Power Mobility: A Clinician's View

The Restore Access to Mobility Partnership (RAMP), a coalition working to ensure that all beneficiaries with medical need have access to mobility products, has been working with clinicians and consumers across the country to achieve this objective. This month, I'd like to take backstage and let one clinician explain her perspective on the current Medicare coverage policy for power wheelchairs.

Susan Taylor is a clinician at the Rehabilitation Institute of Chicago, one of the nation's leading providers of specialized therapy services. She has spent more than 20 years working with consumers with disabilities.

How do power wheelchairs help your patients?

As an occupational therapist, I have seen wonderful changes after powered mobility has provided someone with independent mobility. I have worked with individuals of all ages and disabilities, and providing powered wheelchairs is a large part of my recommendation for their independence. It helps them get from point A to point B in their rehabilitation.

Powered mobility is for anyone who is unable to walk safely or propel a manual wheelchair in all of the environments that they encounter. Mobility is not exercise; it's not a choice. We don't take the stairs because it's fun. We don't look for the farthest parking space at the mall. People need mobility to function.

Are power wheelchairs a key part of your treatment?

Ninety-eight percent of my patients are not ambulatory in a functional manner. Their choices are usually [among] a manual chair, an independent manual chair or some form of powered mobility. Researchers at the University of Pittsburgh have found that the repetitive stress of long-term use of a manual wheelchair negatively impacts the shoulder girdle, carpel tunnel/wrist area and neck.

For individuals aging with a disability, these long-term effects have sometimes resulted in the inability to use their upper extremities for daily activities due to the muscular damage or pain. Powered mobility is very important to sustaining these individuals over the long-term.

Do power wheelchairs have a psychological impact on your patients?

Anytime someone's mobility is restricted there is a devastating psychological impact, especially in relation to self-esteem and autonomy. Activities become too difficult to plan or manage; they become more dependent on others. Their worlds become smaller and smaller until they simply give up. Improving their mobility can improve their spirits and give them hope.