Assistive Technology: Mobility Products
Introduction[edit | edit source]
Mobility can be described as "an individual’s ability to move his or her body within an environment or between environments and the ability to manipulate objects". An individual’s ability to perform any mobility task can be compromised by impaired body functions or structures. Mobility can get restricted gradually, as occurs with multiple sclerosis, or instantly, as occurs with traumatic spinal cord injury, cerebral vascular accidents, and limb amputations. It can also affected by less obvious impairments. For example, associated pain can significantly alter walking ability. Assistive devices and technologies are those whose primary purpose is to maintain or improve an individual’s optimal level of functioning and independence to facilitate participation and to enhance overall well-being.
What are Mobility Products?[edit | edit source]
The ICF framework underlines that ’disability’ results from the dynamic interaction of the user, technology, and the environment. There might be restricted participation of an individual because of a dissociation between environmental demands and the individual’s mobility resources, and technology may assist either indirectly (therapy) or directly (physical assistance) enhancing the individual's participation in society.
Mobility products are designed to facilitate or enhance a user’s personal mobility – i.e. ability to change and maintain body position and walk and move from one place to another. The mobility device used by an individual depends upon his need, ability to use a device and on his mental and psychological status.
Assessment[edit | edit source]
Comprehensive assessment needed to ensure that the mobility devices meet the needs of individuals within their homes, schools , work and community environments. A comprehensive assessment should include a medical history, a review of current function, individual goals, an evaluation of existing assistive devices and a physical examination.
Types of Mobility Products[edit | edit source]
- Wheelchair: manually propelled by the user, pushed by someone else, or electrically powered. Their fitting, design and accessories are individual specific selected after careful assessments.
- Walking Poles
- Canes, Crutches,
- Walking aids,
- Prosthetic devices, and Orthotic devices.
- Robotics: This is an upcoming field looking to improve the mobility of an individual greatly. Some robotic devices are:
- Hybrid Assistive limbs (HAL): is a powered exoskeleton that can assist in daily activities in a rehabilitative capacity, or magnify the strength of the user by a factor of 10.
Benefits[edit | edit source]
The benefits of using these mobility products are:
- More independence,
- Reduced pain,
- Increased confidence and self-esteem
- Reducing fall risk
- Reduced efforts and physical burden for caregivers
- Improved health and quality of life
Barriers to using them[edit | edit source]
- It is considered a a low area of priority for governments and, often not reflected in national legislation, policies or strategies.
- Finances and affordability
- Services relating to provision of mobility devices are in short supply.
- There is a lack of properly trained personnel for the provision of appropriate mobility device services.
- Physical environment may restrict the use of these devices to a large extent. for eg. an individual will not be able to use a wheelchair of good quality in an inaccessible house, school or workplace.
- Awareness, social and cultural factors.
Provision of Mobility Products[edit | edit source]
These devices are provided by a broad range of stakeholders like governments , international agencies, non-governmental organizations (including charitable and faith-based organizations), and the private sector. In some countries, they are an integral part of healthcare and are provided through Ministry of Health, while in some other countries, the Ministry of Social Welfare takes this responsibility.
Individuals can access these products from hospitals, rehabilitation facilities, mobile/outreach facilities and community-based programmes, and also from private retailers and special education agencies.
The health personnel involved in the provision of mobility devices, includes therapists (e.g. occupational therapists and physiotherapists), medical staff , orthotists and prosthetists, and community-based rehabilitation workers.
The United Nations Convention on the Rights of Persons with Disabilities (CRPD) highlights the responsibility of States to take effective measures to ensure personal mobility with the greatest possible independence for persons with disabilities, and a corresponding responsibility to promote and ensure availability and access to mobility aids, devices and assistive technologies (UN, 2006).
Additional Information[edit | edit source]
There is constant improvement going on in the development of these products in terms of their efficiency and technology. A paper published in 2012 observed a seamless integration of the capabilities of the user and the assistive technologies. They stated that the approaches to enhance integration can be broadly classed into three areas:
- improvements to the assistive technology mechanics (hardware and software interface;
- improvements to the user-technology physical interface; and
- improved shared control between the user and the technology.
A review conducted in 1996 supported matching a person and technology considering the environments of device use, characteristics of the user's preferences and expectations, and device features and functions. They concluded that for assistive technologies to enhance users' quality of life, the focus should be on consumer involvement in the selection and evaluation of appropriate assistive technology, and ways to make technologies more widely available and affordable.
Studies have shown an interrelation between Assistive devices and environs to realise community mobility, underlining the need for building accessible communities via systemic advocacy to improve personal mobility and community participation.
Conclusion[edit | edit source]
There is an unmet need in regards to data and provision of mobility products in the world which needs to be assessed. At the same time, it important to address the barriers experienced in their usage.
This is a rapidly changing field, which has the potential to revolutionize the rehabilitation process; however, these products need to be studied in greater detail.
References [edit | edit source]
- Cowan, R.E., Fregly, B.J., Boninger, M.L. et al. Recent trends in assistive technology for mobility. J NeuroEngineering Rehabil 2012; 9 (20). https://doi.org/10.1186/1743-0003-9-20
- WHO. Disability: Assistive devices and technologies.https://www.who.int/disabilities/technology/en/
- Khasnabis C, Heinicke Motsch K, Achu K, et al., editors. Community-Based Rehabilitation: CBR Guidelines. Geneva: World Health Organization; 2010. Assistive devices. Available from: https://www.ncbi.nlm.nih.gov/books/NBK310951/
- International Society for Prosthetics and Orthotics. Prosthetics and orthotics services. https://www.ispoint.org/page/POservices
- Suzuki, K, Mito, G, Kawamoto, H, Hasegawa, Y, Sankai, Y. Intention-based walking support for paraplegia patients with Robot Suit HAL. Adv Robot. 2007;21:1441–1469.
- WHO- Joint Position paper on the provision of mobility devices in less resourced settings (2011). http://apps.who.int/iris/bitstream/handle/10665/44780/9789241502887_eng.pdf;jsessionid=F3B1F1E49BD2A00D1F5C60D8DED6D0BE?sequence=1
- Dejong G et al. The organization and financing of health services for persons with disabilities. The Milbank Quarterly, 2002, 80:261–301.
- Pearlman J et al. Lower-limb prostheses and wheelchairs in low-income countries: An overview. IEEE Engineering in Medicine and Biology Magazine, 2008. 27:12–22.
- Kamaleri Y, Eide AH, eds. (2011). Living conditions among people with activity limitations in Lesotho: a national representative study. 2011. Oslo, SINTEF
- Scherer M. Outcomes of assistive technology use on quality of life, Disability and Rehabilitation, 1996;18:9, 439-448, DOI: 10.3109/09638289609165907
- Layton N. Barriers and facilitators to community mobility for assistive technology users. Rehabil Res Pract. 2012;2012:454195. doi: 10.1155/2012/454195. Epub 2012 Sep 13. PMID: 23029617; PMCID: PMC3458275.
- Gorgey AS. Robotic exoskeletons: The current pros and cons. World J Orthop. 2018 Sep 18;9(9):112-119. doi: 10.5312/wjo.v9.i9.112. PMID: 30254967; PMCID: PMC6153133.