People who had difficulty walking because of a spinal cord injury, limb loss or brain injury often used aids to help their mobility. These included wheelchairs, prosthetic limbs, Zimmer walking frames, crutches and walking sticks. People with visual impairments used long canes and/or guide dogs to help them get around.
Some people we talked with were probably going to be using a wheelchair for the rest of their lives. Others learned to walk again unaided, used another mobility aid such as callipers, or used their wheelchair intermittently.
Wheelchairs
Wheelchairs represented independence for some people we interviewed. They began to use wheelchairs in rehabilitation, where physiotherapists helped them to learn relevant skills. They also attended courses to learn how to use their chairs to get up ramps and kerbs.
Some had more than one chair: one for indoors, another for outdoors; or one for upstairs and another for downstairs. People used manual or electric wheelchairs. Wheelchairs were financed through the NHS, local council or primary care trust, wheelchair vouchers, or compensation payouts. Brian’s former workmates clubbed together to buy one for him soon after he was injured.
With any mobility aid, including wheelchairs, people said that experience and a process of trial and error taught them what was best for them. Wheelchairs can be customised to individual need, but Simon felt the best ones were adjustable. It is important to get the right wheelchair for the person and NHS provision was not always good enough.
People with quadriplegia, who can be paralysed from the shoulders or chest down, may need more support for their upper body in a chair. It is possible to get straps to keep people secure in their chair, but people were not sure if this was a good idea in an emergency.
Prosthetic legs
Following limb loss, people usually used prosthetic (artificial) legs to help them get around. Prostheses were usually funded by the NHS. People were mostly happy with their prostheses although sometimes people felt there were budget constraints and differential treatment for some people. Specialised ones (like the blades worn by Olympian, Oscar Pistorius) were not commonly available.
Using their prostheses, people were often able to walk, run and cycle, and do things around the house they had been unable to do since their amputation. Nick considered his prosthetic leg a brilliant alternative to real legs if not a little ‘cumbersome’. People were happy to be able to walk again and some were proud that other people may not realise they were using a prosthetic leg. However, Nick pointed out that his made a slight noise when he walked and Jack has found he cannot stand for long and ‘his good leg takes a bit of punishment’.
Prosthetic legs are fitted quite soon after amputation. The part of the leg that is left after amputation is known as the residual limb or stump. Over time the stump shrinks because it is not being used and so several appointments are needed at the limb fitting centre to adjust the prostheses or to have new ones fitted. (For more information on prosthetic limbs, see Limb Loss Information Centre in our ‘
Resources‘ section.)
A covering called a cosmesis can be worn over the prosthetic limb to make it look more lifelike. It allows people to conceal their prosthetic. Whilst people understood why this may be important to others, they usually chose not to wear one because they did not look particularly realistic or they did not fit well under trousers, especially for above-knee amputees.
The foot on a prosthetic leg is smaller than the other foot. It is quite flexible and gave people a realistic ‘heel to toe sensation’ (Jack). People could buy most kind of shoe to wear with their prosthetic, other than boots or heavy footwear.
People had regular contact with the limb fitting centres and met with prosthetists, the staff who make and fit limbs. The centre was a good place to get information from other patients as well as from staff. Knowing what problems were urgent and what could wait was something people learned from experience.
It is important to keep the stump and limb socket clean because prosthetic limbs can cause skin problems (e.g. skin breakdown, blisters, bruising). A poorly fitted prosthesis can cause pain when the stump touches the socket. Such problems can often be dealt with, and can be related to weight gain or the weather. People used cream, allowed the stump to get fresh air and used the prosthesis for limited time to manage this. Some people were unable to find a satisfactory solution and opted not to use one.
Long canes and guide dogs
People whose injuries resulted in visual impairment used long canes to aid their mobility. Rob described his as ‘a trusted companion’. Long canes were important for alerting others to the impairment and for helping to get around. As well as helping people find mobility aids, rehabilitation staff helped people with visual impairment plan their daily travel routes.
Guide dogs also support visually impaired people to get around. Rob did not want a Guide dog at first because of the responsibility involved in looking after a dog. He has learned how Guide dogs improve the speed at which people get around because they perceive obstacles in the way and make it obvious to other people that the owner is visually impaired.
Other aids