Mobility Devices

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Mobility and safety are extremely important issues for people with Mito or any neuromuscular diseases.  I have no doubt you’ve seen drug store displays of canes that come in every color of the rainbow, flashy walkers with built-in seats, and more.  In this article, I will address mobility devices used while walking; walking sticks, canes, crutches, and walkers.

A general suggestion to anyone who is experiencing a change in baseline, appearance of new symptoms, or decline in function: notify your medical team as soon as possible!  There are many factors that can affect balance/mobility that can be improved with treatment: inner ear infection or other conditions such as Meniere’s or labyrinthitis, vision changes, migraines, even the need for new footwear can lead to falls.  Next, request a Physical Therapy consult.  Ideally, the consult should take place in your home so that the PT can assess your environment, suggest accommodations, and observe your mobility under best and worst conditions.  The MDA offers financial assistance for an annual PT mobility assessment.  Contact your local MDA chapter for more information.  If you are not able to access this benefit, most insurance companies offer Physical Therapy assessments for patients with mobility difficulties.  Contact your PCP and health insurance provider for assistance.

Many people have a hard time psychologically adjusting to illness progression, especially when the “new baseline” includes an assistive device.  Suddenly, an invisible illness becomes somewhat visible.  This transformation can be both helpful and limiting.  Many people have said that they became much more comfortable parking in the handicapped parking spaces, using the supermarket’s electric cart, and asking for help when they needed an item that was out of their reach.  This excerpt is from an article on the National MS Society website: 

“When walking becomes difficult, people need to grieve. It’s normal to feel sad and angry about a limitation that alters one’s life. Changes of this kind force people to develop a different picture of themselves, and changing self-image is never easy.”  

Canes (single point) and Walking Sticks

Best choice for: people with good upper body strength, and good/fair lower body strength, mild balance problems.

Benefits: inexpensive, easy to purchase at drug stores, department stores, and medical suppliers. Wide variety of styles, some canes fold for easy storage-great for people with intermittent weakness or balance problems because they can be stored virtually anywhere and easily unfolded when needed.

Drawbacks:  weakness or dizziness must be mild; so not offer enough stability for moderate to severe symptoms. Weight limits apply, especially for folding canes. A large percentage of people using canes/walking sticks are using them incorrectly and are using the wrong size.

 

Quad cane

Best used by: same as single point cane or walking stick, but can be used by a person with moderate dizziness or lower body weaknessCane has four contact points that give the user extra stability.

Benefits: same as single point canes, except quad canes do not fold.

Drawbacks: same as single point canes; weight limits still apply, but can accommodate higher weights. 


Crutches
Common Axillary Crutch

Best used by: People with very good upper body strength who need a mobility aid on a short-term or intermittent basis.

Benefits: Inexpensive and readily available, When used correctly, can support 80%-to 100% of a person’s body weight, enabling them to avoid weight bearing one lower extremity.

Drawbacks:  Does not allow hands to be used while walking, requires a lot of upper body strength and endurance.  Crutch axillary pads and hand grips are often made of latex, which can cause serious allergic reactions.  If used improperly, the person can sustain nerve damage from axillary (armpit) pressure.

Forearm Crutches (also called Canadian or Lofstrand)

Best Used by: people with mild-moderate weakness in both upper and lower extremities

 Benefits:  less cumbersome than axillary crutches, able to maneuver easier than with a walker, encourages a more normal gait, user is able to momentarily free a hand to open a door or pick up a small item while the wrist cuff remains in place.

Drawbacks:  Requires upper and lower body endurance, crutches only hold 40-50% of body weight so individual must be fully weight-bearing;


Walkers
Walking Frame (commonly called a “standard walker”) three-sided metal frame that may have wheels, plastic “skis” for gliding on carpets or floors, or rubber cane tips.  Comes in foldable and fixed models.

Best Used By: people with moderate to severe balance problems, mild-moderate upper extremity and moderate lower extremity weaknessRecommended for people who need assistance ambulating even short distances, such as bedroom to bathroom.

Benefits: offer the most stability of all mobility aids.  Some models fold completely flat for storage or transportation.  Some walkers can be turned around and placed over the toilet to provide a sturdy grab bar configuration to assist with standing. 

Drawbacks: Walking speed is slow.  Rubber tips or skis provide much greater stability than wheels, but result in the need to completely lift the walker with each step (4 rubber tips, or 2 tips/2 skis or wheels) or slide the walker forward on the floor or carpet.  Not designed for use on grass or uneven terrain, do not include a seat for resting.

 

Wheeled walker (commonly called a “rollator”) A walker with either 3 or 4 wheels and a built-in seat.  Most designs have hand brakes that can be used to improve control of the walker and also to lock the wheels when necessary (such as when sitting on the seat or standing in place.)

Best used by: Rollators are designed for those who have some mobility issues however can still get out and might require some extra rest for their endurance by using the seat.

Benefits: Provide much more mobility than a standard walker, and can be used inside or outside the home.

Drawbacks: The addition of wheels make the rollator less stable than a standard walker.