Segways for Patients

[SegwayLongIsland]

I’ve got an idea and I’d like some opinions. I followed the Segway like most on this board since its mere mention 2 years ago, ordered one the very first day and although I haven’t tried it yet, my training is days this weekend.

Although DK has been a medical engineer his whole adult life, has anyone talked or mentioned using HTs for patients with ambulatory problems?

I’m a family physician and I can think of a heck of a lot of my patients who will benefit from this!!

As we get older, the size of the world we travel in becomes progressively smaller until in our later years we become limited to very short distances from home and eventually become... homebound.

Besides advancing age, diseases can contribute to shrinking our world. Respiratory and cardiac diseases such as Emphysema, Chronic Bronchitis, Angina, etc. can limit our walking capacity due to shortness of breath or chest pain.

Osteoarthritis patients often complain that the effort and pain of walking can limit their ability to travel within the community, even thought they can stand and balance.

For all these patients, it is not standing...but the work of walking that limits them and their mobility.

I’m thinking of putting my Segway in my office (when not on it!) and doing demo rides on say, Tuesday nights, for patients I think might be helped. There are a lot of patients in my community that are beyond a car and its problems of cost, repair, parking, etc. yet they are
active enough to stand on a Segway. They aren’t handicapped enough to need a wheelchair (sorry Dean, Ibot) but walking alone is too much.

When the “P” comes out and the price comes down, maybe health insurance would pick up a part of the tab in patients where it was medically necessary!

Does this make sense to anyone or am I just going batty counting the days?

[pam]

quote:Originally posted by Segway Long Island

I’ve got an idea and I’d like some opinions. I followed the Segway like most on this board since its mere mention 2 years ago, ordered one the very first day and although I haven’t tried it yet, my training is days this weekend.

Although DK has been a medical engineer his whole adult life, has anyone talked or mentioned using HTs for patients with ambulatory problems?

I’m a family physician and I can think of a heck of a lot of my patients who will benefit from this!!

As we get older, the size of the world we travel in becomes progressively smaller until in our later years we become limited to very short distances from home and eventually become... homebound.

Besides advancing age, diseases can contribute to shrinking our world. Respiratory and cardiac diseases such as Emphysema, Chronic Bronchitis, Angina, etc. can limit our walking capacity due to shortness of breath or chest pain.

Osteoarthritis patients often complain that the effort and pain of walking can limit their ability to travel within the community, even thought they can stand and balance.

For all these patients, it is not standing...but the work of walking that limits them and their mobility.

I’m thinking of putting my Segway in my office (when not on it!) and doing demo rides on say, Tuesday nights, for patients I think might be helped. There are a lot of patients in my community that are beyond a car and its problems of cost, repair, parking, etc. yet they are
active enough to stand on a Segway. They aren’t handicapped enough to need a wheelchair (sorry Dean, Ibot) but walking alone is too much.

When the “P” comes out and the price comes down, maybe health insurance would pick up a part of the tab in patients where it was medically necessary!

Does this make sense to anyone or am I just going batty counting the days?


For insurance to pick up part of the tab, I think it would have to be considered a medical device, which means FDA approval (as I understand it). This apparently would have slowed release of the machine by years (and raised the cost!), so they haven't requested medical (FDA) approval on it. I'm sure someone else on the list longer than I knows more about it, but that's the current information I have.
Pam

[Brooster]

I don't think you're going "batty" at all, Dr. SLI. I can definitely see the potential here, and it's absolutely a good point for discussion.

As Pam was quick to point out, the obstacle for the time-being is the fact that the Segway HT hasn't been approved as a "medical device," and that's something that the folks at Segway LLC have been very careful to point out.

My feeling is that ultimately, it will be able to play a vital role in helping certain non-ambulatory people. But it'll obviously have to be looked at on a case-by-case basis, and looked at very carefully. While the machine does balance the rider, it depends upon a fully alert, capable rider to do its job. In cases where patients may not have firm capacities for balance and equilibrium, the Segway HT won't be an appropriate solution.

You'll have a far better understanding of what I mean, once you've ridden the HT yourself ... and that won't be long from now. :)

Broo







Brooster

[Lazarus]

There are several of us with MS who have purchased the Segway. The reason FDA approval is not in the works now is exactly as Pam mentioned.

But you are correct, many many people could benefit. It will be a delight for many to stand and travel distances instead of sit in electric scooters and be out of sight during conversations...etc. Linda

[SegwayLongIsland]

Hi Pam. I thought about the FDA thing. I know the Ibot is still going thru that..it's been years. But I often write prescriptions for assistive devices like canes, walkers, wheelchairs, bathroom assist handrails, etc. Does a cane or a walker need FDA approval?

Something probably as complicated and expensive as a Segway wound. I wonder what the criteria are?

Although, I can think of things that ARE... FDA approved that the insurance companies WON'T pay for, like breast implants.
OK, so it's not the best example, but it's the first thing that came to mind. (OOps, my masculinity is showing!!)

Anyway, the benefit to patients is an improved quality of life. That would sell the patient on the idea.

What would sell an insurance company on the idea? It would have to save insurance companies money so their profit increases. That's why they pay for cancer screening. It's cheaper than paying to cure you. I'm sure the expression, "An once of prevention..." was written by an insurance company accountant.

How would buying a patient a Segway save an insurance company money in the long run????

Wayne

[Brooster]

Preventing further joint deterioration, perhaps?

But Segway HT riders need to be able to bend their knees to absorb shock (much like skiing, as GlideMaster has pointed out), and lean into their turns. There's without doubt a good amount of aerobic activity involved.

I don't think I'd be looking for insurance companies to get involved at all, at least for the time-being. This is just my 2¢, but for the near-term, I think the issue will be counseling would-be buyers on whether it's an appropriate solution.

Brooster

[SegwayLongIsland]

I agree Brooster. Leave the insurance company out of it.

KISS Keep it simple...If it improves the quality of a patient's life, they'll just have to pay for the improvement.

By the way Pam, I loved your writings from your trip in florida. Really Great!!

Wayne

[jillmac]

I can see your point Dr. Ever since I first heard of Segway (via my son) I have been reading everything I could, signing up for e-mail updates etc. etc.

My husband has been just as keen on the updates as me and I was astounded when I mentioned that Segway had gone on sale on Amazon (the first day) and he announced "Sign yourself up!" I had no idea that this was going to happen and was absolutely thrilled to bits.

Like Lazarus I have MS. I have a fairly mild form and although I have used a wheelchair at times, and a cane more frequently my main problem is fatigue. I can start the day out feeling fine but arrive at noon feeling totally wiped out.

A trip to the mall can start well but after a couple of stores I have had enough. Ditto places like the Getty Center, the zoo, amusement parks, walking from a parking lot to the theatre etc. etc.

Segway will leave me with the energy to enjoy my trips.

Segway personnel have been very careful to point out to me that it is not authorized as a medical aid.

I was concerned about balance problems, and vertigo, but in my trial of the machine in LA a while back I found neither to be a problem. In fact I have more problem just riding in a car.

By the way - my son has suggested a bumper sticker for my Segway - "My other car is an SUV." It's true too.

Jill

[BruceWright]

Good for you, Jill!

William Gibson wrote "the street finds its own uses for things."
He was describing a sort of Darwinism of technology. Useful items find niches undreamed of by their inventors.

-Bruce Wright

Segway: Vehicle of Dream

[Brooster]

These are the stories we like to hear. :)

Brooster

[pam]

quote:Originally posted by Segway Long Island

I agree Brooster. Leave the insurance company out of it.

KISS Keep it simple...If it improves the quality of a patient's life, they'll just have to pay for the improvement.

By the way Pam, I loved your writings from your trip in florida. Really Great!!

Wayne


Thanks, Wayne. It was a great time. Now I need to update my BLOG. <sigh> OK, one of these days <G>.
Pam

[Lazarus]

Hi Jilmac!
I posted to you recently on MGH. I go for training next Sunday!

The foot and a half on snow we are going to get today is a well timed blizzard--we will be all cleaned out and it will be above freezing in a day.....everything is clicking....Here we come-go-come-go (that's me gliding back and forth).

Linda

[ronzul]

Thanks for starting this thread Doc. It is such an important one for many of us with mobility limitations.

I myself have a chronic muscle condition that significantly limits my mobility, however I manage to stand and balance for reasonable periods of time.

For me I either use a Segway (if suitable) or get an electric wheelchair. As you can guess, I am reading everything that could give me a sense of what physical exertion is required in using the Segway, hoping it is within my capabilities.

(I can't use an "old-person" type electric scooter because of the manual steering - the electric control for the Segway steering should be manageable)

Unfortunately (usually I say fortunately), I live in Australia and can't just try one out for the weekend.

Any information about physical exertion (especially by people with some sort of muscular limitation) is greatly appreciated.

As a comparison, what if I place a wooden square with an area equal to that of the Segway atop a half inch high pivot? If I can balance on that moving from side to side for a reasonable period, would that be a fair comparison?

Cheers
Ronny

[pam]

quote:Originally posted by ronzul



As a comparison, what if I place a wooden square with an area equal to that of the Segway atop a half inch high pivot? If I can balance on that moving from side to side for a reasonable period, would that be a fair comparison?

Cheers
Ronny


Hmmm, well, since the Segway has gyroscopes which will keep you balanced, and the wooden square will not have gyroscopes to keep you balanced, I'm not sure if it will work for a comparison. You just need to come to the States, Ronny, and try one <G>.
Pam

[n/a]

quote:I’m a family physician and I can think of a heck of a lot of my patients who will benefit from this!!

That is good to hear from a doctor.

As for FDA approval. I dont see why they couldnt apply for it when they released first Segways? They wouldnt have to stop selling the Segways as ordinary transporters while they waited for approval would they? The Segways are built to be very safe and durable so I dont imagine they would have to do many modifications to get them approved.

[Stan671]

I agree with you, Dr. SLI, that the Segway could help more people get around who can stand and balance but not walk so good.

I agree with the others, though, that FDA approval will not happen for a long time, if at all, and that the insurance companies will probably make a fuss.

But inspite of all that, you should show the HT to your patients and see if it can help. I think that is a great idea you have.

And about you being "batty". Don't feel bad about that - it is happening to all of us right now. I was lucky enough to get a demo ride on the Segway from Frank so I at least have that out of my system. I am still yearning for March to get here.

Stan Dobrowski

[np]

Insurance companies do pay for breast implants if the procedures are necessitated by medical causes, e.g. cancer. Canes, walkers
again may or may not be covered by the insurance company.
Crutches are covered, if you are willing to go through with the paperwork.
I have ambivalent feelings about this difficult issue and I can understand perfectly why Segway LLC did not want to go in that direction at this point.

What I would like to know is this: if someone shows up with some
disability (etc. severely limping on one side due to a previous accident) for the training, someone who already ordered their Segway on Amazon.com and even paid to Segway LLC, would they refuse training
that person?

quote:Originally posted by Segway Long Island

Hi Pam. I thought about the FDA thing. I know the Ibot is still going thru that..it's been years. But I often write prescriptions for assistive devices like canes, walkers, wheelchairs, bathroom assist handrails, etc. Does a cane or a walker need FDA approval?

Something probably as complicated and expensive as a Segway wound. I wonder what the criteria are?

Although, I can think of things that ARE... FDA approved that the insurance companies WON'T pay for, like breast implants.
OK, so it's not the best example, but it's the first thing that came to mind. (OOps, my masculinity is showing!!)

Anyway, the benefit to patients is an improved quality of life. That would sell the patient on the idea.

What would sell an insurance company on the idea? It would have to save insurance companies money so their profit increases. That's why they pay for cancer screening. It's cheaper than paying to cure you. I'm sure the expression, "An once of prevention..." was written by an insurance company accountant.

How would buying a patient a Segway save an insurance company money in the long run????

Wayne


http://www.neuroprosthesis.org/blogger.html

[pam]

quote:Originally posted by np

What I would like to know is this: if someone shows up with some
disability (etc. severely limping on one side due to a previous accident) for the training, someone who already ordered their Segway on Amazon.com and even paid to Segway LLC, would they refuse training
that person?


I don't think they'd refuse training to someone who limps. However, someone who is unable to stand or control their body weight (I'm not talking about fine motor movements, but about literally someone who can't control lean forward or back) would not be a good candidate for the Segway. How Segway'd handle it, I don't know.

Pam

[Homer]

FYI, we have a resident who is a double amputee using one in Celebration. I ride around town and park mine behind my office and get a lot of questions about it. I agree that it shows great promise for "extending the range" of those who are limited in the distance that they can travel about due to debilitating conditions.

What a sad situation that the government stands in the way of progress under the guise of protecting its citizens.

[BruceWright]

I don't think that FDA approval is a guise. I think it could be improved to work faster, and with less bureacracy, but I wouldn't call it a guise.

In fact, I would like them to extend their reach to attack the quackery that falls under the labels "nutritional supplements" and "alternative medicine."

-Bruce Wright

Segway: Vehicle of Dream

[Kinky]

quote:Originally posted by Segway Long Island

I#8217;ve got an idea and I#8217;d like some opinions. I followed the Segway like most on this board since its mere mention 2 years ago, ordered one the very first day and although I haven#8217;t tried it yet, my training is days this weekend.

Although DK has been a medical engineer his whole adult life, has anyone talked or mentioned using HTs for patients with ambulatory problems?

I#8217;m a family physician and I can think of a heck of a lot of my patients who will benefit from this!!

As we get older, the size of the world we travel in becomes progressively smaller until in our later years we become limited to very short distances from home and eventually become... homebound.

Besides advancing age, diseases can contribute to shrinking our world. Respiratory and cardiac diseases such as Emphysema, Chronic Bronchitis, Angina, etc. can limit our walking capacity due to shortness of breath or chest pain.

Osteoarthritis patients often complain that the effort and pain of walking can limit their ability to travel within the community, even thought they can stand and balance.

For all these patients, it is not standing...but the work of walking that limits them and their mobility.

I#8217;m thinking of putting my Segway in my office (when not on it!) and doing demo rides on say, Tuesday nights, for patients I think might be helped. There are a lot of patients in my community that are beyond a car and its problems of cost, repair, parking, etc. yet they are
active enough to stand on a Segway. They aren#8217;t handicapped enough to need a wheelchair (sorry Dean, Ibot) but walking alone is too much.

When the #8220;P#8221; comes out and the price comes down, maybe health insurance would pick up a part of the tab in patients where it was medically necessary!

Does this make sense to anyone or am I just going batty counting the days?


As a person with Spina Bifida who has used canes for mobility most of my life, I can tell you that I will be on my Segway 90% of the time. My joints, elbows especially are shot and my back suffers from the strain as well. I need a mobility device that is easily transportable and can fit into the trunk of my Mazda Protege so an electronic wheelchair or scooter won't cut it for me. And a manual wheelchair (which I use as alternative transportation) also wears out the shoulders. Living in the DC area, I have the opportunity to attend conferences and meetings designed to educate the disabled community on new initiatives coming out from this current administration. One is that most states already will reimburse the cost of any quality of life inhancements needed by persons with disabilities. Check with your state representatives. Anyway, no matter the cost I have ordered mine and I'm waiting with credit card in hand.

[Homer]

quote:Originally posted by BruceWright

I don't think that FDA approval is a guise. I think it could be improved to work faster, and with less bureacracy, but I wouldn't call it a guise.

In fact, I would like them to extend their reach to attack the quackery that falls under the labels "nutritional supplements" and "alternative medicine."

-Bruce Wright

Segway: Vehicle of Dream


And how long are you going to wait for the practice to catch up to the promise before you realize that the whole thing is a fraud?

"The FDA - using lots of your money to protect you from Dean Kamen's inventions while overlooking quackery daily."

Every day we see that regulation doesn't work, yet we keep making excuses for it or keeping quiet lest someone realize that the only reason that society works at all is because most of us have figured out how to circumvent it.

Would that physicians could make as many excuses as the government, there wouldn't be any such thing as malpractice, much less a crisis.

http://www.stopstart.fsnet.co.uk/Gif/SIMPHomer2.gif

[np]

Please don't write this about FDA in relation to Dean Kamen and his inventions; right now they are in the process of evaluating iBOT in a fair, although lengthy procedure and it will probably be approved very soon. Clearly many of his earlier inventions got appropriate approval; cosider the heart stent for example, which got implanted even into the heart of the Vice President.

Nobody ever asked for approval of Segway as a medical assistive device - any info would be appreciated if you have heard otherwise.

quote:Originally posted by Homer

quote:Originally posted by BruceWright

I don't think that FDA approval is a guise. I think it could be improved to work faster, and with less bureacracy, but I wouldn't call it a guise.

In fact, I would like them to extend their reach to attack the quackery that falls under the labels "nutritional supplements" and "alternative medicine."

-Bruce Wright

Segway: Vehicle of Dream


And how long are you going to wait for the practice to catch up to the promise before you realize that the whole thing is a fraud?

"The FDA - using lots of your money to protect you from Dean Kamen's inventions while overlooking quackery daily."

Every day we see that regulation doesn't work, yet we keep making excuses for it or keeping quiet lest someone realize that the only reason that society works at all is because most of us have figured out how to circumvent it.

Would that physicians could make as many excuses as the government, there wouldn't be any such thing as malpractice, much less a crisis.

http://www.stopstart.fsnet.co.uk/Gif/SIMPHomer2.gif


http://www.neuroprosthesis.org/blogger.html

[Homer]

Think again about what you just said - essentially, criticizing the government is dangerous. O tempora, o mores.