Mobile disability travel challenges

One would favor how many countries seem to be somewhat more conscious about tourists with mobile disabilities. They treat them as invalids – not valid. But they try. Overcoming mobile disability travel challenges are difficult both in the USA and internationally. It is virtually impossible for those without disabilities to conceive all the details people with wheels, crutches, and canes require to smoothly go from point-a to point-b. Current statistics show about 10% of the world’s population (650 million) have some form of disability.

Part of the statistical problem is that most people who need mobility aids don’t want to use them. It took me years to realize I needed a cane to walk better. Another 6 months that I needed AFO braces. Based on data from the 2002 US Census Bureau, 96 percent of people who live with an illness live with an invisible one, and 73 percent of people who live with a severe disability do not use devices like a wheelchair. So, counting invisible mobile disability and mental disability, about 15 percent of the world’s population — some 785 million people — has a significant physical or mental disability, including about 5 percent of children, based on the World Health Organization in 2011.

Mobility handicaps meant no challenges if you sat comfortably on the inside looking out. For most of history that seemed fine. Mobile disability travel challenges happen when you want to go somewhere. Devices and scooters help you move. Traveling between points and having the comforts and necessities you need require considerable study. Yes, when going to supermarkets to parks or on vacations, even visiting friends and relatives, mobile disabilities uncover some hidden travel challenges.

It can be very disconcerting for those with mobile disabilities to navigate into certain stores, houses of worship, and other public spaces. There are disability travel challenges whether you are young and old. United States, over the past 30 years, has been implementing standards to help enable those that require mobility aid. Passed by Congress in 1990, the Americans with Disabilities Act (ADA) is the nation’s first comprehensive civil rights law addressing the needs of people with disabilities. Of course many buildings, subways, and other areas built prior to 1990 still have poor access for disability travel.

I use AFO braces as a mobile compromise for walking. To others I am walking relatively well, albeit slowly. What many do not know is, while I can walk on smoothly paved paths, I really can’t walk stairs, on grass, on sand, cobblestones, and rough surfaces. Somehow, when it comes to mobile disability travel challenges, manufacturers are designing more mobility scooters for travel.

Thinking of accessibility, parts of New York City are working towards removal of 19th-century cobblestones so that disability travel on those streets could be more accessible. This is causing many debates from travelers and local residents who see the removal as damage to historic infrastructures. In countries all around the world, different cobblestones have remained for centuries. Some countries replace old cobblestones with new ones.

For people using AFO braces, canes, and walkers, these surfaces may be impossible to travel. For those in wheelchairs or mobility scooters, this can be a very bumpy ride, even a dangerous ride if the scooter isn’t stable. For tourists, these rough surfaces make public plazas and churches historically attractive. After all, when these were built, disabled people weren’t supposed to travel anywhere.

Many of these countries barely have accessible accessories (high toilets with bars or shower bars) available in hotel rooms. There aren’t any ADA standards there. They barely have sidewalks and most still maintain bricked streets.

Rough and rugged US National Parks also provide facilities for wheelchairs and some trails that accept human-pushed wheelchairs. They are not accommodating for powered mobility scooters and virtually impossible for AFO-brace users.

First introduced in the 1960’s, Mobility scooters offer freedom and independence, leading to improved quality of life for a growing number of people. Manufacturers are continually investing in research and development to enhance existing products and introduce new models and features. Even electric car research has trickled to mobility scooters by introducing longer-lasting and lighter lithium-ion batteries to extend power and range abilities. More companies are introducing folding scooters that may be stored in the boot of many cars. Some of these are called travel scooters. But are they easy to fold and unfold?

What’s Required to Transport a Typical Travel Mobility Scooter:

Remove the seat by lifting it off of the scooter
Remove the battery pack by lifting it off of the scooter
Undo the retaining clips that connect the front and rear halves of the scooter, separating the frame into 2 compact pieces
Fold the tiller (steering column)
Place the scooter component into vehicle

Basically, any person with the need for convenient disability travel would require a competent aid. There are new design revolutions that simplify the processes, if you aren’t very tall or big.

Yet the largest challenges that disability travel encounter are the many roads, hotels, dining areas, and recreation areas that define accessible within narrow definitions. For example, Disney parks are accessible – bathrooms and paths. The rides and shows are probably not. Some restaurants there may have some stairs.

I have spoken to people using mobility scooters and their realities are they wish they could use AFO or K-AFO instead. Ultimately, all these disability travel accessories are compromises and out-of-the-box compromises. They allow mobility challenged individuals some control to move around environments.

Many technologies are being explored to allow people with mobility challenges more independence. Some scooters have elevating seats so you can have eye-contact with people. There are also more heavy-duty models with solid suspensions to tackle rough and rugged terrains, while remaining comfortable and easy to maneuver. Advances in battery technology mean you can now cover substantial distances on a single charge too, offering greater freedom. In deed, greater hope exists for overcoming disability travel challenges. The world wasn’t really designed for us.

Among all the challenges that people with motion disabilities encounter is that handicap accessible usually does not follow ADA standards. People without these challenges, as in many things, can only view things through their constructions of reality. After accidents, they might be sharing your perspectives. They get better but you don’t. Thankfully physiatrists, orthodists, and manufacturers strive for better mobility devices to give those with disability travel challenges better solutions that promote movement.

As far as international traveling, much care and attention is still required. On an AFO, I found it impossible. Some people with scooters find it challenging. We, unfortunately, can’t expect the world to adapt to our conditions. Thankfully, in the USA, the Congress passed the ADA act. Since passing that act, people with all forms of disabilities may get accessibility options that were never considered before.

In the aging baby-boomer generation, deeper studies isolate issues of disability as a stigma. Having a disability is seen as socially inferior. There is a sense of discrimination toward those with physical or mental disabilities. Some disabled people try to adapt to the world around them, if they can. As one of the most overlooked minorities of the world, disabilities are by ways of genetics and environment. No one wants a disability.

When travelling to other countries, the stigma is probably unintentional. Mobile disability travel challenges are to try to overcome the many staircases, cobblestones, and other features that make areas tourist destinations. From bathrooms, hotel rooms, and many public spaces, one actually sees those features that are not adaptable.

For fear of falling or injury, while physically disabled people do attempt to adapt toward experiencing many of the world’s wonders, those remain from a chair staring at images on a tablet or computer. Mobile disability travel challenges will likely remain one of those perilous things that require extensive research for superior disability awareness.

Surestep SMO helps baby walk

Development of a muscle group around the ankle may determine whether your baby will be able to walk on his/her own. A Surestep SMO is one of many external devices that gently wrap around your baby’s lower leg. It is an orthosis that helps your baby take those first steps.

Babies usually stand on their own and walk between 12 and 18 months. If baby is too unstable to do either, a good pediatrician suggests a pediatric neurologist. An SMO may help your baby take first steps. An SMO stands for Supra Malleolar Orthosis. It is designed to help support weak dorsal muscles and associated areas so your baby can walk.

The basic SMO is similar in design to an Ankle Foot Orthosis (AFO) that adults wear. It is a reinforced plastic sleeve that attaches to the ankle and is fastened with Velcro.It does not cure a possible condition but adds support to help make walking possible for those who can not support themselves/ The Surestep SMO is usually the most recommended device for babies.

I use an AFO called ToeOff BlueRocker to help me walk with mt muscular dystrophy impairment. I can’t walk without it.

David Zwicker, a certified orthodist, at Prothotic Laboratory in New York. He suggested the ToeOff AFO as an alternative to the one my physiatrist prescribed. He was right. Upon trying one of these ultralight carbon graphite devices, I was able to walk smoother than I had in previous years.

An SMO and AFO are particularly helpful with foot drop when your foot moves abnormally due to weak dorsal muscles at the juncture of your leg and foot.

Consequently, an SMO and an AFO have certain inabilities based on a wearer’s condition. Walking stairs and doing simple to complex maneuvers are difficylt. Falling in these may cause considerable damage to the supported area that is “caged” in the brace support. SMO and AFO are braces, albeit products using modern technology.

Controlling consequences, Surestep SMO suggests seeking out a competent orthodist (such as David Zwicker) who can help adjust the Surestep SMO for maximum comfort, usability, and performance. Many pediatric neurologists aren’t aware of the nuances of these devices.

A pediatric neurologist focuses on development delay of your baby. The practitioner also considers hypotonia or poor muscle tone.

Many pediatric neurologists connect with rehabilitation specialists. The key specialist is a physiatrist, a medical doctor that deals with helping muscle and limb structure and movement.

Unlike an AFO, the basic Surestep SMO is designed to be least invasive for your baby, as an integral part of the shoe. As such, muscle tone may improve as the baby walks more.

A Surestep SMO targets babies with muscle and angular improprieties as a device that helps move development along. At 18 months, most babies overcome the need by age 3.

After age 3, your pediatric neurologist may advise exploration of advanced and genetic testing that may point to dystrophies of muscles or some neural conditions. At any rate,

Basically, the Surestep SMO is an ideal way to aid walking movement and improved muscle tone with gait for most babies that may require it. It is a rather common neuromuscular problem with a variety of solutions.

Braces have evolved in leaps and jumps since those bulky ones that Forest Gump wore as a child. Can it be a challenge? Among those children who have walking diffriculties, an SMO or AFO is a major boost for healthy walking and social development.

ToeOFF Walk Aide is for New Balance

Imagine, if you will, that a child or adult is stricken by an event that leaves muscles inactive. There is loss of movement and, with it, losses of freedom. New technologies and research are helping mobility challenged to meet those extra challenges that bring more than the sense of normal movement. We are talking 21st-century ways to help you move much better than you’ve dreamed.

Muscular Dystrophies, ALS and Multiple Sclerosis are leading diseases that immobilize patients. There are also conditions due to compressed or damaged nerves as results of development, accidents, and war. When nerves and muscles can’t evoke action potentials to stimulate movement, you are unable to move. There are many levels of research to infer causes and effects. Biochemistry has thus far been leading symptom control. Over the past 20 years, giant strides have developed technological devices that can help promote movement, albeit better movement than none. There are perhaps only a few million people in the USA where chronic immobilization is a symptom. New tech research is helping those walk forward.

Immobilization may often occur in the mind but many suffer immobility from muscle weakness to severe paralysis. Those with spinal cord injuries may become permanently paraplegic with the inability to move their legs at all but new studies with electrical impulses can help carve ways to mobilize the immobile of body. For those with weak leg muscles, pushing walkers or using wheelchairs and scooters are the common ways of finding mobility. Precious few seek out trying to walk with braces. Braces are changing. They are no longer clunky and heavy. ToeOFF is a leading orthosis that you fit in your shoe. For those who have a form of ankle weakness, ToeOFF offers dynamic mechanical devices that help people walk more naturally. In recent years, alternate technologies, such as Functional Electric Stimulation of nerves have been emerging (FES). Is there attractive hope toward mobilizing the immobile?

Until FES experiments began in the late 1990’s, if you couldn’t walk you used a cane or crutch for support. In more severe cases, you might have used a wheelchair or would have been bedridden and constantly dependent on others.

In the mid twentieth century during the polio epidemics, leather and steel leg-braces were quite a common sight. A Persian, in the 15th century, first described the coating of plaster for fractures and other bony injuries of the limb. By the 17th century, there were braces for those who could not walk but they were heavy and cumbersome. President Franklin Delano Roosevelt was stricken with polio and used braces to stand when making speeches. They were those heavy leather and steel contraptions that were difficult to put-on and take-off. His braces were extremely difficult to use. In recent years, uses of aluminum and carbon fibers make braces lighter. Adjustable rubber and/or Velcro straps make them easier to adjust. AA Swedish designed brace, sold in USA as ToeOFF, is a prescription brace that helps certain people walk better and more comfortably.

Allard ToeOFF is known as a dynamic Ankle Foot Orthosis, often referred as an AFO that aid those people that have muscular weakness from the muscle groups that disable ankles to move up and down. The result is foot drag. ToeOFF using a lightweight, mechanical carbon-fiber device that helps restore a more normal walking gait. It’s a great device and helps many people with muscular dystrophy, multiple sclerosis, neuropathies, and myopathies that are aware of ToeOFF and the availability of the ToeOFF line and the use of other dynamic AFO devices.

ToeOFF is an appliance that allows people to easily put on and fit into different types of shoes. It is a lightweight, supportive brace specifically designed to correctly position feet for walking without foot drop. It covers the symptoms attributed to weaknesses in dorsiflexion of the ankle. Dorsiflexion problems may come from acute or chronic conditions. ToeOFF is a non-electric device that acts as a dynamic brace that normalizes the way you walk when a group of muscles don’t allow that seemingly simple action. Foot Drop is a relatively common problem among people of all ages but is also a symptom of nerve and muscle diseases. It can disable walking. ToeOFF is a prescription brace that helps facilitate “normal” walking (within degrees and limits) in those people with dorsiflexion from weak muscles.

ToeOFF has become a great aid for people with diseases where dorsiflexion is a symptom. Where other muscles are not as weak, ToeOFF is a fantasy device that helps people with muscle diseases walk. For overcoming the challenges of biped walking, ToeOFF really offers an alternative to some from being confined to a wheelchair or scooter.

Science fiction sometimes becomes reality and neurokinetic and neuromuscular researchers have more avenues and tools with which to explore how to stimulate movement and mobility for many muscle group problems. Of course, many studies are too small to deliver impact. Through various independent resources, including injured veterans from recent and ongoing Asian wars, there has been a drive to test electrical impulses as means of preventing pain and restoring movement. It seems like fantasy but small steps are being realized every day. For some, small steps bring large results.

Stimulating muscle movement to enable the motion-challenged to find motion is now being experimented with as a means to help people walk. The principle isn’t a new one. About 300 years ago, Luigi Galvani at the University of Bologna in Italy. He realized that if he sent an electric impulse at the lower spine of a frog, the frog’s legs would twitch. Similar experiments helped Galvani create neurophysiology as a study of how nerves can activate muscles in the body.

Galvani’s studies transitioned to studies of stress. In law enforcement, a Galvanic Skin Response in the hand helps determine whether a person may be telling the truth or not. The skin conductance response, also known as the electrodermal response (and in older terminology as “galvanic skin response”), is the phenomenon that the skin momentarily becomes a better conductor of electricity when either external or internal stimuli occur that are physiologically arousing. It occurs in the fight or flight response at the root of placing the body on stress alert.

A Superman on screen, actor Christopher Reeve suffered virtually total paralysis after a spinal injury. The Christopher Reeve Foundation offered grants (in the last decade) to study Functional Electrical Stimulation of nerve tissue to help induce movement. Functional Electrical Stimulation applies small electrical pulses to paralyzed muscles to restore or improve their function. FES is commonly used for exercise, but also to assist with breathing, grasping, transferring, standing and walking. FES can help some to improve bladder and bowel function. There’s evidence that FES helps reduce the frequency of pressure sores.

For research, FES is extremely valid when FES is used with a functional task such as walking, cycling, or grasping objects for a number of rehabilitative purposes and across differing diagnoses. FES has demonstrated the capacity for strengthening muscles enhancing circulation and blood flow, reducing pain, and retarding muscular atrophy.

In 2001, Case Western Reserve University, Department of Veterans Affairs, developed an intramuscular implanted system that activates the hip, knee, and trunk muscles to facilitate ambulation. At the time, the problems of electrode integrity in addition to adjusting the wavelength and amplitude signal measurements demonstrated promise.

Over the years, Federal Drug Administration worked at approving several devices that could provide enhanced results. Bioness L300 Plus adds a thigh component that facilitates knee extension and adds stability during walking as well. Other similar peroneal nerve (associated with the muscles that cause foot drop) stimulators commercially available are the WalkAide System and the Odstock devices. These systems have demonstrated long-term improvement in walking skills for persons with stroke as well as persons with multiple sclerosis and, possibly, other (thus far) incurable muscular diseases.

Alas, the rub is that virtually all these disabling diseases and conditions have no cure. Devices like ToeOFF and FES help the immobilized meet the challenges of moving. When you’re immobile or paralyzed, the facility of movement is like a light from the sky, even if only a short one.

The AFO and FES devices available for public use have been approved by medical agencies and federal groups like the FDA. This doesn’t mean that there are no side effects and contraindications as patients use them. While ToeOFF and WalkAide (and similar devices) are approved for certain conditions, each individual may be affected uniquely. Improvements may be individual specific and may not likely be generalized to work equally for a general population.

FES seems to be laying the groundwork toward the future of orthosis and. thankfully, there are products that offer advanced alternatives to the AFO. As relatively new, and somewhat unknown through the medical profession, FES is still somewhat expensive and most insurances do not cover use of a device like WalkAide. In addition, a pair of AFO (generally covered by insurance) may cost in the $1,000 to $2,000+ range. The WalkAide System may cost around $5,000 for a single and, a bit more, for a pair. Often these conditions may affect both left and right legs. Poverty and lack of adequate health insurance for those disabled by chronic nerve and muscle diseases. The merits of these prosthetics, however, could be life-changing to those afflicted by conditions.

In cases like multiple sclerosis and muscular dystrophy, understanding the etiology (causes) of the disease dynamics and causes is extremely important. Dorsiflexion is only one of possibly hundreds of symptoms. ToeOFF and WalkAide are examples of special devices that assist at making immobilization levels more mobile. While FES is promising for some, others may not benefit from neural electric therapies and devices.

ToeOFF and other AFO may work better with patients of muscular dystrophy and diseases of weakening muscles that are not necessarily associated with nerve damage. WalkAide may have little or no effect in those cases and, ominously, dystrophies have not been indicated to be (possibly) effective using an FES product. FES has been shown to be effective by generating electrical signals along nerve pathways and the nerves that are primarily associated at controlling muscles in certain areas. Some cases of dystrophy patients may not gain positive effects from an FES device because weakness is due to a genetic disruption of a neurotransmitter called Dystrophin and those signals may not change the efficacy of those muscles that affect foot drop and some other gait issues. That is why ToeOFF may still be the most advanced form of orthosis for muscular dystrophy patients.

Understanding those subtleties requires an integrated approach between physiatrists and rehabilitation specialists familiar with the problems behind neuromuscular conditions of different severity and sources. This is one of many reasons why ToeOFF and WalkAide are prescription products. For the most part, the etiologies of many of these conditions still require further research as well. In limited studies, however, products like ToeOFF and WalkAide remain to offer considerable help for those that can benefit by them.

ToeOFF is a partial solution and professional orthotists like David Zwicker, in conjunction with your prescribing doctor, can help patients optimize mobile functions. An AFO is an appliance and the appliance fits in a shoe, primarily a New Balance sneaker is recommended. As shoes are designed for feet and not necessarily a foot and an orthosis, the material of the shoe needs to be strong and stable enough to support it. Otherwise your balance may be compromised. You may require a wider size and may find that shoes last months instead of years. It’s a consequence that can be annoying. It’s fortunate that New Balance makes shoes with several width selections. That helps. Afflicted with moderate to severe dorsiflexion, ToeOFF helps you walk more normally than if you did not wear it. As an alternative to one of those electric wheelchairs, ToeOFF is a good device.

WalkAide does not require to be placed in a shoe. The battery powered unit may be placed anywhere on the calf around the peritoneal nerve fiber that is beneath your knee. That makes WalkAide an attractive alternative but only where nerve fibers and muscles interact with functional electrical stimulation. It may not work with patients suffering from muscular dystrophies or certain myopathies.

An orthosis, like a dynamic AFO (such as the Allard ToeOFF device) is a form of prosthetic. You might have your physical leg but the muscles related to dorsiflexion (and walking) don’t work. For the past 100 years, these prosthetics were heavy and large. While wealthy victims of Polio (i.e. President Franklin Delano Roosevelt) had to learn how to use them, ToeOFF is part of a group of AFO that are light and easy to use. Neuro-prosthetics is the study and development of medical devices that replace or improve the function of damaged neuromuscular organ systems and restore normal body processes, create or improve function, and/or reduce pain.

There is no 100% solution as of yet. It is promising that technological strides are being researched to offer immobile, afflicted people some more choices at the ease of getting around. Ranges might be limited. I guess it’s better to have some mobile range than none. There is promise in better AFO and FES development as the future unfolds. At least, there is hope.