Improved lower body exoskeletons are giving new abilities and hope to people with limited mobility. They are helping patients relearn how to walk and reeducating their nervous systems. Exoskeletons can help patients take more steps in physical therapy sessions than other methods. Exos have been improving and are more adjustable and sophisticated than they were just a few years ago. They are allowing people to move faster and in spaces that would have been inaccessible.
Lower body exoskeletons can be used for gait training, mobility, and exercise. They can help users improve their balance, conditioning, and neuromuscular cortical activity; reduce spasticity and pain; and improve their quality of life. Although many people say they have dramatically improved their mobility, exos have not been studied rigorously and are prohibitively expensive for many people.
ReWalk was the first exoskeleton to be approved by the Food and Drug Administration for sale to individuals. It can be used for gait training and personal mobility. ReWalk has sensors that monitor upper body motions and trigger stepping and gait patterns for walking and shifting from sitting to standing positions. Users can use their hands. ReWalk is recommended for T4 and lower injuries and can be used for 3.5 hours of walking on one battery charge.
The makers say people who use ReWalk have reported improvements in balance, core strength, bowel and bladder function, bone density, body composition, fitness, and sleep patterns and less pain, spasticity, hospitalizations, and need for medications. The company can work with purchasers to help them get reimbursement for ReWalk from their insurance companies.
The Ekso Bionics exoskeleton lets a user shift weight and activate footplate sensors to initiate steps. It has a variable assist mode, automatic mode, and manual mode. It can also be programmed to walk at a specific speed and stride length. Ekso adjusts depending on the user’s level of muscle control. It can also be adjusted for a person with different amounts of strength on each side of the body.
The Ekso is currently classified as a “Class II pending” medical device (medium safety risk) for functional-based rehabilitation, over-ground gait training, and upright weight-bearing exercise. It is intended to be used under the supervision of a physical therapist and can fit a wide range of users.
Parker-Hannifin is working on the Indego to help people relearn how to walk and to serve as a mobility assistive device for those who are fully or partially walking-impaired. It is intended to be used in conjunction with a wheelchair, not to replace it. The company intends for it to be used to help patients with spinal cord injuries, MS, strokes, and other neurological problems
A user can stand up and walk with the device compensating for muscle weakness. Mild vibrations and LED lights signal to the user when the Indego is about to initiate a step. It has a five-piece design with a back component, two upper leg pieces, and two lower leg pieces with integrated ankle-foot-orthoses. The pieces can be carried in a bag and are easy to put on and take off. Indego can support a person with level 3 spasticity.
These exciting innovations are giving new abilities and hope to people with limited mobility. We have been privileged to observe these devices being demonstrated at several Abilities Expos. It is heartwarming to see people move and walk who have been unable to for a long time. Their joy is obvious. As technology continues to advance and prices diminish, we hope that more people will be able to improve their mobility with these exoskeletons.Read More
The City of Los Angeles has reached a tentative agreement with disability advocates to spend $1.4 billion to fix crumbling sidewalks that do not provide people who use wheelchairs with the adequate public access required by the Americans with Disabilities Act.
The lawsuit was filed in August 2010 by Communities Actively Living Independent and Free (CALIF) and several disability advocates. The plaintiffs alleged that Los Angeles discriminated against disabled residents by not fixing damaged sidewalks; not repairing sidewalks with curb cuts that were too steep for wheelchairs; not removing obstructions that blocked sidewalks, such as signs and trees; and not ensuring enough access to public transportation via sidewalks. It is estimated that 40 percent of the sidewalks in Los Angeles are in need of repair.
Damaged sidewalks have been a problem for disabled Los Angeles residents for decades. Many residents of Los Angeles have been involved in accidents related to broken sidewalks. The city has paid over $6 million in damages related to trip-and-fall lawsuits since 2011.
According to the settlement, which still needs to be approved by a judge, the City of Los Angeles has 30 years to repair or replace damaged sidewalks. It is required to spend $31 million per year to improve sidewalks starting in 2016 and gradually increase it to $63 million per year in the future. The settlement also requires the city to pay $15 million in attorneys’ fees and costs.
This settlement is an important victory for disabled residents of Los Angeles. Cities and towns have a responsibility to make sure that their public spaces are accessible to individuals who use wheelchairs in accordance with the Americans with Disabilities Act.Read More
Working with a disability can be a challenge, but many people who use wheelchairs have overcome difficult odds and discrimination and found success in the workforce. We found some inspiring stories in New Mobility magazine that we wanted to share with you.
Renee Tyree, 49, knew from an early age that she wanted to be a doctor. When she was enrolled in college as a pre-med student, she was diagnosed with transverse myelitis, which caused lower limb paralysis. She encountered problems with an inaccessible college campus and people who tried to steer her away from her dream of becoming a doctor. She transferred to the University of Arizona, which was more accessible and had more supports in place for disabled students. She competed in the Paralympics in Spain and graduated as a doctor of pharmacy in 1993.
Tyree encountered discrimination in some jobs by people who questioned her abilities, but she persevered and won several promotions. She now works as a clinical implementation specialist, setting up computer operations systems for hospitals. She attributes her success to staying focused on her goal, putting people at ease, and giving them chances to ask questions.
Justice Ender, 29, was born with VATER Syndrome that caused a slanted pelvis, legs of different lengths, and small stature. He overcame abuse, an adoption that didn’t work out, and living without basis necessities and found a career as a media specialist and freelance writer. He advises other job seekers with disabilities to work as much as possible to avoid resume gaps and to network with others who might be able to offer them jobs.
Liz Davis, 24, was born with sacral agenesis. She uses a power wheelchair outside and a manual wheelchair to get around indoors. She studied graphic design and works as a web catalog administrator who designs, builds, and maintains web/e-commerce stores. She was fortunate to find a job in her hometown with an employer who is willing to work around her medical appointments. Davis says she works as hard as possible and always strives to do better.
Kip Johnson suffered a C5-6 complete spinal cord injury from a skiing accident six months before graduating from high school. His aunt helped him finish his studies, and he devoted the next two years to rehab. He tried several jobs before finding success as a real estate agent. Johnson and his fiancée plan to get married this August.
These individuals provide that people with disabilities can succeed in the workforce. With determination and perseverance, people who use wheelchairs can demonstrate their abilities and contribute to their chosen fields.Read More
Innovative physical therapy techniques are giving new movement and improving the quality of life for paraplegics and quadriplegics with spinal cord injuries.
Joanne Petersen had been a T9-10 para for 25 years. She was suffering from spinal stenosis, narrowing of the spine, that caused constant pain. She was considering surgery, but a friend urged her to try ADAPT Training, a gym that specializes in helping people with spinal cord injuries. She soon saw her pain decrease and some mobility return.
Project Walk is a gym that opened in Carlsbad, California in 1999 and later expanded to other locations. The trainers there encourage people to get out of their wheelchairs and work with mats, exercise machines, and standing to improve their strength and mobility.
Trainers at ADAPT Training and Project Walk guide exercisers’ legs through motions and have them focus on pushing or kicking. They often tap on muscles to trigger spasms that people can learn to control to increase their sensation and abilities.
Many people with spinal cord injuries are skeptical about what gyms like ADAPT Training and Project Walk have to offer. For a long time, people have generally accepted the idea that those with spinal cord injuries would have limitations for their entire lives and that there was little that could be done to help them. Views about how the spinal cord works and what people with both complete and incomplete spinal cord injuries can do have been evolving in recent years.
Participants in these programs often find that their strength has increased, their range of motion has improved, they are able to stretch and exercise at home, and they have gained the knowledge they need to target specific muscles. They are also inspired by the positive atmosphere and camaraderie among the quads, paras, and their trainers.
Treatment for spinal cord injuries has come a long way. Quads and paras today have the possibility to regain some of their sensation and movement through intensive work with qualified trainers. We encourage other trainers and physical therapists to learn these strategies so that they can help people with spinal cord injuries improve their quality of life.Read More
Universal design is a standard that applies to landscape architecture in which public spaces are created that can be used by all people without the need for adaptation or specialized design whenever possible. Many design firms across the country are embracing this trend and creating public spaces that are accessible to people who use wheelchairs.
Michael Van Valkenburgh Associates designed the 396-foot-long Squibb Park Bridge at Brooklyn Bridge Park. This pedestrian bridge is eight feet wide and has gentle slopes, handrails, and impressive views of Manhattan, the Statue of Liberty, and the Brooklyn Bridge. It was designed to provide visitors who use wheelchairs and other mobility devices with the same access as runners, cyclists, and other visitors. Van Valkenburgh Associates prefers to use landscape-based solutions, rather than mechanical ones, which can experience technical problems. They believe landscape-based solutions provide better continuity and greater enjoyment of parks and other public spaces.
MAde Studio in Detroit has used universal design to turn an abandoned railway cut into a greenway that provides easy access to historic parts of the city. Dequindre Cut is a railway that was created in the 1920s to transport freight. It runs below grade as it travels north, which posed challenges for the landscape designers. They used a series of ramps and landings to integrate spaces designed for sitting, eating, and socializing near markets and around the Dequindre Cut. The Detroit Edison Academy is connected to the Dequindre Cut with ramps, retention walls, and terrace garden beds.
Olin Studio in Philadelphia has redesigned several public spaces around national landmarks to incorporate elements of universal design. The firm has worked on Independence National Historic Park, the Washington Monument, and Bryant Park in New York. Their designs include gentle slopes and ramps that are made to look like they are part of the original designs.
The 25-acre Millennium Park in Chicago was originally designed with a number of staircases and other elements that would have made it inaccessible to people who use wheelchairs. It was redesigned to provide wheelchair accessibility with a series of ramps, gentle slopes, and barrier-free play areas, earning it a Barrier-Free America Award from the Paralyzed Veterans of America. The park includes Crown Fountain with an accessible reflecting pool.
MIG, based in Berkeley, California, has always practiced universal design. The firm has designed dozens of accessible parks and has written guidelines for agencies about how to make public spaces accessible. MIG designed the Always a Dream Play Park in Fremont, California, that has gentle slopes, misters, water cannon play areas, swings with improved back support, and a slide. Partners in the firm are involved in the re:Streets project that aims to make streets accessible to people of all ages and abilities.
The practice of universal design has allowed public spaces to come a long way in terms of accessibility, but more work remains to be done. We applaud these designers for their efforts to make public spaces accessible to people with disabilities and encourage others to follow suit.Read More
Latisha Anderson is an “RN on wheels,” a paralyzed nurse who has overcome the odds to succeed in her chosen field. She has proven that she is capable of doing all the things that other nurses do and can manage the challenges of the job even though she uses a wheelchair.
Anderson was struck by a stray bullet when she was 17, just two months before she was planning to join the Marines, and became paralyzed. After she was shot, Anderson received treatment at East Carolina University, the same college she would later attend. She obtained her GED from Wake Tech and rode buses three times a day. If a bus arrived without a wheelchair lift, she called Washington, DC to complain.
She was inspired by an article she read about Barry McKeown, a former surfer in Hawaii who was paralyzed in a car accident and uses a wheelchair. He managed to have a successful nursing career. Anderson wrote to him, and he told her all she needed was a stand-up wheelchair.
Anderson graduated from both East Carolina University and online Grand Canyon University. She drove herself to Arizona to pick up her online diploma. Both schools published articles about her and her accomplishments. She has worked in psychiatric units, a veterans’ hospital, and a senior center.
Even though she has achieved many of her goals, some people still question Anderson’s abilities. She has faced bias toward her disability on the job, but she is determined to show that she can do her work just as well as anyone else.
Central Prison in Raleigh, North Carolina hired her through a nursing agency. She underwent a phone interview but did not meet with anyone in person until her scheduled first day on the job, March 2. When her employer found out that she used a wheelchair, she was sent home and told that they could not use her.
Anderson refused to accept that. She filed a complaint with the governor’s office, called a reporter, and sent out a number of emails explaining that she works hard and desperately needs income from the prison job. The prison called her back and asked her to start on March 16.
Latisha Anderson is an inspiration because she has proven that she is just as capable of doing her job as a person who does not use a wheelchair. She has shown strength and determination and has stood up for her own rights and those of disabled people across the country. We wish her success in her new job.Read More
Disney is continuously working to make visiting its parks a fun and comfortable experience for guests who use wheelchairs. Its parks are well known for being accessible to visitors with disabilities. Hotels, monorails, boats, and walkways are all designed with wheelchair accessibility in mind.
New rides are built with features to accommodate guests with limited mobility. Several older rides have been retrofitted with special cars that allow for a level transfer from a wheelchair. Some rides allow visitors to remain in a power wheelchair. Guests are given a map that highlights rides that are wheelchair accessible.
Scootaround provides a Meet and Greet service at Disney World Properties. Guests can rent personal mobility equipment through Scootaround’s reservation service in Orlando and Winnipeg and have the equipment delivered to them when they arrive at Disney World. Staff explain the features and are available to answer questions.
Disney introduced the Guest Assistance Card two years ago to help visitors with disabilities avoid long lines and other problems. The GAC was helpful for many guests, especially those with developmental disabilities. However, it was also abused, and in 2013 the GAC was terminated and the Disability Access Service card was introduced.
The Disability Access Service card is designed for guests who are unable to wait in long lines due to a disability. A card is issued at Guest Relations main access locations. Guests are given return times for rides based on the current wait time. Ride return times can be added at kiosks located throughout the park. After finishing at one attraction, a guest can receive a return time for another. The DAS card can be used in addition to the FASTPASS Service and Disney FastPass+.
FastPass+ is a virtual queuing system. Guests make an appointment for an attraction, show up at that time, and avoid waiting in line. Guests are limited to using FastPass+ for three rides per day.
Disney has shown a commitment to making its theme parks accessible to children and adults with disabilities. We applaud Disney for serving as a model for accessibility and providing its guests with the most comfortable and enjoyable experience possible.
Have you visited a Disney theme park and taken advantages of the services they offer for disabled guests? If so, please share your experience with us.Read More