A device designed to assist walking or otherwise improve the mobility of people with a mobility impairment. There are various walking aids which can help with impaired ability to walk and wheelchairs or mobility scooters for more severe disability or longer journeys which would otherwise be undertaken on foot. Wheelchairs and mobility scooters substitute for walking by providing a wheeled device on which the user sits. Wheelchairs may be either manually propelled or electrically powered. Mobility scooters are electrically powered, as are motorized wheelchairs.
Assistive devices - such as wheelchairs, scooters, canes, crutches, and walkers - are effective ways to alleviate the impact of mobility limitations for many people, allowing improved ambulation and independence. Because the U.S. population is aging, the use of assistive devices by people with mobility impairments is of increasing importance. Assistive technology may be responsible for the observed reduction in the level of activity limitation at older ages (Manton, Corder, and Stallard, 1993).
The use of mobility devices has grown in recent years (LaPlante, Hendershot, and Moss, 1992), with the populations using wheelchairs and walkers doubling from 1980 to 1990. Crutch and cane use also increased by 14 percent and 53 percent, respectively, over this period.
Growth in the usage of these devices continued from 1990 to 1994 (Russell, Hendershot, LeClere, Howie, and Adler, 1997), far exceeding what could be attributed to the aging of the population. It is likely that improved survival of trauma patients has also contributed to the growth in mobility device use. However, significant improvements in the design of mobility devices, both in function and image, have also fueled this growth.
While financing may have become more available, it remains the case that about half of people or their families pay for devices solely on their own. The unmet need for devices is substantial, with the primary barrier being that people simply cannot afford to purchase them.
Although mobility device users represent only a relatively small minority of the population with disabilities, their importance transcends their numbers. Mobility devices, especially wheelchairs, are highly visible signs of disability; they have even become symbols in themselves of the concept of disability. Understanding the magnitude and characteristics of the population using these assistive technologies is therefore of particular importance.
For mobility devices to be used effectively, the environments in which they are used must be accessible. Yet, there is little data on the extent of accessibility barriers faced by people who use these devices.
This report focuses on the population using devices, providing a detailed profile of their demographic characteristics; health and disability status, including diagnoses and impairments, physical functioning, and activities of daily living; and health insurance status. More significantly, the report addresses the accessibility of mobility device users' homes and larger environments, demonstrating that improvements in physical accessibility remain a priority for millions of mobility device users who still experience accessibility barriers.
As a group, the 6.8 million community-resident Americans who use mobility devices differ in many significant ways from the population at large. They experience severe functional and activity limitations in much greater proportions, and they are more than 40 times as likely to need assistance with self-care activities as their counterparts who do not use mobility devices. A majority are in poor or indifferent health, and many have experienced a recent hospitalization. Many are affected by debilitating health conditions, such as arthritis, stroke, or serious back problems; others have long-term conditions and impairments, such as multiple sclerosis or some form of paralysis.
A majority of the population using mobility devices is elderly, but there is a substantial minority who are of working-age. Members of this group are very unlikely to have jobs and, partly as a consequence, are substantially more likely than the remainder of the population to live in poverty. At all ages, income levels for mobility device users tend to be low, as do levels of educational attainment.
Women are more likely to use mobility devices than men, and African Americans more likely than whites, who are in turn much more likely than Asians and Pacific Islanders to be device users. Latinos are less likely to use mobility devices than people not of Hispanic origin.
Most mobility device users, especially those using wheelchairs and scooters, perceive themselves as having disabilities. Given the extent of functional and activity limitation they experience, this fact comes as no surprise. But to the extent that disability is seen as a result of environmental factors, the high rate of self-identification as disabled is even more easily understood. This report provides ample evidence that mobility device users face access barriers on a daily basis. A majority of device users, for example, cannot leave their homes without using steps; half of wheelchair users face the same obstacle. Few have the home accessibility features that would facilitate basic household tasks, not to mention moving about inside. And the vast majority report difficulty with public transit; for many, the difficulty is insurmountable.
Despite recent changes in society that have led to greater attention to environmental accessibility and to opportunities for employment and independent living for people with disabilities, it remains clear that the population using mobility devices continues to face substantial challenges in achieving these goals.
LaPlante, M. & Carlson, D. (1996). Disability in the United States: Prevalence and Causes, 1992. Disability Statistics Report (7).Washington, DC: U.S. Department of Education, National Institute on Disability and Rehabilitation Research.
LaPlante, M.P., Hendershot, G.E., & Moss, A.J. (1992). Assistive Technology Devices and Home Accessibility Features: Prevalence, Payment, Need and Trends. Advance Data from Vital and Health Statistics, 217. Hyattsville, Maryland: National Center for Health Statistics.
Manton, K.G., Corder, L.S., & Stallard, E. (1993). Changes in the Use of Personal Assistance and Special Equipment from 1982 to 1989: Results from the 1982 and 1989 NLTCS. Gerontologist 33 (2), 168-176.
National Center for Health Statistics (1998). National Health Interview Survey on Disability, Phase 1 and Phase 2, 1994 (machine readable data file and documentation, CD-ROM Series 10, No. 8A). Hyattsville, Maryland: National Center for Health Statistics.
Russell, J.N., Hendershot, G.E., LeClere, F., Howie, L.J., & Adler, M. (1997). Trends and Differential Use of Assistive Technology Devices: United States, 1994. Advance Data from Vital and Health Statistics, 292. Hyattsville, Maryland: National Center for Health Statistics.
This report was supported by the National Institute on Disability and Rehabilitation Research (NIDRR), under ED Grant #H133B980045. The views expressed herein are those of the participants. No official endorsement by the U.S. Department of Education is intended or should be inferred.
Published by the U.S. Department of Education, National Institute on Disability and Rehabilitation Research.
Kaye, H. S., Kang, T. and LaPlante, M.P. (2000). Mobility Device Use in the United States. Disability Statistics Report, (14). Washington, D.C.: U.S. Department of Education, National Institute on Disability and Rehabilitation Research.
Credits: For their participation in preparing this report, the authors are grateful to the staff of the Disability Statistics Center; David Keer, project officer, and the staff of NIDRR; and Will Leber, graphic designer.