PhysicalTherapy.com Phone: 866-782-6258


Augmented Mobility Intervention

Augmented Mobility Intervention
Michelle Lange, OTR, ABDA, ATP/SMS
November 8, 2021

To earn CEUs for this article, become a member.

unlimited ceu access $99/year

Join Now
Share:

Editor’s note: This text-based course is a transcript of the webinar, Augmented Mobility Intervention, presented by Michelle Lange, OTR, ABDA, ATP/SMS.Learning OutcomesAfter this course, participants will be able to:identify clinical indicators for canes and crutches to increase functional balance and functional mobility for ADLs/IADLs.identify clinical indicators for walkers to increase functional balance and functional mobility for ADLs/IADLs.identify clinical indicators for gait trainers to increase functional balance and functional mobility for ADLs/IADLs.What We Are CoveringMobility SeriesAugmented MobilityDependent MobilityManual MobilityPower MobilityThis is part of a series on mobility. Mobility devices are on a spectrum. We start with augmented mobility devices like canes, crutches, walkers, and gait trainers. From there, we move into dependent mobility devices such as adaptive strollers, transport chairs, and tilt-in-space manual wheelchairs. Manual mobility and power mobility devices round out the series. We have courses on each of these topics. If you are interested, I encourage you to check out each of these.Augmented mobility uses devices that augment or assist ambulation. These are used with someone who has some ability to ambulate. A device augments mobility to either improve efficiency, safety, or both. This includes walking aids such as canes and crutches, walkers, and gait trainers. These are each used for different reasons with different ages, populations, and diagnoses. We will touch on this as we move through this information.Why Does Someone Need These Devices?Decreased strengthDecreased balanceDecreased stabilityWhy does someone need these devices? It could be for a host of reasons. Many of us have used a pair of crutches or maybe even a cane. You may have sprained your ankle or broken your leg. These are fairly familiar pieces of equipment to us and are often used temporarily. People who may need to use these on a longer-term basis may have decreased strength, decreased balance, or decreased stability.Goals of Augmented MobilityFall preventionIncreased mobilityStrengtheningDynamic weight-bearingOne big goal with using augmented devices is to prevent falls by compensating for lack of strength or balance. We also want to increase their mobility, so this person can go a little further or ambulate in other environments than their home. Many people "furniture walk" in their home, which we know is not very safe and certainly limits where they can move. Sometimes, this equipment is used for strengthening to improve functional abilities. Again, it depends on the item and the person using it. Some of this equipment, particularly gait trainers, provides dynamic weight-bearing, rather than static weight-bearing, like in a stationary stander. The person moves while bearing weight through their legs.Who Uses This Technology?Varies with deviceWho uses these devices varies by device. We will talk about people who use these in each of these categories of augmented mobility as we go. CanesDefinitionTypesClinical indicatorsContra-indicatorsPopulationClinician roleWe are going to start with canes. You may be thinking, "I know what a cane is. How hard can this be?" There are times when it is appropriate for a client to use a cane and times where we should be recommending something else. And, there is a surprising amount of variety of features on canes that can make a significant functional difference to the client. DefinitionA cane is generally a vertical pole with a handle grasped by one hand to assist in ambulation.TypesStandard canesTypically, height adjustableQuad canesSeat canesWalking sticks (1-2)We have all seen those standard canes. These are typically height-adjustable, designed to be rather generic, and are typically accessible at local drugstores. They are designed to meet many people's needs. These are height-adjustable to find the correct height for an individual. This is based not just on their own height but also on whether there is some fixed kyphosis happening or other factors to best support the individual. There are quad canes like the one pictured in Figure 1.Figure 1. Quad cane from ProBasics.The idea is to provide more stability under the cane than one single point of standard cane. There are seat canes. These are a little clunky to use as a cane, but the idea is that if someone gets tired, they can stop and sit down.Some people benefit from using walking sticks. I use a walking stick when I am hiking. These are also height-adjustable, and a person might have better control with a walking stick, particularly if they need that height to be much higher than a standard cane.AccessoriesFlex tipSelf-standing tipIce cane attachmentThere are also a variety of accessories for canes. In Figure 2, there is a flexible tip that is available from many manufacturers. This means that when I put my cane down, even if the cane is not absolutely perpendicular to the ground, the tip of that cane will be firmly in contact with the ground because it flexes. This can really help someone be safer as it improves stability. Figure 2 shows a self-standing tip.Figure 2. Flexible cane tip by FlexSTICK company.It depends on the cane's surface, but this helps someone be less likely to drop their cane. For example, a person can put their cane down to unlock their front door. They do not have to worry about leaning it up against something and it slipping. This can be a common concern. There is even an ice cane attachment that you see pictured in Figure 3.Figure 3. Ice cane tip by Vive Health.I would be a little leery of recommending that my clients go out with their cane in an ice storm. However, if the conditions are such that this type of tip is required to improve safety, it is available.FeaturesFoldingVarious style handlesThere are folding style canes. If someone does not need their cane all the time and wants to fold it up to stash it in their purse or bag, it gives them that option. This is also a convenient option when traveling, especially on airplanes. There are different handles too. Some of these handles are designed to look a little more interesting, while others are designed for specific ergonomic purposes. Depending on your client's grip or range limitations, different styles can be used to best match the person's abilities.Clinical IndicatorsTo provide walking assistanceTo assist sit to standTemporary use: post-injury or surgeryLong term use: decreased mobilityCanes provide walking assistance as someone is moving along....

To earn CEUs for this article, become a member.

unlimited ceu access $99/year

Join Now

michelle lange

Michelle Lange, OTR, ABDA, ATP/SMS

Michelle is an occupational therapist with over 30 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, editor of Fundamentals in Assistive Technology, 4th ed., 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 certified ATP, certified SMS, and is a Senior Disability Analyst of the ABDA.

 



Related Courses

Matching Products to Seating Needs
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #4099Level: Introductory1 Hour
Once the wheelchair seating assessment has been completed and seating interventions considered, it is time to match specific client needs to product interventions. This course presents various categories of seating systems. Seating systems, whether linear, contoured, or molded, are comprised of primary support surfaces, secondary support components, and materials. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Dependent Mobility Intervention
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #4102Level: Introductory1 Hour
Dependent mobility devices are not designed for self-propulsion. These include adaptive strollers, transport chairs, tilt-in space manual wheelchairs, reclining manual wheelchairs, and standard manual wheelchairs. For very small children, adaptive strollers are often required to meet positional and dependent mobility needs. Other dependent mobility bases, such as transport chairs and standard wheelchairs, are used for quick trips or for temporary use. Clients may also use a dependent mobility base as a backup to a power wheelchair. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Augmented Mobility Intervention
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #4107Level: Introductory1 Hour
Augmented mobility is used with clients who require assistance in ambulation. This category of equipment includes walking canes, crutches, walkers, and gait trainers. Augmented mobility is used to prevent falls, increase mobility, and provide strengthening and dynamic weight-bearing. This course will systematically present each of these options with clinical indicators. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Manual Wheelchair Mobility: Self-Propulsion
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #4176Level: Introductory1 Hour
Most manual wheelchairs are designed for self-propulsion and fall into categories. This course systematically explores each category with clinical indicators, as well as optimal frame configuration to increase propulsion efficiency and reduce the risk of repetitive stress injury.

Power Wheelchair Advanced Features
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #3990Level: Advanced2 Hours
Power wheelchairs do far more than drive – the driving method can be used to navigate and control other features including Reverse, Speeds, Power Seating, or an Interfaced Assistive Technology device (i.e. a communication device). Power Wheelchairs can send Bluetooth signals to control devices such as tablets and smartphones. Finally, new SMART technologies are making power wheelchairs safer and more efficient for everyone. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.