Change is hard.
We as human beings are all in a process of change but sometimes as we change it can be difficult to accept and make appropriate choices to adapt. Aging, pain, and disability can certainly change how we approach and adjust to our world. At some point in everyone’s life there comes a time when we know we need to make changes, and if we are lucky, we can discuss these issues with doctors and/or therapists.
Typically, manual wheelchair users (especially those who have used their wheelchair for a long time) may experience changes that affect their ability to propel as well as participate in aspects of their daily lives which ultimately can affect their quality of life. Shoulders, neck, wrists, and hands can get overused when propelling a manual wheelchair every day.
Thinking of how pain or other issues affect you and communicating it to your doctor and therapist can help them help you determine the best options moving forward based on your lifestyle. For more generic information on how to talk to your doctor and/or therapist regarding new medical and mobility equipment please refer to another of our Permobil blogs, “Process to obtain new mobility equipment: A little preparation goes a long way.”
As well as the chapter “Process to obtain equipment” from The Wheelchair Handbook: A consumer's guide to seating & mobility equipment (permobil.com).
For power assist, pain and understanding how chronic pain affects your mobility can help a therapist and/or doctor determine what is the best course of action. When looking at any new mobility device funding is an especially important part of the equipment procurement process. Discussing with your therapist how pain affects your mobility, your daily life, and your quality of life can help them to justify a power assist device to the funding agency in your area – if you qualify. If you are paying out of pocket, having a therapist involved in this process is important as you want to make sure you get the best equipment that matches your needs.
There is nothing worse than investing a lot of money in a device that does not fully meet your needs. If you would like more information regarding funding, please take a look at this Permobil blog: Process to obtain new mobility equipment: funding.
Explaining to your therapist what is important to you in your daily life is important. Explaining where you use your wheelchair, how you transport your wheelchair, and how you put your wheelchair in and out of a vehicle is key. It is also a beneficial to let you doctor and/or therapist know if you need help mobilizing in certain situations and if this has been a recent change. Explaining these aspects of your life can help your therapist determine what best suits your needs and lifestyle.
Here are three questions to reflect upon before seeing your doctor and your therapist if you are experiencing changes and or pain:
1. Are you now taking pain medication when you did not have to take medication before?Even if you’re currently taking over-the-counter medications like Tylenol or Advil due to the strain of pushing your wheelchair, this can serve as an objective measure for your doctor or therapist to assess whether using a power assist device positively impacts your pain levels. For example: during my Smart Drive demo, I noticed my arms and shoulders did not hurt as much going up my ramp.
2. Have you now started asking for help to do a functional mobility task that you previously could do before by yourself?In the past, as a prescribing therapist, I would prescribe a power assist device for clients who could no longer push their manual wheelchairs by themselves on carpets, ramps, or long hallways in the hospital. Sometimes they needed someone to come with them to all their appointments, which was not always easy. Knowing that you need more help than before can help the therapist justify the equipment to help you return to independence with your functional mobility and get you back out there living your life.
3. Have you stopped doing something such a hobby or sport due to your upper extremity function or mobility change?Quality of life and being able to independently do the things that make you happy is particularly important. Providing detailed information of what the hobby or activity that you are no longer able to do can help your therapist determine what is the best equipment to meet your needs. If it is getting outside on grass and uneven ground, like going to your kid’s baseball or football games, knowing where and how you use your wheelchair can be extremely helpful for your therapist.
These are questions that you as a mobility device user can answer prior to your clinic or doctor visit. The answers to these questions are objective, measurable and documentable and can be reviewed after a power assist device is trialed to help prove it works and should be funded.
Please take time to research your options. YouTube is a great resource. Searching your diagnosis and power assist devices in the search bar should provide you with information not just from manufacturers but also from end users. Also please take a look at Permobil’s white paper on power assist devices. The intro section of this white paper has quotes from end users and explanation of the different types of power assist which may help you with answering your questions about what might be appropriate for you.
At the end of the day, everyone is different and communicating what is important to you for your mobility, your goals, and your ability to participate in life is key. Keep in mind that your therapist, based on your responses to these questions, may suggest trying other types of equipment and even a power wheelchair. Keeping an open mind can be hard when you are facing change but can be extremely important as you face your evolving mobility needs.
While this blog’s theme may explain a reactive approach to procuring a power assist device, hopefully your experience is more of a proactive approach. For someone who uses a manual wheelchair for their primary means of mobility, combining a custom-configured manual wheelchair and a power assist device can significantly enhance the quality of life by providing them with greater freedom and comfort. Ideally, the goal would be to start with combining the manual wheelchair custom-configuration and a power assist device to enhance independence and decrease the risk of pain and injury.
Stefan Morin, OT, ATP, is a registered OT, graduated from the U of T in 2008 with a master’s degree in OT. Stefan started his practice at the Lyndhurst Centre in Toronto. In the early 2010s Stefan moved to Moncton, New Brunswick Canada and worked in the community, providing complex seating and mobility solutions for his clients. Stefan joined Permobil in July 2021 as a Regional Clinical Education Manager serving the Atlantic provinces as well as Quebec. Stefan is a council member of the New Brunswick Association of Occupational Therapists. Stefan became an ATP in May of 2024.
