July 2, 4:41 PM · Kathryn Arbour - Denver Mobility Products Examiner



Physical therapists and durable medical equipment (DME) manufacturers and dealers have spent a lifetime telling people NEVER to use a rolling 4-wheeled walker as a wheelchair. The traditional A-frame design of these ubiquitous and mighty machine

s is not designed to be pushed or rolled in any direction with someone perched on the seat. The advantage of a rolling 4-wheeled walker with brakes and a seat is that it offers a resting option for the user who may tire easily and often. Many falling injuries occur as elders try to scoot themselves while seated on these walkers.

However, all that great advice is about to change with the arrival of combination rolling walkers/transport wheelchairs. Long on the radar screen of DME manufacturers from a design perspective, the actual translation of the design into manageable pieces of mobility equipment has taken longer than most would have guessed. Some of the earliest models as recently as five or six years ago required so much manipulation for the transformation that some claimed a degree in engineering was necessary. And, weight is always a problem with DME products whose users already have physical challenges of one sort or another.
Things changed last year as a number of manufacturers cracked the code and produced some of the first viable combination units. This review examines versions created by three different manufacturers, American Bantex, Drive Medical and Medline.
American Bantex calls their unit simply a combo walker/transport chair. It sports the A-frame typical of rolling 4-wheeled walkers. When converting to a transport wheelchair, the back rest pops out of one side and into the other. Two footrests stay folded against the side of the walker ready to pull down into position once the individual is seated. The look is attractive and unobtrusive and the actions needed are minimal to create the transformation. The one difficulty occurs with steering. Rear swivel wheels that work well as a walker create some frustrations as they become front wheels of a transport chair. The individual pushing the unit fights against these unwieldy wheels. As one of the first to market, however, at a very reasonable price point, the unit sells well and users accommodate this quirky feature.
Drive Medical also released their version, dubbed Duet, in 2008 with a few big improvements over the American Bantex. All four wheels are the same. By using larger wheels, the unit moves more smoothly both as a walker and a transporter. This manufacturer also developed a footrest that swings out of the A-frame, keeping it tucked out of the way when the unit is used as a 4-wheeled walker. The backrest is sturdier and layered with extra foam. This unit also has two handles that fold out to use as armrests when in the transporter mode. These two features alone provide more comfort to the individual. The unit weighs about the same as the American Bantex version and looks quite similar, although the folding mechanism is tight and offers challenges to typical users.
Medline, a family owned U.S. business and one of the largest provider of medical supplies and related products, is introducing its version, The Translator, this summer in a few U.S. markets. The earliest version offers a number of advantages over its competitors. First and foremost, it is considerably lighter in weight with a nylon seat and backrest and a lightweight aluminum frame. The backrest simply flips over with the simplest of movements. Medline uses the footrest design popularized by American Bantex. The unit is wider, which is both a plus and a minus. A wider seat is more appealing to a large number of users. A wider frame, however, makes it difficult to maneuver easily through stores and the insides of many older homes. Of the three models this one is by far the easiest to transform. However, of the three it is also the most difficult to fold. The seat is firmly anchored in seat guides that are exceptionally tight. While this ensures a solid sitting surface, it makes it virtually impossible to fold without assistance. Once folded, though, the Medline Translator is the lightest weight model on the market and can fit easily behind the seat of a car. No heavy lifting required.
As one of the newer DME products to hit the marketplace, the combined rolling walker and transport wheelchair is welcomed by individuals and caregivers alike. The product will not eliminate the widespread popularity of both the rolling 4-wheeled walker and the transport wheelchair, but offers a satisfying solution for families who are looking for a single solution. There is an MSRP price point differential of about $50 among all three models, although dealer pricing varies widely, especially on the internet.
For more info:
See the Drive Medical Duet
Read more about walkers
A local retailer changes one woman's life with a transport chair

Author
Kathryn Arbour is an Examiner from Denver. You can see Kathryn's articles at: "http://www.examiner.com/x-10736-Denver-Mobility-Products-Examiner

CityNews.ca Staff

It's one of the most devastating diseases in the world, a silent thief that gradually robs patients of their ability to do all the things they once took for granted, from playing sports to simply going for a walk.

Canada has one of the highest rates of multiple sclerosis in the world, although experts still aren't exactly sure why. They do know it can affect a person's balance and leave them in a wheel chair. And there's no cure.

But now there may be some new hope and it's thanks to the remarkable determination of some patients not to give up - and an amazing invention out of Alberta. Sylvia Bauer is the former and she's putting the latter to good use.

It's called the WalkAide, a miniature computer that stimulates the muscles in the leg and allows some MS sufferers the chance to walk normally again.
"I developed drop foot," she explains. "It means that the muscles that make your foot and your muscles move don't work any more." She had to rely on large awkward braces to move around and getting anywhere was an agonizing chore.
And then she heard about WalkAide, a small device you wear around your legs. It teaches the computer to adapt to your normal gait.

It then electronically stimulates the muscles, forcing your legs to work as close to the way they used to as possible.
"We're artificially replacing muscles that don't work," outlines Yim Lok. She's an orthotist, a person who makes and fits appliances for people with weakened muscles.
And it's not just MS patients who benefit. The WalkAide can also help those with other mobility related ailments, like cerebral palsy or a stroke.




So how well does the WalkAide work? Bauer's braces are gone and she's able to traverse the floors of her home easily. She was also able to take part in the 5K MS Walk earlier this year, something she never would have dreamed possible before.
The device isn't cheap - it costs $4,500. But Bauer thinks it's worth every penny. "This gives you a sense of just living your life normally and not thinking about it every time," she relates.

Want to know more? Take a virtual walk here to find out if the device will work for you.

New robotic walking system gives hope to people with paralysis

By BRITTNI REINERTSEN

Bellevue Reporter Contributor Jan 12 2009, 5:30 PM · UPDATED

Pushing Boundaries, Washington’s only exercise-therapy center for people with paralysis, is gearing-up to introduce the state’s first robotic walking system, the Lokomat, early next year. The machine will be available for public use and may help those with paralysis regain strength and, in some cases, learn to walk again.
The Redmond-based facility held a luncheon at Bellevue’s Meydenbauer Center Nov. 6 to raise funds for the much-anticipated machine. Together with friends, family, and clients, Pushing Boundaries raised close to $90,000. The total cost for a Lokomat is $300,000.

“It (the luncheon) turned out really well, better than we could have hoped for,” said Shawna Hanson, the Event and PR Coordinator for Pushing Boundaries.
Featured at the event were client testimonies, a video describing the machine and its use, as well as a speech from co-founder Sharon Northrup.
“Pushing Boundaries started as a result of an injury Allan (her husband) sustained while we were both driving over I-90 seven years ago,” Northrup explained. The accident left Allan paralyzed from the mid-chest down.
They decided to move to San Diego where their daughter had discovered a new type of exercise therapy. Eventually, Sharon and Allan returned to Washington and founded a similar facility.
The mission of Pushing Boundaries is to improve the lives and health of people with paralysis through intensive and creative exercise-therapy programs, whether the condition is recent or long term.
The Lokomat is an example of the creative therapy that Pushing Boundaries emphasizes that could reverse “learned non-use” in affected muscle groups.
Here’s how it works. A person strapped into a harness is suspended over a treadmill, where they are attached to robotic sensors. They help move the legs in a natural walking pattern that is even, consistent and can be sustained over long periods of time.
According to the Rehabilitation Institute of Chicago, it is believed that this repetitive walking pattern helps the brain and spinal cord work together to re-route neural signals that may have been damaged due to illness or injury. The resulting “re-connection” helps the body regain mobility that has been lost due to injury, stroke or other neurological disorders such as Multiple Sclerosis.
The institute, which began clinical trials of this therapy in March 2002, claims other benefits that may include regained muscle strength and improved circulation. The weight-bearing nature of the machine may also help strengthen bones at risk for osteoporosis.
“Locomotion therapy is becoming something that’s more widely accepted,” said Hanson. “Doctors are learning that there are things that can build around the site of the injury to make a new connection.”
Jerry Daniels, an exercise therapist and certified personal trainer at Pushing Boundaries, explained how exercise therapy, like gait-training, helps to improve mobility. He compared the spine to a “super-highway.”
“Just because the highway’s been choked off, doesn’t mean we can’t go around the back roads. The body is always trying to fix itself; it wants to get better! If you help it by being active, it will work with you.”
Devin Givens, a young man and client at Pushing Boundaries, is an example of this concept.
In August 2007, Givens was in an all-terrain vehicle accident while vacationing with his family in Canada. Despite wearing all the required safety gear, the crash left him with three broken vertebrae. Luckily, Givens’ spinal cord was not severed and he maintained sensation throughout his body. However, he was left unable to walk.
“Virtually, he had a little bit of movement and a lot of spasms,” said his mother, Shannon Vernerey.
Both Givens and his mother were told that what mobility he could regain in the first 12 to 18 months following his accident would be it.
“I was told by the doctor in Canada that there was nothing we could do for him,” Vernerey said.
Then in December 2007, they came to Pushing Boundaries. There, Givens and his mother encountered an optimistic atmosphere where the vision is to inspire hope for those living with paralysis to do things they never thought possible.
At first, Givens could only stabilize himself while sitting on the edge of a mat.
“Today, he is standing at the parallel bars and taking some steps. He’s still regaining movement, he hasn’t plateaued at all,” said Vernerey.
She and Givens look forward to the boundaries they will continue to break through when the Lokomat arrives.
“As soon as I get on it, I’ll take off. Connections will be made,” said Givens.
Vernerey said she is totally convinced that the machine will help her son.
“With the success of this machine, how it helps the body reconnect and regenerate the nervous system. … I am totally 100 percent believing that he will walk again in his lifetime. There isn’t one doubt in my mind.”
William Holmes is another Pushing Boundaries client who is “psyched” for the Lokomat to arrive.
“You get to exercise. It’s going to be amazing! To have something that’s going to walk you. I mean, I haven’t walked in seven and a half months,” Holmes said.
He became paralyzed from the chest down as a result of a motorcycle accident along Seattle's Lake City Way last February.
Mike Buckel, one of Holmes’ trainers, is looking forward to the Lokomat as an alternative method of gait-training exercise. Clients currently practice walking on a light gait treadmill where they rely on trainers to set the pace and place their feet. The process is often slow and difficult.
“I think it’s going to be so much easier having a machine that walks somebody with the proper gait pattern rather than us doing it in cadence. Five minutes of doing that thrashes your body,” Buckel explained.
Another benefit of having a Lokomat at Pushing Boundaries is public access.
“We identified that this type of therapy was not available to anyone in the state of Washington,” said Tricia Lazzar, director of Pushing Boundaries.
“That’s the benefit of having it here; anybody who has the ability to go through gait-training would have the opportunity to use it,” she said.
Lazzar explained that there is a Lokomat in Portland at the Oregon Health Sciences University. However, it is used for stroke rehabilitation and not available for public use.
There will be no extra cost for client’s to use the Lokomat at Pushing Boundaries. An hourly fee of $80, some of which can be subsidized by the facility, includes the use of all equipment during one-on-one therapy sessions with a qualified trainer. Clients are required to come in for two-hour sessions at a minimum of two days a week.
“Bringing the Lokomat to Pushing Boundaries will impact literally hundreds of people in the state of Washington that are affected by paralysis each year,” Northrup explained at the luncheon.
The numbers alone reinforce her statement. According to Northrup, there are almost two spinal cord injuries a day in Washington state.
Northrup ended her speech by saying that whether "we want to believe it or not, tomorrow, the next day and every day there will be people who have things happen to them who will need us.
“We cannot change how many are injured,” she said, “but we can change how many we can help.”
For more information on the Lokomat or to make an appointment for a tour of the Pushing Boundaries facility, visit its Web site at www.pushing-boundaries.org or send an e-mail to info@pushing-boundaries.org.
Brittni Reinertsen is a student in the University of Washington Department of Communication News Laboratory.