ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Wheelchairs and Powered Chairs for Increased Independence

Updated on September 6, 2013
rmcrayne profile image

Rose Mary has been an Occupational Therapist since 1987. She has treated children and adults with a wide array of conditions.

People with disabilities often have misconceptions about power mobility.  What is power mobility?  Electric or battery powered carts or scooters, or motorized wheelchairs are all forms of power mobility.  What kind of misconceptions?  People with disabilities sometimes equate wheelchairs or power mobility devices with the appearance of a greater state of physical disability.  Sometimes they buy into the old adage, “If you don’t use it, you lose it.” 

I worked with a woman about my age whose leg was amputated when she was a teenager.  I’ll call her Shirley.  She had cancer, so the eventual outcome, having her leg amputated high above her knee, happened in phases.  By the time I met her, we were both in our early 40s.  Shirley was the receptionist for our therapy clinic, and a delightful woman.  Our clients loved her! 

Source

Shirley was an attractive woman, with beautiful thick long blond hair.  She did not wear a prosthetic leg.  Some would consider this an unusual choice for an attractive woman.  She had tried prostheses over the years, but was never satisfied with the fit. 

Shirley would park her car in a handicapped spot, but still a fair distance uphill from the hospital.  She would use her crutches to make the walk to the emergency room entrance.  At the entrance, she would get one of the hospital wheelchairs that was typically there, and push herself backwards using her remaining leg, to the elevator and then to our clinic.  Within our clinic, Shirley used her crutches, or would hop for short distances. 

Thumb splint.  Personal photo.
Thumb splint. Personal photo.

This system worked for Shirley for many years.  Near the end of my three year assignment at this facility, Shirley started having episodes of pain to her left wrist and thumb, consistent with the sensory branch of the radial nerve.  These episodes caused pain, both when using her crutches, and when conducting her administrative duties.  In my assessment, this condition was caused and aggravated by the pressure of her crutch in her armpit. 

I treated Shirley’s symptom of left wrist and thumb pain with a splint and ice.  I spoke to her about addressing the cause of her pain, namely her crutch use.  I told her I thought the time had come to increase the use of a wheelchair, or even a motorized wheelchair or cart, and decrease her crutch use.  After all, she had been managing mainly on crutches, or by hopping for 30 years. 

Shirley caught me totally off guard with her response!  She said, “But I don’t want to lose my independence.”  I was flabbergasted!  I said, “Shirley, you hold down a full time job, own your own home, live alone, drive a car.  You are independent!”  Somehow Shirley had equated using a wheelchair with not being independent.  This led to more conversation. 

Wheelchair Athletes

Many sports can be played from wheelchairs
Many sports can be played from wheelchairs | Source

Plenty of handicapped individuals use wheelchairs when they or capable of using crutches, or walking, or use motorized wheelchairs or carts when they are capable of using a manual wheelchair.  They do this to become more independent. 

I’ve been a member of an interdisciplinary team that follows children with spina bifida.  Many of these kids can ambulate with leg braces and crutches.  As they get older, most of them will transition to a wheelchair, because walking is no longer efficient.  They can’t keep up with their peers.  Some continue to avoid the chair, and use crutches.  I’m sure some of them think like Shirley.  Unfortunately, for these kids and adults with spina bifida, this ambulation causes great stress to their knees and hips.  On the other hand, it helps them keep their weight under control.  It is common for people with spina bifida to become overweight.  For this reason, many doctors are reluctant to give the green light to transition from a manual wheelchair to power mobility.  This is where the team approach is a good one, to evaluate the benefits versus downside of transitioning to motorized wheelchairs, so that these kids and adults can keep pace with life’s demands. 

People with spinal cord injuries face similar decisions.  Often a person with a spinal cord injury will use a motorized wheelchair, even though they are physically capable of using a manual chair.  They don’t do this because they are lazy.  They do this to be more efficient with their energy reserves. 

Men in manual wheelchair and power chair
Men in manual wheelchair and power chair | Source

In my practice as an occupational therapist, I often use my model of the “energy allowance” principle.  Imagine a one gallon pitcher on a table before you.  What if I told you, “This is your energy allowance for the whole day.  Use it wisely.  And here’s the catch:  Your physical, mental, and emotional energy all come out of that same pitcher.” 

People with spinal cord injuries often choose motorized wheelchairs to preserve their physical energy, so that they can work part time.  Or maybe so that they can work full time.  Or maybe so that they can work full time and have a family.  Sometimes you need to save on physical energy so that you have some allowance left over for intellectual or emotional pursuits. 

I was able to make some headway with Shirley.  I talked her into parking in one of the handicapped spots on the circle drive at the emergency room entrance.  I also wrote a letter to her physical medicine and rehab doctor to revisit the issue of power mobility.  The issue largely boils down to funding, and takes time.  Unfortunately I moved on to my next assignment shortly after that.  I hope that Shirley’s doctor was able to help her.  And I hope that Shirley was able to make choices that are good for her body, but didn’t negatively impact her image of an independent woman.  This is in part dependent on whether I was able to help Shirley embrace a new picture of what independence means. 

Comments

Submit a Comment

  • HandControls profile image

    HandControls 

    7 years ago from Shenzhen, China

    I agree with the people above, you tend to see mobility wheelchairs far more aimed at the elderly or incredibly overweight people as opposed to those with physical disabilities.

  • rmcrayne profile imageAUTHOR

    rmcrayne 

    8 years ago from San Antonio Texas

    I see a lot of obese people using the scooters in stores. Probably hip and knee problems. I'd guess there are also a fair few with emphysema or other endurance problems.

  • ethel smith profile image

    Ethel Smith 

    8 years ago from Kingston-Upon-Hull

    Interesting read Rose Mary. You do see more motorised scooters and the like more in the UK these days but only usually being used by the elderly.

working

This website uses cookies

As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

Show Details
Necessary
HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
LoginThis is necessary to sign in to the HubPages Service.
Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
AkismetThis is used to detect comment spam. (Privacy Policy)
HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
Features
Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
MavenThis supports the Maven widget and search functionality. (Privacy Policy)
Marketing
Google AdSenseThis is an ad network. (Privacy Policy)
Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
Index ExchangeThis is an ad network. (Privacy Policy)
SovrnThis is an ad network. (Privacy Policy)
Facebook AdsThis is an ad network. (Privacy Policy)
Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
AppNexusThis is an ad network. (Privacy Policy)
OpenxThis is an ad network. (Privacy Policy)
Rubicon ProjectThis is an ad network. (Privacy Policy)
TripleLiftThis is an ad network. (Privacy Policy)
Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
Statistics
Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)