by Bill Norman

More than 6 million Americans, including many with neuromuscular diseases, use mobility devices such as walkers, canes and crutches to assist them with getting around. The type of device people should use depends on how much assistance they require with weight support and balance. Deciding on the right device calls for expert consulta-

option and should be used when there is minimal balance impairment or very mild leg weakness.

“Walkers, specifically rolling walkers, are very supportive and are useful with balance impairments, leg or trunk weakness, and even respiratory insufficiency. Walkers without wheels and crutches are less useful in neurological diseases because they require very good arm and

repair/maintenance costs. General guidelines for selecting an appropriate mobility assistive device other than a wheelchair are:

• Stability and balance mildly affected — single-point cane

• Stability and balance moderately affected — four-point (quad) cane

• Difficulty in climbing stairs: special stair-climbing walker

• Weakness in both lower extremi-ties — walker/rollator (a walker

 

tion and some product comparisons.

Canes — which supply the least amount of support — are the most widely used mobility device, according to the National Center for Health Statistics. Some 4. 8 million Americans rely on them. Walkers provide the greatest support, and are the aid of choice for 1.8 million citizens. Some 566,000 people use crutches, which fall in the middle of the support range.

When to get one

Jacqueline Montes, clinical coordinator and physical therapist at the Eleanor and Lou Gehrig MDA/ ALS Research Center at Columbia University in New York, said, “Signs that assistive devices such as canes or walkers are needed could be poor balance or unsteadiness, leg weakness, trunk weakness, slower than usual pace and, most importantly, falls. A cane is the least supportive

hand strength and minimal balance impairment.”

A continuum of support

People with progressive neuromuscular diseases often find they require progressively more supportive mobility devices as time goes on. In selecting one of the three devices mentioned here (as opposed to a wheelchair), four factors need to be considered:

• Effectiveness: How well the device enhances user independence in performing daily living activities.

• Reliability: How well the device performs under repetitive use in the user’s typical surroundings.

• Ease of use: Access to grips and handles, comfort during operation, and ability to navigate surfaces of different textures and slope.

• Economics: Purchase price and

with wheels) or, in some cases, crutches

• Stability and balance severely affected — walker or rollator

• Hand or wrist impairment — forearm walker

Why get one?

Why should people with lower extremity weakness caused by neuromuscular diseases elect to stay upright and ambulatory when they could just as easily elect the wheelchair option?

First may be a logical desire to be able to see others at face level, eye-to-eye. Second, some people feel they would be “giving in” to their disease if they switched to a wheelchair. They equate walking, even if assisted, with continuing to fight back.

Montes concurs with that assessment. “The use of equipment or

(continued on page 52...)