Mobility Devices, Moon Landings, and Pirates

One of the things I’ve been mulling over the last week is how the very temporary nature of an injured limb has influenced the development (or lack thereof) of mobility devices for the able bodied population. We put a man on the moon 50 years ago but when you break your leg, the default option to get around is still crutches. (As an aside, when I was much younger, I thought that Neil Armstrong was terribly clever and profound to have said, “That’s one small step for man, one giant leap for mankind.” I realize now though that he must have been well aware that his first words upon stepping on the moon would go down in history, and likely spent months coming up with a pithy remark that would strike exactly the right tone for posterity. I bet his first thought as he stepped out of Apollo 11 was actually more like, “Holy s**t, I can’t believe I’m really doing this!” Not all that different from crafting the perfect social media post when you think about it. But I digress….)

Regular crutches are pretty terrible. They’re not very stable and require the use of both hands at all times. Better than just hopping on one leg (maybe), but they haven’t advanced much since medieval times. Although the Americans with Disabilities Act has done wonders to make the country more accessible to those with physical impairments, the fact is that the world is still very much designed with the able bodied in mind. Almost all public spaces assume the use of one’s hands. Many doors do not open automatically or have a button that will open them. Yesterday on our drive up to Jacksonville, we stopped at a gas station so I could take take a break and go to the bathroom. I specifically chose to stop at a gas station I know well, where the restrooms meet a basic level of hygiene. (Always, always chose somewhere that is attached to a McDonalds or similar establishment.) It was a hassle to unload the knee scooter for such a short stop, so I crutched my way inside. Husband opened the first door for me but I was on my own in the restroom. Washing your hands and opening doors while on crutches is precarious business. I have very good strength and stability in my left leg and good upper body strength for my size, yet I felt the most unstable that I have since the surgery. I can only imagine how it would feel for someone older or less athletic.

The inventor of the knee scooter, on the other hand, deserves a Nobel Prize. When planning for this adventure, I had initially thought that I would use only a combination of regular crutches and the iWalk. A colleague however offered me the use of a knee scooter his mother had. I have thanked my lucky stars the last few days that I took up this offer. Not only is the knee scooter the fastest way to get around, but it is the most stable modality and it comes with a basket on the front. The importance of the basket cannot be overstated. The ability to carry phones, drinks, food, clothes, and books from room to room is crucial to the couch bound life. The knee scooter also opens up the outdoors better than other modalities, primarily because it allows you to go further with less effort. It’s almost like having a bike. While out and about, the scooter also provides a surface to keep your operative leg up on if you take a break to sit down.

The versatility of the knee scooter

The knee scooter is not, however, without its drawbacks. It is necessarily on the heavier side which is not a problem for me but could be for someone with less upper body strength. On rough, uneven surfaces, things get less stable (although an all terrain version with bigger, more rugged wheels is available). Its biggest drawback though is its lack of maneuverability in small spaces. In our rather narrow Jacksonville bathroom, I cannot turn it around and so have to either back in or back out. Preparing food, which typically requires a few steps in different directions to reach items in different cupboards, drawers, and the refrigerator, becomes a tiresome experience on the knee scooter (although still better than the impossible experience it is on crutches).

This is where the iWalk truly excels. If not quite Nobel Prize worthy, it certainly deserves a nomination. Essentially a peg leg with a platform for your lower limb, the iWalk is the most similar of all the modalities to actual walking. Husband, who has always been convinced that I’m descended from pirates, finds the idea of me having a peg leg entertaining. (Note: There actually is a pirate connection — Mum’s side of course — but no evidence that anyone had a peg leg.) It takes a little practice to feel confident but then, as my also-currently-non-weight-bearing sister in law says, it’s as if you are free. I didn’t use the iWalk the first few days after surgery because I spent so much time on the couch and it takes a minute to put on and is slower to get around on than the knee scooter. I also wasn’t feeling completely confident in my abilities right after surgery although I had no problems testing it out beforehand. My surgeon rather sternly informed me that several patients who had had accidents using the iWalk, so I elected not to risk adding to that number in the first couple of days post surgery.

I just need an eye patch and a parrot to complete the look.

So, the knee scooter and the iWalk are both enormous improvements on regular crutches but the technology is still very basic when you consider what the MIT robots are up to. More importantly, both have some very basic and easily corrected design flaws.

The biggest issue I have with the particular knee scooter I’m using is that, even with the knee pad on the lowest setting, it’s still a little tall for me even when I’m wearing my highest running shoe. I end up scooting either by pushing off on my left tip toes or bent at the hip, neither of which feel like sustainable positions if I were to decide to go for an hour long scooter. I’m certainly not tall, but at 5’3 I still tower over thousands of potential users so I’m perplexed at such a basic design flaw.

I have a bit of a sizing issue with the iWalk too. While the iWalk accommodates users shorter than me, I seem to fall between the adjustment options which are roughly 2 cm apart when barefoot and still cannot find a shoe of the exact right height to match. Again, it results in a position that doesn’t feel sustainable over extended periods.

That’s likely the real issue here. Better versions that allow you to scooter and iWalk for hours at a time don’t exist because people aren’t using these devices for extended periods. Fortunately for most of us, our foray into the world of mobility devices is brief and quickly forgotten. It’s telling (and good) that technology for individuals who have long term or permanent limb impairments is significantly more advanced, to the extent that controversy rages over whether prostheses offer runners who are amputees an unfair advantage over runners with biological limbs. I feel that there is a good business development opportunity here (and my background as a products liability lawyer would certainly help with the legal side of things) but the great likelihood is that, as soon as I don’t need any of these devices anymore, I’ll forget all about developing a better one.

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