Page 20 - Mobility Management, May 2017

ATP Series
Justify It:
Power or
Manual
Determining (& Justifying) the Better Mobility Choice
By Laurie Watanabe
hen working with clients who have lower- cervical spinal cord injuries (SCI) — think of the C5/C6 region — clinicians and ATPs can face a mobility crossroads.
Option 1: Ultralightweight manual mobility that’s self propelled, typically minimalist and elegant in design and appearance, and significantly more capable of fitting into less than ideally accessible environments, including cars and taxi- cabs. P.S. — they’re also typically less expensive, a detail very meaningful to funding sources.
Option 2: Power mobility, which preserves its user’s energy (and possibly its user’s shoulders) while offering touch-of-a- button powered positioning functions such as tilt to perform critical weight shifts.
Which pathway is better for any given client depends on many variables — clinical and, just as importantly, personal ones.
What Drives the Decision
Curtis Merring, OTR/L, MOT, is now a clinical education manager for Permobil. But as a former director of rehabilita- tive services, he has years of experience in assessing clients for complex seating and wheeled mobility. Clients have included
20 MAY 2017 | MOBILITY MANAGEMENT
those with SCI, and those whose level of injury could have indicated either manual self-propelled or power mobility.
“The decision between manual and power always starts with the person and their MRADL \[mobility-related activities of daily living\] needs,” Merring said. “The process is the same regardless of injury, but there are specific considerations that come up when working with a person with SCI.”
He noted that two clients with the same level of SCI could opt for different equipment choices based on other factors, including “genetic factors beforehand, ADL demands, what do they need to do, what do they want to do.
“We’re designing one wheelchair for one million functions, and each time I do a wheelchair evaluation and a wheelchair design, I’m just trying to eliminate as many trade-offs as possible.”
A Thorough Evaluation
While evaluations of clients with SCI will always include discus- sion of the levels of injury and incomplete vs. complete injuries, Merring suggested that clinical questions should be only part of the overall conversation that helps to determine whether a client uses manual or power mobility.
“I have an evaluation form that I put together,” he said. “\[It
MobilityMgmt.com
SPINE IMAGE: ISTOCKPHOTO.COM/BESTSALE