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Augmented Mobility

Augmented Mobility
Michelle Lange, OTR/L, ABDA, ATP/SMS
June 26, 2015
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Learning Objectives

  • The participant will be able to describe clinical indicators for canes and crutches.
  • The participant will be able to describe clinical indicators for walkers.
  • The participant will be able to describe clinical indicators for gait trainers.

Introduction

Augmented mobility is categorized into three main subcategories:  walking aids, which includes canes and crutches, walkers, and gait trainers.  All of these either "augment" or assist someone's ambulation.  A client may have decreased strength and needs something to provide some additional support.  These devices sometimes take the amount of strength that would be required in the legs and transfer some of it to the upper body.  These devices can be helpful for people who have decreased balance or a high risk of falling by providing stability for them.  Our goal, when prescribing these devices for clients, is to prevent the client from falling, as this can lead to injury.  Our clients may have difficulty getting up from a seated position and these devices can help with this as well. These devices may increase either the distance that a client can move themselves or the efficiency of that movement, decreasing the amount of work that the client needs to put into the task. Overall, we want our clients to be as independent and safe with mobility as possible.

By getting this person upright, we are also providing strengthening and dynamic weight-bearing.  This is particularly true of gait trainers.  Gait trainers are a unique area of augmented mobility, where our purpose may be improved mobility, but also specific therapeutic goals like strengthening and dynamic weight-bearing.  

Who uses these devices?  It varies quite a bit by type of device.  A client who requires a cane for ambulation may have very different motor skills and needs than a client who uses gait trainer.  We will get into this a little more as we look at each of these subcategories. 

Augmented Mobility- Canes

The first subcategory we are going to discuss in augmented mobility is canes.  We might have even used some sort of cane ourselves.  A modified version of a cane is a walking stick, and this is something we might even use if we are hiking, just to give us a little more of a boost when we are climbing up that mountain or to give us a little more stability when the surface is uneven.  Just as we might use a walking stick when we are hiking, a cane provides a similar goal for the clients who use them. 

A cane is generally a type of vertical pole with some type of the handle.  The client typically holds that handle with only one hand and the cane then provides an assist with ambulation.  There are a number of different canes out there. 


michelle lange

Michelle Lange, OTR/L, ABDA, ATP/SMS

Michelle Lange is an occupational therapist with over 35 years of experience and has been in private practice, Access to Independence, for over 15 years. She is a well-respected lecturer, both nationally and internationally, and has authored numerous texts, chapters, and articles. She is the co-editor of Seating and Wheeled Mobility: a clinical resource guide. She is the former NRRTS Continuing Education Curriculum Coordinator and Clinical Editor of NRRTS Directions magazine. Michelle is a RESNA Fellow and member of the Clinician Task Force. Michelle is a RESNA-certified ATP and SMS.



Related Courses

Continued Conversations, The CE Podcast: The Top Ten Mistakes Clinicians Make During Seating and Mobility Evaluations
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
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Course: #4610Level: Introductory1 Hour
This podcast will be a conversation about common mistakes made during wheelchair seating and mobility evaluations. The discussion will give you new ideas to improve the evaluation process!

Wheelchair Mobility: Power Wheelchair Alternative Driving Methods
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Video
Course: #4363Level: Advanced2 Hours
While some clients require a power wheelchair to achieve independent mobility, not all will be able to use a standard joystick. Clients with paralysis, muscle weakness, increased muscle tone, and uncontrolled movements can often drive a power wheelchair successfully when matched to the most appropriate alternative driving method. This course will systematically explore various alternative driving methods, including specific features, to match these complex client needs. Case studies will be used throughout.

Wheelchair Seating For The Pediatric Population
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Video
Course: #5907Level: Advanced2 Hours
Pediatric seating and mobility equipment are not simply smaller than equipment designed for adults. This course will present the importance of pediatric positioning, clinical considerations, how to determine if a child is positioned adequately, as well as alternative positioning. A detailed case study will pull all the information together in a practical way.

Computer and Tablet Access
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Video
Course: #5140Level: Intermediate1 Hour
This course will present a hierarchy of computer and tablet access options for clients unable to use standard access, such as a keyboard, mouse, and touch screen. Access assessment requires analysis of motor skills, vision, cognition, and functional applications. Alternative keyboards and mice will be presented, as well as other alternative access options.

Switch Assessment: Determining Optimal Switch Type And Placement
Presented by Michelle Lange, OTR/L, ABDA, ATP/SMS
Video
Course: #5928Level: Advanced2 Hours
An access method is used by the client to control assistive technology devices, such as power wheelchairs and speech generating devices. Single or multiple switches can be used for access, though careful switch assessment is required to determine optimal switch placement and switch type to meet an individual’s needs.

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