
With the weight of the rider concentrated over the rear wheels, these models have greater capability to climb inclines -- and create better traction on rough surfaces.
In addition, these models typically have more speed capability and a longer range. The downside is that they are less maneuverable and some models may not be suited for indoor use. Some scooters have the ability to freewheel the drive wheels, allowing them to be pushed manually (though scooters overall are heavy and difficult to push without power).
Wheels and Tires : Like any other wheeled vehicle or equipment, the size of the wheels and tires on a mobility scooter correlate to steadiness and travel capability on various surfaces. Larger wheels and tires create more stability and allow for greater functionality riding over a wide variety of surfaces, including outdoor terrain, wet pavement, curbs and hills.
Smaller wheels and tires make it easier to navigate cramped spaces and tight turns. As a result, smaller wheels are best suited for indoor use or on smooth, flat pavement.
Scooter tires can be upgraded to enhance shock absorption and reduce maintenance. Your tire options include everything from standard rubber tires to those with air-filled tubes, anti-flat compounds, foam inserts, different types of tread, and tires that are specially treated to prevent scuff marks on floors.
Seating: Choosing the right scooter seat can make the difference to your comfort and scooter functionality. Seats are usually padded to provide shock absorption and can be adjusted to maximize your visibility, seat height, comfort and circulation.
You should be easily able to reach all controls from your seated position and feel no pressure from sitting when you ride. Some scooter manufacturers offer custom seats, lumbar supports and separate cushions to maximize comfort.
Armrests are another consideration and may not come with all scooters. Those that do may have armrests be fixed in place or designed to swivel or flip up to help with transfers on and off of the mobility scooter.
Steering Controls : When selecting a mobility scooter, you need to be comfortable with how to steer and operate the controls on the model you are considering. Thumb levers are the most common mechanism and allow users to adjust speed and move the scooter forward and in reverse while keeping their hands safely on the handle bars. Some scooters have joysticks or other types of finger levers to control speed and direction.
Before Making a Mobility Scooter Purchase
•Always test drive a number of models for comfort and functionality.
•Make sure you are provided with the total cost of your scooter in writing, including add-ons, accessories, upgrades, battery (which is usually extra) any delivery or shipping charges, and tax.
•Inquire about warrantees and how your scooter will get serviced.
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Disabled mobility access and assistive technology products from SabreCare - Disabled and mobility access products from SabreCare
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