History of the Wheelchair

There are reports of wheeled chairs going back to the 6th Century in China found on stone tablets. The idea of the wheelchair has been around since the day's of King Louis XIV, who used a chair with wheels to get around his Kingdom. In 1595 the Invalid's chair was made for Philip II of Spain.  In 1655, Stephen Farfler, a paraplegic watchmaker built a self-propelling chair on three wheels. In the Mid 1700's the first recorded  wheelchairs being used to carry the disabled, interesting these chairs were called Bath Chairs, as they were made in a place called Bath.  In 1869 there was a patent registered for a wheeled chair to help people returning from the Civil War. The war spurred the production of wooden wicker chairs bound with wheels to help the injured return to their lives.  

In 1869 there was a patent registered for a wheeled chair to help people returning from the Civil War.

In 1993, Herbert Everest broke his back in a mining accident. His good friend Harry Jennings, a mechanical engineer; together they invented the first folding wheelchair, designed from steel tubes. This allowed the chair to be lighter, more comfortable and much more mobile than previous designs. E&J (Everest and Jennings) was also much cheaper, easier to product and allowed the chair to get to a much larger population. This brand is still being provided today.

In the 1950's Everest and Jennings came up with the idea of a powered wheelchair. For people who could not self propel, adding motors to a manual wheelchair frame gave the freedom of getting around. These first chairs was made from a steel frame, with attached motors, belts and pulleys, and with a hand control that activated switches in the back of the chair that told the motors what to do.

In 1952, in England, the Stoke Mandeville Games took place where War War II veterans competed in a series of wheelchair games. This was the beginning of international wheelchair games. Due to these efforts, the wheelchair was re-created, and several categories of wheelchairs were created; from basketball, rugby, racing, tennis and more.

The designs were dramatically improved in the 1970's. Motion Designs, who became Quickie, made changes in design to both folding and rigid framed wheelchairs. These enhancements made these chairs lighter, and easier to maneuver; improving access and independence.

Throughout the 1980s and 1990s several new companies spawned offering a new spin on these wheelchairs.  Several materials were tried to make chairs lighter, different grades of aluminum, carbon fiber, and titanium.

Until 2010, there were continued efforts to further technology and innovation.  With the wheelchair class, there are now several manufacturers making; companion wheelchairs, standard wheelchairs, light weight wheelchairs, ultra light wheelchairs, sports wheelchairs, reclining wheelchairs, tilt in space wheelchairs, lateral tilting wheelchairs, powered wheelchairs with a joystick and powered wheelchairs with controls ranging from no effort joysticks, to eye gaze control.

Now that the world is involved, there is no stopping innovation and technology. As other industry technologies arise, with the internet and manufacturing; the ability to share technologies will make these transformation much faster. We have seen in the last few years, computer game controls adapted to control powered wheelchairs. We have seen the touch pads from laptop computers be adapted to allow the finger to move / control the powered wheelchair.The use of even lighter Aluminum and Composite products to help improve the manual wheelchair.

We are watching the smartphone and tablet market boom, and watching mounts that will hold, and in some cases integrate with the powered wheelchairs.

In 2010, in the US, the federal government has instituted legislation that has slowed innovation due to the coverage determination for Medicare and other Insurances. Hopefully this is a speed bump, as with the babyboomers aging, there is still so much more needed and demanded from these products.

Since everyone deserves the opportunity for freedom and independence, the wheelchair will continue to evolve and improve.  Wheelchairs help those who cannot walk allow individuals to experience the quality of life that so many of us take for granted.

This article was written by Carey J.Britton, Assistive/Rehab Technology Supplier and Seating and Mobility Specialist for Active Mobility Center. He can be reached at cbritton@wheelchairguys.com or (800) 326-4463.

Staff Presentation: Enrico Cartei on Ramps

Not All Ramps are Created Equally !

Enrico presented on Ramps on 07/24/2013 to help educate our staff.  His presentation showed that ramps are not only important for the safety of the patient, but also will preserve the integrity of the equipment being used.

ADA (The Americans with Disabilities Act)

Twenty-three years ago this week our nation established a comprehensive mandate to eliminate discrimination against people with disabilities by enacting the Americans with Disabilities Act (ADA). The Department of Justice is proud to play a critical role in enforcing the ADA and opening up the gateways to full participation and opportunity for people with disabilities. Today, the Department of Justice is working towards a future in which all the doors are open to equality of opportunity, full participation, independent living, integration and economic self-sufficiency for all for persons with disabilities.

General Rule

For Businesses and other Public areas, for every 1" of rise (height), the ramp has to be 12" in length. In a home setting it can be 12" length for every 2" in rise. It should be noted that although in residential setting the ramp can be steeper, if the equipment user is using a manual wheelchair, having the ADA standard for public areas will be much safer and easier.

Types of Ramps

Fixed Ramps, which include concrete and wood style ramps.  Wood fabricated ramps can be inexpensive if you have a handy person who is good with carpentry. Wood although inexpensive, needs to be treated, and inspected regularly due to wear and exposure to the elements. Concrete ramps are very durable, need little maintenance; however can be expensive, and may not be desirable for re-selling a home. 

Modular Ramps, are a good option when the rise is high, or when there are obstacles in the way. These ramps are typically made from Aluminum. Typically constructed with a platform off the door, and can be configured as needed to allow safe egress to/from the location. Many times when the equipment user is in a rental home, this type of system is required as it can be dismantled and taken with them. These ramps can get costly but in many cases are less than concrete or wood.

Portable Ramps- the most common ramps, these can be used for thresholds, for steps or for entry into vehicles.
These ramps are offered with and without rails, with and without side rails and folding and non-folding.  Threshold ramps are offered in Rubber, Aluminum and Fiberglass. They can be configured for a small step or over sliding glass door tracks. The 2-5 foot ramps are offered in a single folding style. When getting over 5 foot, the ramps typically fold twice allowing the ramp to be transported in a vehicle.

Concerns When Choosing a Ramp

Care is needed when dealing with an outward swinging door.   Most ramps have edges for safety, and typically front doors open outward. Many times the ramp edges interfere with opening and closing a door. There are ways to overcome this and a mobility consultant should be contacted to help these issues.

Securing a ramp is important for safety. If a ramp is used intermittently, securing may not be as
important. If a ramp is left at a step, it should be secured with proper hardware or pins to ensure it does not move or create an unsafe condition.

Ramps have different coatings for traction. Some have grooves within the material and others use gritty adhesive paper which offers traction.

Popular Manufacturer's of Ramps

There are many ramp manufacturers today. The most common is EZ Access, Guldmann, PVI, and Pride.  There are others, and a consultation can guide you on which may be right for your application.

Conclusion

If you are uncertain on what type of ramp is for you, it is important to have a trained professional consult you over the phone or visit your location; measure and make recommendations on what equipment is right for your and your needs.

Great Job Enrico ! your information not only helped our staff, but also will help our customers. Active Mobility Center offers a wide range of assistive and rehab technology equipment. Their staff is expert in listening and matching equipment to your specific needs.  If you or someone you know needs advice or equipment, we can be reached at (954) 946-5793 or sales@wheelchairguys.com

Assessible Travel Part 2 : Cruising

Crusing the World

Crusing has become a very popular way to travel the world; and the vacation of choice for people with mobility challenges.  Where else can you book a vacation, and do not need for a vehicle, access to enterainment, meals, and more....

Cruise ships docking at U.S. ports are required to have accessible facilities for disabled travelers, under the Americans with Disabilities Act (ADA)._¹ This includes on board services suitable for special needs travelers who must use motorized wheelchairs and/or mobility scooters in order to get around while vacationing.

 Accommodations for travelers with special needs will vary by cruise line and among individual ships. You should discuss these itesm when booking your cruise.

• Assistance from airport to pier; during embarkation & debarkation
• ADA-compliant cabins, doorways, corridors and ramps
• Grab bars, raised toilets, wheelchair-friendly bathrooms
• Areas to charge power wheelchair batteries and store mobility equipment

 Air Travel to your Destintation

It may be necessary to travel by air to the location of the cruiseline.  This can be stressful and confusing, Active Mobility Center has provided you with information in a previous article that can help.

Accessible Vacation Information

Cruise ship passengers who need to use a wheelchair, power chair, or power scooter should research accessible vacation options before setting sail. Here are a couple of places to start.

1. Cruise Line Websites Information on cruises with accessible itineraries and other disability travel services is easily found online. Begin by searching for 'disability cruises' or 'cruising with a wheelchair,' and go from there.

2. Accessible Travel Agents This type of agent specializes in disabled travel booking.

As demand grows for wheelchair accessible vacation packages, more cruise lines are expected to provide a wider range of travel services specially designed for the disabled traveler.
When you need personal mobility assistance, look to Active Mobility Center first for the highest quality in wheelchairs, scooters and power wheelchairs, compact scooters and wheelchair accessories. Simply contact us at 1-800-326-4463 to learn more.

Accessible Travel : Part 1 Airlines

It is challenging enough when you do not need Assistive Mobility Equipment; here are some tips on how to make Air Travel less stressful.

Flying will get you to your destination the quickest and Airline and airport personnel are fully equipped and trained to assist you as needed. Take the time to be an informed customer and to allow the Airline and Airport Staff to help you with the process.

Review the airlines Contract of Carriage before booking your flight. Read the disability section carefully which informs of the airlines obligation to you upon purchasing a ticket.  This includes any responsibility on repairing your equipment if it were to become damaged.

 

Visit seatguru.com for plane seat maps. Use this website to determine the best seat to reserve before booking your flight. You may find bulk head or first class to be your best choices for restroom access and being closest to the exit door.

 

Always try to get direct flights. It can be stressful with transfers as your equipment will need to be switched to a different plane which increases the risk of damage.  Be sure to have your Mobility Equipment checked as "gate checked"  luggage so it will be delivered to you upon your arrival.

 

Inform the airline that you will need special assistance. When making reservations, make sure the service personnel know exactly what kind of assistance you will need. The more they know, the more they will be able to help you.  Additionally since Air carriers are transporting more cargo to offset costs, they need to prepare for the weight of your equipment, as they many not accept a heavy powered wheelchair if the plane is overweight.

 

Airport accessibility. Call the airport ahead of time to determine which services are available to you.

 

Boarding. You may want to request a bulkhead seat or first class, which allows more legroom.  For easier transferring, request a seat with folding arms or removable armrests. Try and breakdown your equipment if possible, taking off expensive or sensitive components. Bring your cushion! Many wheelchair users have a special cushion to reduce pressure and protect skin, bring it on the plane with you and use it.

 

Transportation of batteries. Non-spillable, sealed batteries are approved for commercial airline travel by the Civil Aeronautics Board (CAB) or FAA. It is required that you take lithium batteries/battery-pack onboard as carry-on luggage.

 

Write Down your Itinerary. You should have a list of all your travel information.  Having the Airline Flight numbers, the hotel information and ground transportation information, if delayed you will be able to stay in touch and ensure that everything is in place.

 

Destination Transportation. To reduce stress, you may want to arrange transportation in advance. Traveling with Assistive and Rehab equipment is heavy and bulky and requires a vehicle than can accommodate this. 

 

Special handling tags. If you travel frequently, it would be helpful to have a special handling tag that states special handling is required.

 

Navigating Airport Security

Security screening is required for all airline passengers. Your Equipment will be inspected first -- a mirror is often used to inspect underneath -- followed by a series of questions regarding any recent maintenance (within the past 48 hours) of your Equipment. A TSA representative will then use a hand-wand and perform a security pat down. Upon passing the security screenings, drive through the metal detectors on your Equipment and you're on your way! If you are uncomfortable with these public screenings, feel free to request a private screening area.

Inspect and Report any Damage on Arrival

It is critical to inspect your equipment on arrival. The airlines will cover damage caused by traveling but it needs to be reported immediately to be considered.  In the event you find your equipment damaged, find the baggage department with your airline and report/document any problems so these will repaired at no cost to you.  Airlines will be happy to rent you equipment while yours is being repaired.

Helpful Links

Air Carrier Access Act
US Department of Transportation
    Filing a Complaint with DOT
TSA Cares- Department for Special Needs

 I am confident that this information can reduce the stress and increase the speed at which you get through the airport and on your way to your destination. This Article was written by Carey J. Britton, ATP/SMS, CRTS with Active Mobility Center and can be reached at cbritton@wheelchairguys.comcbritton@wheelchairguys.com or (800) 326-4463.

Our Staff is Committed Getting Better !

Beginning this week, during our Wednesday staff meetings we will have a new topic discussed to help improve staff knowledge and performance.  This week, from Sarah P, was Power Operated Vehicles or commonly called scooters. These devices are very common, come in various shapes, sizes and in three and four wheel configurations.

It was discussed that since the changes in Medicare, providing indoor models, that we are seeing more wear and tear, more need for service and maintenance.  We discussed that when talking to customers, ensure they have reviewed the owner's manual and that the customer is performing preventative maintenance or having at a minimum a yearly check up on their equipment.

Sarah had listed several common questions coming from customers calling in.  One was from Scooter Store customers, do we provide service and is it covered under Medicare?  Since the Scooter Store was closed down, this is very common. We discussed our policy on needing medical documentation on all equipment that is provided and how to request it from the customer. 

List of Questions:

1. What is your scooter doing or not doing?

2. What happens when you turn you key on?

3. when was the last time you charged it?

4. Can you move the scooter when the key is turned off?

5. Could it have gotten wet?

6. Is the battery pack engaged/connected?

7. When was it last serviced?

We discussed many more senerios....The staff was asked to bring a list of common questions and solutions to next weeks' meeting.

Great Job Sarah !

This blog is written by Carey Britton, Seating and Mobility Specialist at Active Mobility Center. He can be reached at cbritton@wheelchairguys.com or (954) 946-5793.

Buying Locally is it Important?

As a consumer, we all wrestle with the decision on whether to make a purchase locally or from a catalog or from a website. Many times you can get a lower price from a catalog or website, but sometimes at a huge cost.

If you are in the market for a book, Amazon is the leader; not only because of the price, but because of the selection. It only takes a few times of going to a local book store and not finding what you are looking for and are told they can special order it for a premium; that you become an Amazon Fan.

There is a trend of people shopping on line for medical equipment. The reason many times, is that a local brick and motar company is more expensive than the catalog or on line company. As a consumer I understand that every dollar needs to go farther these days; but also understand that when buying equipment that needs service and support I need someone in my corner when there is an issue.

I receive regular phone calls from customers asking me to repair their equipment, to modify equipment that they bought on-line or to take their on-line equipment as a trade when they find out it doesn't work for them. 

Although the mission of Active Mobility Center is to help the community, we have had to make tough decisions on how to best service our customers. This is a trend in the Medical Equipment industry; as when a customer calls and asks us to put tires on their wheelchair that they purchased on line to save a few dollars, or wants us to consult them on how to fix, or modify a chair they purchased online cheaper that doesn't fit.  Most companies have adopted the policy that they didn't provide the equipment than they do not service it.

Not to sound uncaring, but the costs to operate a medical equipment company are tremendous. Like other brick and motor companies, there are the standard operating costs. Unlike many of these other companies, medical equipment companies have additional insurance, accreditation fees, yearly fees to work with Medicare, required continued education of staff, contstant retraining of staff to the changes in the industry and with insurance, and much more. 

To spend time with those customers who do not patronize the local provider takes valuable time and resources from the firm's loyal customers; and the key to keeping customers is ensuring their needs are met.

Your local medical equimpent company provides the valuable services of their knowledge, their experience, and their network.  This experience and available follow up service/support is what you pay extra for; and to ensure your local support will be there when you need it. Because they are local, they have to be the expert to keep people coming back, they need to have a network so when you have a question or problem, they can recommend a person or place to solve your issue.

Please contact Carey Britton at cbritton@wheelchairguys.com with any questions or comments, he can be reached at 954-946-5793.

Happy 4th ! from Active Mobility Center

Every year at this time, I reflect on how Active Mobility Center and our Country's Independence Day have much in common.  For many people with walking impairments, it is a time to celebrate; as not to long in our history, people with mobility impairments were left inside their homes and were not felt as EQUAL.  Their impairment left them "Disabled" or "Invalids" and were looked down upon. 

With the passing of the ADA, Americans with Disabilities Act,  in 1990;  the world has literally opened up doors, improved access, and increased independence for all. 

Active Mobility Center, in 1992, opened its doors to ALL people with Mobility Impairments, with the goal to maximize their abilities, and to Make Every Day Independence Day ! It may sound like a corny expression, but each and every day, our experienced staff listen to our customers, gain knowledge and understanding of what their obstacles are and offer solutions with equipment, or with recommendations to other professionals within our community. 

Through Equipment; wheelchairs, scooters, powered wheelchairs, gait trainers, walkers, bicycles, and handcycles; we are allowing people to stand and be equal.  We believe it is our duty, to ensure that all have access to mobility allowing everyone to be MOBILE, INDEPENDENT and FREE.


From all of us at Active Mobility Center, Happy 4th, !
Carey

Carey Britton is the resident Seating and Mobility Specialist wth Active Mobility Center, he can be reached at cbritton@wheelchairguys.com, or at (800) 326-4463.

Wheelchairs, Medicare and the Five Year Rule

As is a theme in Durable Medical Equipment (DME), there are established guidlines for how long equipment needs to last and how often in can be replaced. In this article we will be discussing Seating and Mobility Equipment guidelines; it is important to know that all equipment has a usable and functional life and is listed in the fee schedule. 

Ultra Light Wheelchair

CMS/Medicare generally set's the standard for all other insurance companies follow their guidelines, it is after all easier to copy than create your own standards; and if it is good enough for the government than it is safe for other insurance companies to follow.

Seating and Mobility Equipment has a five (5) year usable life expectancy.  Until a few years ago, it was an expected entitlment that after five years you get a new wheelchair, scooter, powered wheelchair or seating system.  Although it is the eligaiblity requirement, due to over utilization, there are new guidelines that require an equipment provider detail why the equipment is no longer working, too costly to repair, is discontinued, is outgrown, or no longer provides for some other need; even after the five year term.


Scooters

It is also important to know that Medicare allows for condition progression and will consider new equipment if a patient has changed and where the current equipment no longer provides function and independence.  An example may be a patient receives a wheelchair, and loses the ability to self propel. With adequate documentation, this patient may then qualify for a scooter or powered wheelchair depending on their needs; prior to using the equipment for five years.


It is also a requirement for much more documentation to support the need coming from a physician 

Power Wheelchairs

and/or clinician. 

If you have questions on the Five Year Rule, or if you are having problems with your currently equipment, contact Carey Britton, your guide to Seating and Mobility. Carey is the resident Seating and Mobility Specialist at Active Mobility Center. He may be reached at cbritton@wheelchairguys.com or (800) 326-4463.