Wallace
03-31-2005, 06:32 PM
Vol. 21 •Issue 6 • Page 42
Standing Tall
How one determined man 'stood up' to disability through determination and technology
By Jessica LaGrossa
Jerry Kerr was a successful real estate developer in his early 40s when a diving accident in 1998 threatened to end his life. "Even as they were pulling me out of the lake, I recognized what had probably happened to me," Kerr told ADVANCE. "[Christopher] Reeve was foremost on my mind." Only three years earlier the world had witnessed the star of Superman tumble from his horse as they attempted to scale a show fence. The accident left Reeve in a wheelchair with quadriplegia.
Kerr, too, had shattered a vertebra—C-4—into nearly 20 pieces and had cracked other vertebrae in his neck. Eventually, surgeons replaced his C-4 with a cadaver bone and bolted his spinal cord back together. An avid runner and golfer, Kerr was told he would possibly never move from the neck down again.
The months of rehabilitation proved difficult for Kerr emotionally. The power wheelchair that he was now supposed to live with daily was simply unacceptable to him. With an unsteady relationship with his occupational therapist and a rocky prognosis, Kerr was facing adversity like he had never seen before. Yet he didn't give up.
Today, Kerr—officially with C-4 incomplete spastic quadriplegia—can stand and walk short distances with a cane. Although falls loom whenever he takes even a few steps, he asserts that he now knows how to properly land without causing injury.
And his biggest achievement? "Looking people in the eye," he revealed, which he accomplishes with the Segway Human Transporter, self-balancing personal transportation technology that rose to popularity in 2001 amid public acclaim that touted the machine as the next biggest thing to hit the world since the Internet.
"Eye contact is such a meaningful thing—people don't ever understand unless you have been in a wheelchair—and my Segway allows me to achieve that."
But a little sweat, grit and self advocacy went into it, too.
Rehabilitation
Once Kerr's surgical procedures were over, he was moved to St. John's Mercy Medical Center in his hometown of St. Louis to undergo rehabilitation, including physical and occupational therapy.
Prior to his accident, Kerr explained that he was quite an active person. "I worked out all the time and was involved in a lot of sporting activities," he told ADVANCE. "Because my injuries were physical and were, in my mind, going to impact me physically, I thought that I could overcome the disabilities by doing those kinds of physical things."
So Kerr was eager to meet with his physical therapist. "I was really interested in what she could do for me," he explained. "But I didn't really understand what my OT was going to do for me."
That lack of understanding consequently made him a difficult patient for his OT, Marsha Peigh, OTR/L. And Peigh agreed. "He flat out refused to work on ADL," she told ADVANCE. "He wouldn't even work on feeding himself."
According to Peigh, Kerr's answer to most everything related to OT was that he would have his wife's help in carrying out tasks or else he would hire someone to help. "Jerry was a very high-powered businessman," Peigh explained. "He could have afforded to do that."
Kerr explained that most of the tasks Peigh tried to get him to do simply didn't seem sensible to him. While his injury was C-4, Kerr had movement typical of a C-5 injury, and had some gross-motor skills in his arms even when his wrists were still in braces; therefore, Peigh attempted teaching Kerr how to type using a pencil in his mouth or strapped to his wrist.
"Before my injury I typed 100 words a minute—I would type a letter at the computer in my office and then give it to my secretary to clean up," he said. "Typing with a pencil didn't seem to make any sense to me."
Peigh presented logical explanations to Kerr of the way function augments strength and how, in turn, strength augments function. "I approached it from every angle I could," she said. "But there are some people that you just can't convince, and I couldn't convince Jerry".
"While she was trying very hard to help me, I wasn't interested in it," Kerr told ADVANCE. "I thought [OT] was a waste of my time."
So instead, he focused fully on building his physical strength. In addition to his PT sessions, Peigh and Kerr did as much strengthening as possible in the OT sessions without further weakening his injured muscles.
Kerr's lack of confidence in her was difficult on Peigh to accept. "I just kept feeling like there was something that I should be explaining differently," she said. "But after a while I had to realize that he was the one making the choices. He was a smart man and was given the information he needed [about his prognosis]; I had to let him come to his own decisions."
Kerr admits now that at that point in his recovery, he still didn't have a full understanding of what exactly his disability was. "The books were there to explain it to me, but when you are in a halo you can't read—your head is at an angle, and you can't move at all from the neck down," he explained. "So I didn't have a grasp on what the totality of a spinal cord injury was, and what it did to you."
His physicians and PT counseled Kerr on a daily basis to work harder in occupational therapy, but it wasn't until he left the hospital that Kerr finally learned to appreciate the benefits of OT. "He realized that there were a few more things that he would like to be able to do once he got home," Peigh explained.
Today, whenever Kerr speaks to someone with a spinal cord injury, he advises them to take advantage of all rehabilitation offered to them while in the hospital, including OT. "I remind them that they have a limited amount of time in hospital care and therapy and that there are going to be all kinds of tools—button hooks, sock aids, eating utensils—that they need to try to understand," Kerr explained. "Once you leave, your access to those tools is even more limited, and if you don't take advantage of them the opportunity is going to be gone."
Getting Around
Kerr was given a power wheelchair in the hospital. "I rejected it," he said of the chair. "To me, that was giving up."
Because Kerr didn't have much strength or grip in his hands, his therapists used all kinds of adaptive devices to make a manual chair feasible. "They added all kinds of things to the sides of the wheels so I could try to push the manual chair," he explained.
Kerr's determination paid off. Eventually, he made his way with his manual chair and only used the power one here and there. Then he worked his way up to a cane for small distances (across a room, for instance).
But outside his house, Kerr was confined to a wheelchair; and power or manual, he didn't care for either one. "Whenever I was in crowded environments in a wheelchair, I would feel covered up," he said. "People couldn't see me, and I couldn't see them; I was looking at people's rear ends all night!
"So I stopped going to fundraisers, weddings and other crowded events."
But then he saw a "60 Minutes" episode featuring the iBOT.™ Created by Dean Kamen, the iBOT is a revolutionary self-balancing mobility device with the ability to climb stairs and curbs and navigate rough terrain. Most importantly for Kerr, it could also raise him up to eye level with others. "I thought it would give me a closer experience to my old life," Kerr said. "I wanted to do more than attend events," he said. "I wanted to participate in them."
But Kerr had no idea how long it would be before the iBOT came to the market. (The FDA approved it in 2003.) So Kerr started following Kamen's work, and in 2001 he heard the rumors that were spreading like wildfire about Kamen's next big project. "I followed it, like many others did, and finally saw the live [unveiling] of the Segway on 'Good Morning America'," he said.
It appeared on Dec. 3, 2001 amid much hype; the Segway is a universal transportation device created using the self-balancing technology invented first for the iBOT.
"My mother called me after the show and asked if I thought I could use it," Kerr said of the Segway. "I said I didn't know, but I figured I could stand even though I couldn't really walk, and the idea was pretty exciting."
Nearly one year later, Kerr ordered his very own Segway the first day the device was offered to the public on Amazon.com.
Learning to Use the Segway
In 2002, when Segways first hit the market, people who purchased them were required to undergo training with Segway employees prior to obtaining their own devices.
"I had to travel to Chicago with my wife to be trained," explained Kerr. "I showed up in my chair, and they didn't know what to do with me!"
Kerr checked into the hotel hosting the seminar-type training session and went to his room. "When I came back downstairs, there was a gentleman there who told me he wasn't sure I could use the Segway," Kerr said. "He told me that even though I had placed a nonrefundable deposit, they had decided to give me an individualized assessment."
If the Segway representatives felt Kerr couldn't use the device they were going to refund his money and cancel his order. "I had test anxiety," Kerr said of the challenge. "Everyone else was training in a group, but I was alone."
Yet when Kerr stepped up onto the Segway, he quickly proved his ability. "It was the most liberating experience in my life; it was unbelievable," he said of his first ride. "I could use it; and not only could I use it, I could use it as well as anyone else there in training."
At the end of the session, Kerr was given official approval to receive his very own Segway, which was delivered to him in March 2003. "From that point on, I used it all the time; and still do," he said. "At home, the wheelchair is parked in the kitchen; the Segway is parked by my bed."
Spreading Awareness
Today, Kerr has a brand new role in life. "He is very involved in the disabled community," said Peigh. "He takes a much broader look at that population and is doing what he can for universal design; he has broadened his scope significantly."
Kerr and friend, Leonard Timm, a double amputee who uses a modified Segway, co-founded Disability Rights Advocates for Technology (DRAFT), an organization dedicated to the promotion of universal design and new technology for people with disabilities. DRAFT's poster "child" is the Segway.
"We have this debate with people in our organization all the time about whether or not they should display a handicap sticker," Kerr explained. "Younger users [see their disabilities disappear] when they get on the Segway; for the first time in their life, they aren't disabled; and they don't want to put a handicap sticker on their Segway to remind people.
"But there are laws that allow people with disabilities to use [the Segway] in areas were they may not allow other able-bodied people to use [it]."
Yet Kerr certainly understands. He knows what it is like to simply want to stand tall and look other's in the eye. And as far as he is concerned, he hasn't done half bad in his quest to do so.
"While my prognosis was never very good in terms of what I would be able to do, I have done quite well," he concludes.
For more information
www.segway.com.
www.draft.cc/DesktopDefault.aspx.
Jessica LaGrossa is ADVANCE associate editor. She can be reached at jlagrossa@merion.com.
http://occupational-therapy.advanceweb.com/common/EditorialSearch/AViewer.aspx?AN=OT_05mar21_otp45.html&AD=03-21-2005
Vol. 21 •Issue 6 • Page 45
The Segway HT: Who Can It Best Help?
By Earllaine Croarkin
The Segway Human Transporter has been marketed as a machine that will change the way people travel. People with impairments have begun to use Segways to improve their ability to participate in activities of daily living, increase their social outlets, and sustain their roles in the community and family. Although this device can be a welcome respite from assistive devices such as wheelchairs, using it requires some precautions and considerations.
The Segway relies on the rider's ability to shift weight to propel the machine forward or backward. The rider can use several strategies to propel the Segway forward, such as flexing the trunk, bending at the hips, or shifting weight from the ankles. Stopping and standing still on the Segway requires a rider to maintain balance in a relatively centered position. Riders can turn by twisting a control on the left handlebar.
Typically, Segways are useful in moderate climates, can travel about 10 miles per charge (depending on conditions of use), and can carry up to 260 pounds.
The EPAMD (electronic personal assistive mobile device) classification allows freer use on city streets and within public transportation systems, such as subway systems. For example, in some metropolitan areas the Segway is allowed more accessibility to public transportation than are bicycles. Presently, 41 states have enacted laws on where Segways can be ridden, minimum user age and helmet requirements. Local ordinances may restrict use regardless of state legislation.
As of 2003, the Segway had not been approved as a medical assistive device; however, as it gains popularity, more people with impairments are considering purchasing one.
Because the Segway is not a medical device, it is our responsibility as health care professionals to be as circumspect as possible if clients ask if the Segway would be reasonable for their use.
Just as with riding a bicycle or using a wheelchair, one must use good judgment while operating the device. Falls can occur when an individual rides too fast, doesn't scan the environment, or fails to concentrate while riding. An individual with slower cognitive processing, delayed responses or poor safety awareness may not be an appropriate Segway candidate, just as it may not be appropriate for these individuals to use a motorized scooter or wheelchair.
An obvious issue is how much balance is required in order to ride safely. Many people with balance concerns have used the Segway with great success. Ironically, the machine may help them compensate for this inability because it offers a platform that moves continually.
Other considerations include the type, severity and number of impairments possible Segway users have. How extensively are they impaired? Are these people also experiencing other motor control impairments? Do not assume that individuals with various types of balance impairment will be able to sufficiently control the momentum of the device, or be able to slow the momentum once maximum speed is reached.
Another prerequisite to safe Segway use may be the requirement for pain-free and unlimited joint mobility. Those with arthritic joints may have limited ability to compensate for the balance demands of significant medial or lateral movement. However, it is also well known that people with chronic pain can adapt and perform many activities. In essence, sound judgment is required. It may not be appropriate for an individual with pain to take the Segway on uneven bumpy terrain, but using the Segway in a shopping mall might be beneficial and safe.
Segway users also must become proficient at abilities other than riding to be independent in its use. For some, the most difficult skill may be learning how to move the Segway from one level to another; for example, up stairs. The power-assist mode allows users to "bump" or partially lift the machine up a step. Once the machine gains traction on the step, the power assist mode engages the wheels and helps the Segway climb the rest of the distance. Ascending and descending stairs with the Segway is one part strength, one part coordination, and one part problem solving.
More than likely the Segway will optimize mobility for many people, including people working in large industrial factories or those no longer working but with goals of improved community mobility. In the future, health care professionals should be able to effectively educate potential consumers about the Segway, to help ensure safety as well as successful outcomes.
Earllaine Croarkin is senior physical therapist in the rehabilitation department at the National Institutes of Health Clinical Center, Bethesda, MD.
Jessica LaGrossa
associate editor
ADVANCE Newsmagazine
www.advanceweb.com
2900 Horizon Dr.
King of Prussia, PA 19406
1-800-355-5627 ext. 1425
Tripod and ROVER
Standing Tall
How one determined man 'stood up' to disability through determination and technology
By Jessica LaGrossa
Jerry Kerr was a successful real estate developer in his early 40s when a diving accident in 1998 threatened to end his life. "Even as they were pulling me out of the lake, I recognized what had probably happened to me," Kerr told ADVANCE. "[Christopher] Reeve was foremost on my mind." Only three years earlier the world had witnessed the star of Superman tumble from his horse as they attempted to scale a show fence. The accident left Reeve in a wheelchair with quadriplegia.
Kerr, too, had shattered a vertebra—C-4—into nearly 20 pieces and had cracked other vertebrae in his neck. Eventually, surgeons replaced his C-4 with a cadaver bone and bolted his spinal cord back together. An avid runner and golfer, Kerr was told he would possibly never move from the neck down again.
The months of rehabilitation proved difficult for Kerr emotionally. The power wheelchair that he was now supposed to live with daily was simply unacceptable to him. With an unsteady relationship with his occupational therapist and a rocky prognosis, Kerr was facing adversity like he had never seen before. Yet he didn't give up.
Today, Kerr—officially with C-4 incomplete spastic quadriplegia—can stand and walk short distances with a cane. Although falls loom whenever he takes even a few steps, he asserts that he now knows how to properly land without causing injury.
And his biggest achievement? "Looking people in the eye," he revealed, which he accomplishes with the Segway Human Transporter, self-balancing personal transportation technology that rose to popularity in 2001 amid public acclaim that touted the machine as the next biggest thing to hit the world since the Internet.
"Eye contact is such a meaningful thing—people don't ever understand unless you have been in a wheelchair—and my Segway allows me to achieve that."
But a little sweat, grit and self advocacy went into it, too.
Rehabilitation
Once Kerr's surgical procedures were over, he was moved to St. John's Mercy Medical Center in his hometown of St. Louis to undergo rehabilitation, including physical and occupational therapy.
Prior to his accident, Kerr explained that he was quite an active person. "I worked out all the time and was involved in a lot of sporting activities," he told ADVANCE. "Because my injuries were physical and were, in my mind, going to impact me physically, I thought that I could overcome the disabilities by doing those kinds of physical things."
So Kerr was eager to meet with his physical therapist. "I was really interested in what she could do for me," he explained. "But I didn't really understand what my OT was going to do for me."
That lack of understanding consequently made him a difficult patient for his OT, Marsha Peigh, OTR/L. And Peigh agreed. "He flat out refused to work on ADL," she told ADVANCE. "He wouldn't even work on feeding himself."
According to Peigh, Kerr's answer to most everything related to OT was that he would have his wife's help in carrying out tasks or else he would hire someone to help. "Jerry was a very high-powered businessman," Peigh explained. "He could have afforded to do that."
Kerr explained that most of the tasks Peigh tried to get him to do simply didn't seem sensible to him. While his injury was C-4, Kerr had movement typical of a C-5 injury, and had some gross-motor skills in his arms even when his wrists were still in braces; therefore, Peigh attempted teaching Kerr how to type using a pencil in his mouth or strapped to his wrist.
"Before my injury I typed 100 words a minute—I would type a letter at the computer in my office and then give it to my secretary to clean up," he said. "Typing with a pencil didn't seem to make any sense to me."
Peigh presented logical explanations to Kerr of the way function augments strength and how, in turn, strength augments function. "I approached it from every angle I could," she said. "But there are some people that you just can't convince, and I couldn't convince Jerry".
"While she was trying very hard to help me, I wasn't interested in it," Kerr told ADVANCE. "I thought [OT] was a waste of my time."
So instead, he focused fully on building his physical strength. In addition to his PT sessions, Peigh and Kerr did as much strengthening as possible in the OT sessions without further weakening his injured muscles.
Kerr's lack of confidence in her was difficult on Peigh to accept. "I just kept feeling like there was something that I should be explaining differently," she said. "But after a while I had to realize that he was the one making the choices. He was a smart man and was given the information he needed [about his prognosis]; I had to let him come to his own decisions."
Kerr admits now that at that point in his recovery, he still didn't have a full understanding of what exactly his disability was. "The books were there to explain it to me, but when you are in a halo you can't read—your head is at an angle, and you can't move at all from the neck down," he explained. "So I didn't have a grasp on what the totality of a spinal cord injury was, and what it did to you."
His physicians and PT counseled Kerr on a daily basis to work harder in occupational therapy, but it wasn't until he left the hospital that Kerr finally learned to appreciate the benefits of OT. "He realized that there were a few more things that he would like to be able to do once he got home," Peigh explained.
Today, whenever Kerr speaks to someone with a spinal cord injury, he advises them to take advantage of all rehabilitation offered to them while in the hospital, including OT. "I remind them that they have a limited amount of time in hospital care and therapy and that there are going to be all kinds of tools—button hooks, sock aids, eating utensils—that they need to try to understand," Kerr explained. "Once you leave, your access to those tools is even more limited, and if you don't take advantage of them the opportunity is going to be gone."
Getting Around
Kerr was given a power wheelchair in the hospital. "I rejected it," he said of the chair. "To me, that was giving up."
Because Kerr didn't have much strength or grip in his hands, his therapists used all kinds of adaptive devices to make a manual chair feasible. "They added all kinds of things to the sides of the wheels so I could try to push the manual chair," he explained.
Kerr's determination paid off. Eventually, he made his way with his manual chair and only used the power one here and there. Then he worked his way up to a cane for small distances (across a room, for instance).
But outside his house, Kerr was confined to a wheelchair; and power or manual, he didn't care for either one. "Whenever I was in crowded environments in a wheelchair, I would feel covered up," he said. "People couldn't see me, and I couldn't see them; I was looking at people's rear ends all night!
"So I stopped going to fundraisers, weddings and other crowded events."
But then he saw a "60 Minutes" episode featuring the iBOT.™ Created by Dean Kamen, the iBOT is a revolutionary self-balancing mobility device with the ability to climb stairs and curbs and navigate rough terrain. Most importantly for Kerr, it could also raise him up to eye level with others. "I thought it would give me a closer experience to my old life," Kerr said. "I wanted to do more than attend events," he said. "I wanted to participate in them."
But Kerr had no idea how long it would be before the iBOT came to the market. (The FDA approved it in 2003.) So Kerr started following Kamen's work, and in 2001 he heard the rumors that were spreading like wildfire about Kamen's next big project. "I followed it, like many others did, and finally saw the live [unveiling] of the Segway on 'Good Morning America'," he said.
It appeared on Dec. 3, 2001 amid much hype; the Segway is a universal transportation device created using the self-balancing technology invented first for the iBOT.
"My mother called me after the show and asked if I thought I could use it," Kerr said of the Segway. "I said I didn't know, but I figured I could stand even though I couldn't really walk, and the idea was pretty exciting."
Nearly one year later, Kerr ordered his very own Segway the first day the device was offered to the public on Amazon.com.
Learning to Use the Segway
In 2002, when Segways first hit the market, people who purchased them were required to undergo training with Segway employees prior to obtaining their own devices.
"I had to travel to Chicago with my wife to be trained," explained Kerr. "I showed up in my chair, and they didn't know what to do with me!"
Kerr checked into the hotel hosting the seminar-type training session and went to his room. "When I came back downstairs, there was a gentleman there who told me he wasn't sure I could use the Segway," Kerr said. "He told me that even though I had placed a nonrefundable deposit, they had decided to give me an individualized assessment."
If the Segway representatives felt Kerr couldn't use the device they were going to refund his money and cancel his order. "I had test anxiety," Kerr said of the challenge. "Everyone else was training in a group, but I was alone."
Yet when Kerr stepped up onto the Segway, he quickly proved his ability. "It was the most liberating experience in my life; it was unbelievable," he said of his first ride. "I could use it; and not only could I use it, I could use it as well as anyone else there in training."
At the end of the session, Kerr was given official approval to receive his very own Segway, which was delivered to him in March 2003. "From that point on, I used it all the time; and still do," he said. "At home, the wheelchair is parked in the kitchen; the Segway is parked by my bed."
Spreading Awareness
Today, Kerr has a brand new role in life. "He is very involved in the disabled community," said Peigh. "He takes a much broader look at that population and is doing what he can for universal design; he has broadened his scope significantly."
Kerr and friend, Leonard Timm, a double amputee who uses a modified Segway, co-founded Disability Rights Advocates for Technology (DRAFT), an organization dedicated to the promotion of universal design and new technology for people with disabilities. DRAFT's poster "child" is the Segway.
"We have this debate with people in our organization all the time about whether or not they should display a handicap sticker," Kerr explained. "Younger users [see their disabilities disappear] when they get on the Segway; for the first time in their life, they aren't disabled; and they don't want to put a handicap sticker on their Segway to remind people.
"But there are laws that allow people with disabilities to use [the Segway] in areas were they may not allow other able-bodied people to use [it]."
Yet Kerr certainly understands. He knows what it is like to simply want to stand tall and look other's in the eye. And as far as he is concerned, he hasn't done half bad in his quest to do so.
"While my prognosis was never very good in terms of what I would be able to do, I have done quite well," he concludes.
For more information
www.segway.com.
www.draft.cc/DesktopDefault.aspx.
Jessica LaGrossa is ADVANCE associate editor. She can be reached at jlagrossa@merion.com.
http://occupational-therapy.advanceweb.com/common/EditorialSearch/AViewer.aspx?AN=OT_05mar21_otp45.html&AD=03-21-2005
Vol. 21 •Issue 6 • Page 45
The Segway HT: Who Can It Best Help?
By Earllaine Croarkin
The Segway Human Transporter has been marketed as a machine that will change the way people travel. People with impairments have begun to use Segways to improve their ability to participate in activities of daily living, increase their social outlets, and sustain their roles in the community and family. Although this device can be a welcome respite from assistive devices such as wheelchairs, using it requires some precautions and considerations.
The Segway relies on the rider's ability to shift weight to propel the machine forward or backward. The rider can use several strategies to propel the Segway forward, such as flexing the trunk, bending at the hips, or shifting weight from the ankles. Stopping and standing still on the Segway requires a rider to maintain balance in a relatively centered position. Riders can turn by twisting a control on the left handlebar.
Typically, Segways are useful in moderate climates, can travel about 10 miles per charge (depending on conditions of use), and can carry up to 260 pounds.
The EPAMD (electronic personal assistive mobile device) classification allows freer use on city streets and within public transportation systems, such as subway systems. For example, in some metropolitan areas the Segway is allowed more accessibility to public transportation than are bicycles. Presently, 41 states have enacted laws on where Segways can be ridden, minimum user age and helmet requirements. Local ordinances may restrict use regardless of state legislation.
As of 2003, the Segway had not been approved as a medical assistive device; however, as it gains popularity, more people with impairments are considering purchasing one.
Because the Segway is not a medical device, it is our responsibility as health care professionals to be as circumspect as possible if clients ask if the Segway would be reasonable for their use.
Just as with riding a bicycle or using a wheelchair, one must use good judgment while operating the device. Falls can occur when an individual rides too fast, doesn't scan the environment, or fails to concentrate while riding. An individual with slower cognitive processing, delayed responses or poor safety awareness may not be an appropriate Segway candidate, just as it may not be appropriate for these individuals to use a motorized scooter or wheelchair.
An obvious issue is how much balance is required in order to ride safely. Many people with balance concerns have used the Segway with great success. Ironically, the machine may help them compensate for this inability because it offers a platform that moves continually.
Other considerations include the type, severity and number of impairments possible Segway users have. How extensively are they impaired? Are these people also experiencing other motor control impairments? Do not assume that individuals with various types of balance impairment will be able to sufficiently control the momentum of the device, or be able to slow the momentum once maximum speed is reached.
Another prerequisite to safe Segway use may be the requirement for pain-free and unlimited joint mobility. Those with arthritic joints may have limited ability to compensate for the balance demands of significant medial or lateral movement. However, it is also well known that people with chronic pain can adapt and perform many activities. In essence, sound judgment is required. It may not be appropriate for an individual with pain to take the Segway on uneven bumpy terrain, but using the Segway in a shopping mall might be beneficial and safe.
Segway users also must become proficient at abilities other than riding to be independent in its use. For some, the most difficult skill may be learning how to move the Segway from one level to another; for example, up stairs. The power-assist mode allows users to "bump" or partially lift the machine up a step. Once the machine gains traction on the step, the power assist mode engages the wheels and helps the Segway climb the rest of the distance. Ascending and descending stairs with the Segway is one part strength, one part coordination, and one part problem solving.
More than likely the Segway will optimize mobility for many people, including people working in large industrial factories or those no longer working but with goals of improved community mobility. In the future, health care professionals should be able to effectively educate potential consumers about the Segway, to help ensure safety as well as successful outcomes.
Earllaine Croarkin is senior physical therapist in the rehabilitation department at the National Institutes of Health Clinical Center, Bethesda, MD.
Jessica LaGrossa
associate editor
ADVANCE Newsmagazine
www.advanceweb.com
2900 Horizon Dr.
King of Prussia, PA 19406
1-800-355-5627 ext. 1425
Tripod and ROVER