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Monday, May 9, 2011

Your Guide to Choosing an MS Wheelchair

Your Guide to Choosing an MS Wheelchair

Has mobility become a problem? There are plenty of wheelchairs and assistive devices that can help you get from place to place. Do you know which one is right for you?

Medically reviewed by Lindsey Marcellin, MD, MPH
Not everyone with multiple sclerosis (MS) will lose mobility or become severely disabled. In fact, two-thirds of people with MS remain able to walk, though many will need to use a walking aid, such as a cane, and some will have a wheelchair on hand because of MS symptoms such as fatigue, balance problems, or weakness.
While there are a variety of walking aids and wheelchairs available, choosing the right one — and paying for it — can seem overwhelming. Here’s how to make the process easier.
Types of Assistive Devices for MS Mobility
The following assistive devices can help restore independence for people with MS symptoms that restrict mobility.
  • Leg braces. If weak leg muscles make it difficult to walk, get up from a chair, or maneuver on stairs, a leg brace can help correct the problem. If it’s only your foot muscles that are weak, an ankle brace may help you walk; this assistive device fits into an ordinary shoe.
  • Cane. If you’re starting to have mild balance problems or if one leg is weaker than the other, it may be time for a cane. A quad (4-legged) cane provides more stability than a regular cane.
  • Walker. Having significant leg weakness? The next step may be a walker, which can also help you maintain balance.
  • Wheelchair. You’ll know you’re ready for a wheelchair if you’re having frequent unsteadiness, you’re falling a lot, or you’re extremely tired. People with MS with paralysis in one or both legs will also require a wheelchair.
Tips for Choosing Your MS Wheelchair
Selecting the right wheelchair for your needs can be tricky. The process begins when your doctor writes you a prescription for a wheelchair.
“But doctors don’t always know the best and latest in wheelchairs, so it’s important to go through the selection process with someone who has experience with MS wheelchairs,” says Allen Bowling, MD, medical director of multiple sclerosis services at the Colorado Neurological Institute in Englewood, Colo., and co-author of The Everything Health Guide to Multiple Sclerosis.
Ask for a referral to an occupational or physical therapist. The therapist will measure and fit you for your wheelchair, measure your house to be sure the wheelchair will fit, and gather and compare wheelchair options from various vendors. Consider visiting a seating or wheelchair clinic with your therapist. These clinics have seating experts with special equipment to evaluate what kind of extra wheelchair features you may need, such as pressure-relieving cushions and seating systems, tilt and recline mechanisms, brake extensions, and other add-ons to help with your MS symptoms and mobility.
Manual vs. Motorized Wheelchairs
Gone are the days when a MS wheelchair was a heavy, clunky behemoth requiring herculean strength to maneuver. Today there are plenty of new and improved models. Whether you opt for a manual or motorized wheelchair should depend on your lifestyle, MS symptoms, and financial considerations — if it has a motor, it’s more expensive.
Which type of wheelchair is right for you? Here’s a comparison:
  • Manual wheelchair. This is a good choice if you have enough upper muscle strength to push the wheelchair yourself by propelling the wheels with your arms. A manual wheelchair will be lighter than a motorized one and easier to take in and out of cars. And many manual wheelchairs fold down, making them easier to store and transport. The lightest manual wheelchairs are made of titanium instead of aluminum and are often used by disabled people involved in sports.
  • Motorized wheelchair. If you don’t have enough arm strength to push your wheelchair, you’ll need a motorized model to maintain your independence. Increased demand in recent years has expanded the choices with more powerful and faster motorized wheelchairs. For those with extensive paralysis, a motorized wheelchair can be outfitted with a breath-activated device. “Motorized wheelchairs are usually pretty heavy, so you may need a van with a wheelchair lift or ramp for getting around away from home,” says Dr. Bowling. This type of MS wheelchair is also pricey, so reimbursement may be a priority.
How Will You Pay for Your Wheelchair?
Private insurers, Medicaid, and Medicare will usually cover the cost of a wheelchair if your MS symptoms necessitate the use of one. However, your doctor may need to write out a detailed prescription outlining your particular needs for insurance approval.
Feeling overwhelmed by the paperwork required for reimbursement? “Medical equipment vendors or wheelchair manufacturers can sometimes help arrange coverage,” says Bowling. “They may also offer financing if you can’t get insurance reimbursement.”
If you don’t meet your insurer’s criteria but still need a wheelchair, you might consider a secondhand one, which may cost half the original price. And you may be able to deduct out-of-pocket costs for medical necessities, such as the purchase of a secondhand wheelchair, on your income taxes.

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