Assistive Technology: Mobility Products

Original Editors - Rucha Gadgil

Top Contributors - Rucha Gadgil, Naomi O'Reilly, Kim Jackson, Angeliki Chorti and Misha Ahir      

Introduction

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 be impaired by minor ailments. For example, associated pain can significantly alter walking ability.

Assistive devices and technologies are primarily used to maintain and improve an individual’s optimal level of functioning. It helps in achieving independence to facilitate participation and to enhance overall well-being.

What are Mobility Products?

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., the 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.

These devices are used by people who have difficulty in moving about as is often seen with arthritis, MS, Parkinson's disease, back pain, Cerebral Palsy, and many other physical limiting conditions.

Assessment

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, environment modifications at home(grab bars, portable ramps, therapeutic footwear) and a physical examination.

Types of Mobility Products

• Walking Aids: It helps a person stand up, sit down, and walk.
  • Canes
  • Crutches: axillary crutches and elbow crutches
  • Walking Poles
  • Walkers
  • Rollators
• Wheelchair:
  • Manually propelled by the user
  • Pushed by someone else, or
  • Electrically powered.
  • Fitting, design , and accessories are individually selected after careful assessments.
• Scooters,
• Prosthetic Devices
• Orthotic Devices
• Robotics:
  • An upcoming field looking to improve the mobility of an individual greatly.
  • Exoskeletons:
  • 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

The benefits of using these mobility products are:

1. More independence,
2. Reduced pain,
3. Increased confidence and self-esteem
4. Reducing fall risk
5. Reduced efforts and physical burden for caregivers
6. Improved health and quality of life

Barriers to Using Assistive Technology Products

1. It is considered a low area of priority for governments and is often not reflected in national legislation, policies or strategies.
2. Finances and affordability
3. Services relating to the provision of mobility devices are in short supply.
4. There is a lack of properly trained personnel for the provision of appropriate mobility device services.
5. The 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.
6. Awareness, social and cultural factors.
7. Cosmetics.

Provision of Mobility Products

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

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:

1. improvements to the assistive technology mechanics (hardware and software interface;
2. improvements to the user-technology physical interface; and
3. 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

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.