Walker Facts

Multiple Sclerosis, “When to compromise”
Case Study

Diagnosis:

52 year old single woman diagnosed 23 years ago with Multiple Sclerosis of the “relapse-remit” type. Four years ago, the MS converted to the “secondary progressive” type. A slow steady physical decline is now anticipated.

Challenges and Strengths:

• Muscle weakness, episodic fatigue limiting endurance, some lower extremity spasticity.
• Unsafe higher level dynamic balance.
• Upper extremity function remains intact.
• Cognitively intact.
• Vision is currently unaffected.
• Lives alone in a supported living apartment.
• Lives on a company & government disability pension.
• Patient’s goals require more than one type of mobility aid.
  Her goals include:
  1) independent community access
  2) participation at social events in the building, and
  3) independent mobility in her apartment

Solution:

Lightweight rollator for indoor apartment use and a 4 wheeled scooter for use in the local community.

The decision to purchase a lightweight rollator with 6” wheels and scooter was heavily influenced by the funding criteria of the regional medicare system. The government program will purchase two complementary mobility aids: one designated for indoor use and one designated for outdoor use, but not two aids from within the same “outdoor” category.

The client, therefore, could not be prescribed a heavier, more stable 4 wheeled rollator categorized as an “outdoor” walker because she also required a scooter for community access.

The therapist and patient ruled out using a standard walker frame with auto-stop brakes as the basic, essential aid because she was unable to manage the walker with her ataxic gait. A lighter weight rollator with four 6” wheels was successfully trialed allowing the client to choose one from a variety of indoor walker possibilities. To safely use it, the client moves the rollator, squeezes the brakes, and steps forward. She was advised not to use the seat option due to her dynamic balance issues. This was unfortunate, but reasonable, as she used the rollator mainly within her apartment. She did benefit from the tray option for carrying items from room to room.

At a later date, this client will be eligible for a power wheelchair when her physical status changes to the extent that she is no longer able to use her rollator and scooter safely.