Many people with multiple sclerosis (MS) have problems with mobility, due to weakness, numbness, imbalance, eyesight problems, pain and other impairments. Muscle weakness can make it hard to climb stairs or stand up.
While physical or occupational therapy can improve mobility to some degree, an assistive device may eventually become necessary to prevent falls, conserve energy, and allow you to live an active, independent life.
Finding a mobility device that’s suited to your particular needs is vital. Your healthcare providers (such as a physical therapist or an assistive technology professional) can help you choose, and use, the right tool for your situation. You may need different aids with different activities or on good or bad days, and your needs may change as the disease progresses.
• Orthotics (or orthoses, or braces) are inserts worn inside your shoes. They brace and support the ankle and foot, increasing stability, reducing fatigue and helping with spasticity (excessive muscle contraction). Specifically, they prevent foot drop – difficulty lifting the front of the foot, which causes you to drag your foot when walking.
• Functional electrical stimulation (FES) stimulates leg muscles with mild electrical currents. This may help you to move your foot and leg and to walk for longer. A small battery-driven device is attached below the knee.
• If you have some balance issues, or if one leg is stronger than the other, a cane is handy to take weight off the weaker side. A multi-point or quad (four-legged) cane gives even greater stability and support, although it may slow you down a bit. The cane must be adjusted to the correct height to prevent pain in the back, shoulder, arm or wrist.
• Forearm crutches are better for long-term use: the arm cuffs and handgrips offer comfortable support and stability, especially when you use two to take the weight off your legs. You can’t use crutches without good hand, shoulder and arm function.
• Walkers are helpful where the legs are significantly weak. A walker without wheels must be lifted as you walk, while a wheeled walker can simply be pushed. (Always put your wheeled walker brakes on before you sit down or stand.) You must be able to use both arms with a walker, and it must be adjusted to the correct height.
• Wheelchairs provide independence for those with great fatigue, weakness or unsteadiness. Manual wheelchairs are propelled with your arms. Other wheelchairs are designed for a caregiver to push. Manual wheelchairs should be light, with adjustable wheels and seat. A manual wheelchair can usually be easily stowed in a vehicle and requires less maintenance than the powered kind. However, they can be tiring, and some surfaces are difficult. Some wheelchairs have battery-operated motors that help to push the wheels in these situations; however, they’re bigger and heavier than regular manual chairs.
• Motorised scooters are three- or four-wheeled battery-powered vehicles, with a seat that swivels sideways to aid getting on and off. The mechanical tiller requires good hand control and coordination, but less physical effort than a manual wheelchair. Scooters cannot be modified if your physical condition changes, and can be unstable on turns – especially the three-wheeled models.
• Power wheelchairs are also battery-driven. Usually, a power wheelchair is operated by controls – joystick and buttons – mounted on the armrest, which can be customised and modified, as can the seating. These wheelchairs are relatively easy to manoeuvre over difficult terrain and longer distances. However, they’re heavy and hard to transport, requiring ramps or automated lifts. If your home has steps and narrow corridors or doors, you might be unable to use your motorised scooter or wheelchair inside. Always check your battery life before you leave home!