Mobility Equipment Supplies

In our 40s, 50s, 60s, and beyond, it is not always easy to stay upright. That is because after age 25, our balance begins to decline. Falls in the later years often result to wrist and hip fractures, which can have a devastating effect on our lifestyle or even threaten our life.

We juggle many activities, responsibilities, and people in our lives with grace. But sometimes we can be physically tossed off balance by a wet floor or uneven pavement. Falls can occur anytime, anyplace, and to anyone while doing everyday activities, such as climbing stairs or getting out of the bathtub.

As we age, our sight, hearing, muscle strength, coordination and reflexes change, weakening our balance. Also, some health conditions, such as diabetes, heart disease, and circulation problems, affect balance. Even some medications have been known to make people dizzy.

Unfortunately, all of these factors make falls more likely. But then, you do not have to be one of them. You can take simple steps to improve your balance and reduce your risk of falling.

And since balance tends to erode over time, regularly performing balance exercises is one of the best ways to protect against falls that lead to temporary or permanent disability. Balance exercises take only a few minutes and often fit easily into the warm-up portion of a workout. Many strength-training exercises also serve as balance exercises. Balance-enhancing movements may simply be woven into other forms of exercise, such as tai chi, yoga, and pilates.

Balance exercises can help us maintain our balance and confidence at any age. This can also improve our coordination. For older adults, balance exercises can promote independence.

Balance may be improved with exercises that strengthen the ankle, knee, and hip muscles, and with exercises that improve the function of the vestibular system, which regulates ones balance.

Nearly any activity that keeps us on our feet, such as walking, can help us maintain good balance. You can also include balance exercises in your daily routine. Try balancing on one foot while waiting in line, or stand up and sit down without using your hands. For a more targeted approach, try specific balance exercises. If you have severe balance problems or an orthopedic condition, get your doctor’s approval before doing balance exercises.

Once a physical therapist has reviewed a complete medical history and thoroughly examined you, he or she will develop a personalized plan. This may include a walking regimen with balance components such as changes in surfaces/terrains, distance, and elevations. The physical therapist may also teach specific strengthening and balance exercises that can be performed at home.

Exercise A:

* Stand directly behind a table or chair and place your feet slightly apart.

* Lift one leg six inches out to the side.

* Hold this position for 10 seconds.

* Repeat with the opposite leg.

Exercise B:

* Stand directly behind a table or chair and place your feet slightly apart.

* Slowly bend one knee toward your chest lifting your foot six inches off the floor.

* Hold this position for 10 seconds.

* Repeat with the opposite leg.

Exercise C:

* Stand directly behind a table or chair and place your feet slightly apart.

* Lift one leg straight back, keeping your knee straight.

* Hold this position for 10 seconds.

* Repeat with the opposite leg.

The above exercises should be performed two to three times a day.

Balance Exercise Safety Guidelines:

* Be aware of your posture. Try to maintain your weight over your ankles.

* Avoid fast movements including quick turns or changes in position.

* Use a chair as a place to not only perform seated exercise but also to hold on to while standing.

* Always get up slowly when rising from a chair.

* Don’t close your eyes when exercising or standing from your chair.

* If you are taking medications, ask your doctor if there are any side effects which may cause light-headedness or decreased balance.

*** Lost your balance and fell? Visit www.doability.co.uk. We might be able to help you.

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Bathrooms at home usually need adaptation if an elderly or disabled wants to stay in the house and remain independent. Ensuring bathroom access and safety may require room customizations.

Falls often happen as people get in or out of the bathtub. Non-slip suction mats or non-skid tub liners or stickers can help prevent falls and provide firm footing.

Grab bars around the tub are a must for safety. These bars should be institutional-grade and installed according to the manufacturer’s directions for firm and solid support.  Using towel rods in place of them is strongly discouraged. Improperly installed bars, as well, will not support a person who loses balance.

Various types of bars and poles are available from plumbing supply companies. The type, number, and positioning of supports depend on:

• The wall space around the tub;
• The wall structure;
• The plumbing arrangements; and
• The disability of the person using the tub.

Two kinds of grab bars are often needed at the bathtub for the disabled or elderly:

1. For use in getting in and out of the tub from a standing position;

2. For use when lowering and raising the body to and from a seated position in the tub.

U-shaped bars are available in 12- to 40-inch lengths. They may be installed vertically or horizontally to a wall.

A vertically placed U-bar, attached to the side wall at the foot of the tub, allows safe entry and exit. Note that the foot of the tub is the end where the water faucets and drain are located. This vertical bar should be about 32 inches long, and placed near the edge of the outer tub.

Horizontally placed support bars are best for lowering and raising the body to and from a sitting position in the tub. A 12- to 15-inch bar may be placed at the foot end of the tub and a longer one along the back wall.

Diagonally placed grab bars are not recommended because the hand may slide; and if footing is not secure, falls are more likely to occur.

If the tub is free-standing at both ends, like in most older homes, and the end wall is too far for grab bars to be secured, a vertically placed pole on the access side of the tub may be used. This pole should be about 1.5 inches in diameter and extend from floor to ceiling. Place it between 1 foot 3 inches to 1 foot 6 inches from the end of the tub, close enough to the access side to reach from a sitting position. It also can be used to grasp with one hand while operating the water controls.

Angle bars from the back wall or behind the tub to the floor, with wall posts, may be used when one or both tub ends are enclosed by a wall. This is useful for persons needing to use both hands to enter and exit the tub.

A variety of portable seats, chairs, and benches are also available if sitting on the bathtub floor is difficult or impossible. One seat has side flanges that adjust to fit any bathtub. Inside-the-tub chairs with backs for greater comfort are also sold in the market today. An inside/outside transfer bench with adjustable legs allows the person to sit on the bench that extends outside the tub then slide to the inside of the tub.

Any chair or bench must have non-slip rubber tips and should be safe and comfortable. When using this type of seats in the tub, a hand-held shower head is preferable to use.

An angle bar attached to two walls provides support while standing, and also aids in sitting and rising from a bath bench or chair.

If the shower floor is slippery, non-slip suction mats or rubber silicone treads should also be used there.

A non-skid bath mat on the floor outside the shower is a necessity.

The standard 15- to 17-inch height of toilet seats creates a problem for many people, especially those with arthritis, hip, knee or back problems. Elevating the seat 5-7 inches more will give better leverage in regaining a standing position.

There are several types of removable and permanently fixed raised toilet seats available in stores. For a more permanent raised toilet, a plumber can put the stool on a wooden platform made to fit the toilet bowl base. If you are building a new bathroom, consider a wall-hung toilet that can be hung at any height.

A portable bidet for cleaning the perineal area without hands or paper may be attached to any standard toilet bowl. It is electrically powered with a mechanism for spray washing with warm water and drying with a flow of warm air. This promotes independence for persons with very limited hand/arm functions.

Grab bars around the toilets are a must. Many types are available, and the choice will depend on:

• Available wall space near the toilet;
• Nearness to other fixtures in the room; and
• Needs of people in the household.

If you have a physical limitation, we recommend you consult a physical therapist or a housing specialist to help you select and recommend placement of grab bars and other accessories for safety in the bathroom. If you are unsure of your wall structure, or do not have proper tools or skills, we suggest you hire a carpenter to install and/or make the new adaptations.

And for the latest bathroom and toilet aids for the disabled and the elderly, visit www.doability.co.uk.

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Another year has come to an end, and the year 2009 is now nothing more but a part of history.
So for 2010’s first article, I thought of sharing with you the history of wheelchairs.

It is uncertain as to what can be considered the first wheelchair, or who invented it. The first known dedicated wheelchair invented in 1595, called an invalids chair, was made for King Phillip II of Spain by an unknown inventor.

King Phillip II of Spain

But the wheelbarrow, a 3rd century invention from China used for moving the sick or disabled, is said to be the oldest evidence of wheeled chairs.

Wheelbarrow

In 1655, Stephen Farfler, a 22-year-old paraplegic watchmaker, built a self-propelling chair on a three-wheel chassis.

In 1783, John Dawson of Bath, England, invented a wheelchair named after the town of Bath. He designed a chair with two large wheels and a small one. The Bath wheelchair outsold all other wheelchairs throughout the early part of the 19th century.

Bath Wheelchair

However, the Bath wheelchair was not that comfortable, and during the last half of the 19th century, many improvements were made to wheelchairs. Comfort for the disabled person became more of an issue. Convertible chairs, with reclining backs and adjustable foot rests, were then invented. An 1869 patent for a wheelchair showed the first model with rear push wheels and small front casters. Between, 1867 to 1875, inventors added new hollow rubber wheels similar to those used on bicycles on metal rims. In 1881, the push rims for added self-propulsion were invented.

Indian Reed Wheelchair

It was also during this time when some wheelchairs were made from Indian reed, with large wheels either front or back, weighing 50 to 58 lbs. depending whether it had push rims or not.

In 1900, the first spoked wheels were used on wheelchairs. In 1916, the first motorized wheelchair was manufactured in London.

Foldable Wheelchair

In 1932, engineer, Harry Jennings, built the first folding, tubular steel wheelchair. That was the earliest wheelchair similar to what is in modern use today. That wheelchair was built for his paraplegic friend, Herbert Everest, who wanted a wheelchair that could go in an automobile. On 1933 in Los Angeles, together they founded Everest & Jennings, a company that monopolized the wheelchair market for many years. An anti-trust suit was actually brought against Everest & Jennings by the Department of Justice, who charged the company with rigging wheelchair prices. The case was finally settled out of court.

In 1934, Samuel Duke, independently of E & J responded to the demand in Chicago. He developed the second manual, lightweight, folding wheelchair for the market.

Over the years, the causes of changes in wheelchairs were brought about by the introduction of the automobile and the need to get wheelchairs into cars; the increased number of injuries due to automobiles; the development of rehabilitation and re-education programs for the injured; improved medical services; and the demand for independence of disabled people.

Wheelchair sports were introduced as a form of therapy in the rehabilitation program of Stoke Mandeville Hospital in Aylesbury, England between 1944 to 1947. They had their Annual World Stoke Mandeville Wheelchair Games. At present, there are more than 70 member countries in the International Stoke Mandeville Wheelchair Sports Federation.

Wheelchair Sports

Wheelchair sports improved the physical function of disabled people. It created more active individuals who want to do more. It increased the demand for performance in manual wheelchairs. Wheelchairs used in sports are lightweight, versatile, and stable.

Early power chairs used belts in the drive-train. The motor turned a rotor which had a belt wrapped around it, and the belt transmitted the power to the wheels. Today’s chairs use direct drive, meaning the motor turns gears which in turn move the power through a gear transmission to the wheels. Direct drive is more reliable and needs less maintenance.

Power chairs were actually once called “electric chairs”, until marketers realized that the public thought of electric chairs as machines of execution. The early power chairs were manual chairs with batteries and drive mechanisms jury-rigged on. The chairs were bulky and difficult to navigate with. Designers have since fixed those problems, and modern power chairs have all their elements integrated into a coherent system. While the first power chairs used electric power only for moving the wheels forward, today’s systems include powered adjustments for seats, foot rests, back pads, and head rests.

Innovation continued, with the first voice activated power wheelchair being used in Norway in 1984, enabling its young user to attend university classes. A new class of portable power chairs was also manufactured, that could be folded and put in the boots of most cars. In the 1990’s, innovation focused on custom power wheelchairs, with the manufacture of bases that can be tuned to suit the individuals needs.

Current innovations are extremely exciting, if rather expensive at the moment. One of the most exciting new developments of the moment is the Ibot. Not only does it rise up on two wheels, if someone tries to push you off your balance, it is better able to keep its balance than a human.

The Ibot

Unfortunately, with a price approaching $30,000, it is not for everyone.

Where wheelchairs will go from here is uncertain, but you can be sure they will be very different from now. It is likely that at some point there will be power chairs controlled by neurological impulses from the brain. Spanish scientists are currently working on a brain to computer interface which will allow users to control their chairs, while Texas Instruments recently demonstrated what they claimed was the first thought controlled wheelchair.

For the latest wheelchairs in the market today, visit www.doability.co.uk

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