ICF model adapted with Quality of Life

We are now introduced to Nora, who is a two-year-old energetic young child who required assistance with meeting her mobility and developmental needs and goals. Nora loves playing in her jump swing, loves anything that goes fast, which includes going on slides and downhill skiing. She lives in Sweden with her mom, dad and 3 older siblings and attends public daycare during the week. She receives physical therapy and occupational therapy services at a pediatric rehab center weekly and has swim lessons. She has a variety of adaptive equipment that she can access, depending on the activity at hand.  These include a static activity chair with a saddle seat, a standing brace or shell, a standing frame, a walker, a crawling board, and an orthosis for her hand.  

We meet Nora when she is first introduced to the Explorer Mini and followed her experiences first-hand for the first three months she interacted and used the device. For Nora’s family and clinical team, they wanted to provide her with a means to be mobile with increasing independence while supervised, to learn about special perception and to be able to explore the environment around her. While Nora is unable to communicate with words yet due to her diagnosis of dyskinetic Cerebral Palsy, it doesn’t stop her from having bright and inquisitive facial expressions.   

Fitness (Body Functions & Structures)

• Motor dysfunction in all four limbs where her legs are impacted greater than her arms
• Spasticity in her limbs and trunk that is triggered by excitement.
• She can support her legs when using her walker, but her trunk balance and coordination is a limitation
• With her hands she can grab and reach in a dyskinetic manner and partially grip things but tends to use left hand most often.
• She is starting to make sounds and attempting to talk and form words as well as communicate in a melodic manner.
• Cognitively her parents report that she can understand what is happening around her and her body is her limitation. Formal evaluations will come as she ages.

Function (Activities)

• Her activities include play (of course!) and lots of it!
• Her parents want her to be as active as possible with activities in the house
• She loves her therapy time especially her swim sessions
• At home with her siblings they love clapping hands and practicing her reach by taking things from her older siblings.

Friendship (Participation)

• Nora primarily hangs out her siblings but also has cousins of similar age that live close by
• At school she loves to interact with her peers and participate in all the same activities and she even has her own sledge (sled)

 Family (Environment) & Fun (Personal factors)

• She lives with her mom, dad and 3 older siblings in a home in the northern part of Sweden.
• She attends an inclusive public day care during the week
• There are additional resources available to support Nora during the day as well
• At the time of the first interview, she was 81 cm (32 inches) and 10 kg (22 pounds), which is within the recommended range of use for the Explorer Mini.

* Images kindly provided by Nora's family and therapists.

Meet Scott: A community activist, clinical psychologist, and pet owner who resides in Mississippi, United States. Scott met with us to discuss his experience with mobility equipment over the past ten years. 

Scott is living with Multiple Sclerosis, which presents with fluctuating symptoms from day to day and so the impact to his daily life will vary as well.

Looking at the way equipment impacts the whole person, here are a few considerations that Scott has to keep in mind when selecting and using his power wheelchair:

Body functions and structures (physical and anatomical)

• Muscle weakness in arms and legs that is progressive
• Spasticity that increases throughout the day
• History of pressure injury on his sacrum from previous equipment 
• Motor and Cognitive fatigue 
• Difficulty with verbal communication

Activities (tasks or actions to complete)

• Dressing himself
• Transferring to the bed or commode/toilet
• Preparing meals, which he only eats once a day to conserve energy
• Standing (for exercise and health, not for functional tasks)
• Caring for his home and pets 
• Grocery shopping 

Participation (involvement in life)

• Past Chairperson with various organizations including Mississippi Coalition for Citizens with Disabilities and National MS Society
• Volunteer with City of Jackson ADA (Americans with Disabilities Act)

Environment & Personal Factors

• Lives in a home in an urban setting in Mississippi, USA
• Pets: Maggie & Misty
• Has a ramp built to accommodate 2 steps into his home, internal doorways are very narrow due to age of the home
• Uses public transportation primarily 
• Late 50s
• Current equipment: Permobil F5 Corpus VS with ROHO® single valve cushion.

* Images kindly provided by Scott.