Mobility

There are a wide range of wheelchairs available and you should be referred to your local Wheelchair Service for an assessment. This will ensure that the chair meet your needs in terms of size, comfort and posture control. Poor seating can lead to increased pain, particularly in the back, hips and neck, pressure sores and decreased mobility and independence.

A proper assessment of individual needs is important, in order to make sure that the correct piece of specialist seating equipment is chosen.

Anyone who is unable to keep a stable, comfortable position when they are seated will need a more supportive chair.

Chairs with adjustable angle seats and backrests can have the seat angled slightly down at the back, while the backrest is adjusted to maintain the most comfortable angle, to assist anyone who tends to fall or slide forwards in their chair, or has difficulty holding their head up. Such a sloping seat, however, is difficult to get out of, and a hoist will almost certainly be required to facilitate transfers.

Multi-adjustable deep seat chairs can be individually tailored to meet the user’s needs, with adjustable head and side supports, as well as back and seat that can be altered in height, width, depth and angle. A tilt-in-space facility means that the chair can be angled backwards to provide a deep seat, then tilted forwards to a horizontal position to make it easier to get out of or to facilitate feeding and activities.

Modular seating systems, as the name suggests, are built out of various elements to meet the exact needs of the user. A common chair base is customised with components such as footrests, headrest, additional lateral supports, etc.

Chairs to meet the needs of users who are largely immobile often have pressure-relieving features built in. Many specialist seating providers manufacture chairs that incorporate pressure-relieving features in the seat and backrest area. These may be based on cells filled with water, air or gel, often combined with hi-tech foam.

There are several different types of walking stick from the traditional wooden type to more commonly used lightweight metal sticks, some of which are foldable. It is important to ensure that the stick is the correct height so it does not cause muscular aches and pains and problems with your posture. Your Occupational Therapist and Physiotherapist will be able to help you ensure you have the correct type.

Many people use walking frames instead of two sticks, again you must ensure that they are the correct height and should always seek advice from your Occupational Therapist or Physiotherapist.

FES uses small electrical impulses to activate muscles by exciting nerves leading to muscles. FES is used widely in rehabilitation for therapy, function restoration and maintenance of vital function in muscle weakness and/or partial paralysis.

Two self-adhesive patches (electrodes) are usually placed on the skin close to the nerve supplying the muscle and over the centre of the muscle. Leads connect the electrodes to a stimulator that produces the impulses.

The most common problem treated by FES is called dropped foot. This is the inability to lift the foot and toes when walking, causing them to drag on the ground. It is caused by weakness of the muscles that lift the foot and excessive tightness (spasticity) in the muscles of the calf.

Stimulation is given to the muscles at the front of the leg which activates the muscles that lift the foot during walking. A switch worn in the shoe triggers the stimulation and the electrical signals reach the muscles through electrodes stuck to the skin on the side of the leg, just below the knee.

The stimulator is the size of a pack of cards which is operated by a small battery and can be worn at the waist on a belt, in a pocket or on a knee strap. Leads connect the stimulator to the switch and electrodes.

Electrical stimulation can help people walk safer, faster, with less effort and with more confidence. Stimulators are being continually developed with computer technology allowing them to be more finely controlled and more muscle groups can be stimulated to produce a more natural walking pattern.

Your Physiotherapist can assess if FES is a suitable option.

If you receive the higher rate of mobility in your Personal Independence payment (PIP) or Disability Living Allowance (DLA) you may be entitled to use the Motability Scheme which allows disabled people to exchange their mobility allowance to lease a new car, scooter or powered wheelchair.

Driving a standard car can be difficult if you have a disability, or reduced mobility or strength in your arms or legs. An adapted car specialist can guide you through the process to understand which adapted features will help you with accessing and/or driving your adapted car.

Car adaptations include:

• Driving aids, such as push-pull hand brakes and pedal extensions;
• Steering aids;
• Wireless keypad controls.

Find out more about adaptations through the Motability Scheme here.

Wheelchair accessible vehicle (WAV) is a term used to describe many different types of wheelchair accessible vehicles. These are often also referred to as Mobility Vehicles, Adapted Vehicles, Disabled Cars and so on. They usually have a ramp or lift alongside appropriate harnesses and restraints which enable wheelchair users to travel safely and securely in the rear of a vehicle. Vehicles are usually MPV or vans with seating for further passengers adjacent to the space for the wheelchair user.

A drive from wheelchair vehicle is a car, van or MPV that has been comprehensively converted to allow a disabled wheelchair user to independently access the vehicle and then drive the vehicle with the benefit of specialist adaptations whilst seated safely and securely in their wheelchair.

Similar in concept to drive from wheelchair vehicles, transfer vehicles are designed in a similar fashion to afford independent travel for wheelchair users who are able to transfer from their wheelchair to either the standard driver’s seat or more commonly to a mechanised seat that can move backwards and forwards, rotate and rise and fall.

These are less common and typically more expensive than standard wheelchair accessible vehicles.  This is due to the additional cost of modifying the vehicle to allow the wheelchair passenger to sit adjacent to the driver.

Some Up-front wheelchair passenger vehicles also have the ability for the passenger to change position with the driver thus also serving as a “drive from wheelchair” vehicle.