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Scooters vs. wheelchairs

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Introduction

Wheelchairs and scooters are assistive technological devices which are utilized when a cane or walker is insufficient. There are a number of reasons why someone may be indicated or contraindicated for either or both of these devices.


Wheelchairs

There are several different types of wheelchairs available depending on issues such as the type of pathology a person has (which can affect muscle function), their body weight, and necessity of transporting the chair. Also, due to greater technological advances, motorized wheelchairs may also be indicated for patients depending on their functional ability. Certain other factors must be considered when deciding what style of manual wheelchair is chosen. Is the patient a dependent or independent user? Is the patient able to transport the wheelchair from home to vehicle? Does the patient have underlying comorbidities that may affect use of a manual wheelchair? Does the patient have the cognitive ability to operate the wheelchair? For each of these factors, there is an option available.


Manual Wheelchairs

At the most basic level, manual wheelchairs will have two main wheels located to the sides of the chair, casters to the front and optional footrests. Some patients are able to wheel themselves, and others may not have the strength and are dependent upon someone to get them from place to place. In addition, wheelchairs can be disassembled or collapsed for storage and transport. Again, the issue of patient ability is a major factor. Some patients can wheel themselves to their vehicle, transfer and collapse/disassemble and store their wheelchair without assistance. An example of such patient could be one with a low level SCI, which affects lower extremity muscle function. Others, who may have underlying comorbidities such as cardiopulmonary problems, or higher level SCI (which may result in upper extremity muscle weakness), must have assistance or have medical transportation take them to and from places.


There are several add-ons available to wheelchairs depending on the patient’s needs. Footrests, various seat cushions, wheel size and type, headrests, lap belts, trunk supports, etc. may be needed.


Power Wheelchairs

When a manual wheelchair is not enough for patients with severe conditions such as MS, high level SCI, or ALS, motorized wheelchairs are available. These conditions can result in upper and lower extremity involvement. Conditions such as MS and ALS are progressive, meaning that these patients may at first be able to operate manual wheelchairs, but as the condition persists, it affects more muscles and to a greater degree. For this reason, power wheelchair have a number of features that suit individual needs. They can be operated by joystick, sip and puff, or by head rests. They have options available for reclining for weight shifts, to assist with edema, or for sleeping.


Scooters

The final alternative for assistive ambulation is a scooter. This option is more cost effective ($900-$3200 vs. motorized WC $1600-$7500), simple to use, and has more limited options. Electronically, they have fewer features, which may be more user friendly for those who are elderly and cannot learn complicated motorized wheelchair features. Scooters have swivel seats, which may make transfers less difficult. Scooters also appear more aesthetically pleasing, are a bit lighter weight than motorized wheelchairs, and operate with a tiller. Disadvantages are that they have a large turning radius, and may be more cumbersome to negotiate indoors.


References