Tilt in Space Powerchair rehab Seating System

When you say Rascal to most anyone they automatically think scooter.  But that's not true anymore. We also have Rascal Powerchairs, and Rehab Equipment. The king of seating systems, and also usually the most expensive,  isn't the one most people need, thank God.  It's what's called a Tilt in Space, it can be used on some but not all powerchairs. It's for those people who are in their chairs from the time they get up until they go to bed, which due to an inability of many to shift their weight can result in discomfort and skin breakdown or in extreme cases bedsores. Bedsores are painful and dangerous. Tilt in Space allows the user to tilt the seat back, to take the pressure off their butt and transfer it to their back, or anywhere in between depending on the degree of tilt. They can also be setup to have a reclining back, as well as powered swingaway legrests. These give the user options for comfort, by reclining the back and/or tilting the seat while raising/lowering their legs, there are literally dozens of combinations to be more comfortable and relieve pressure. They can be ordered with a joystick or very sophisticated alternative controls such as sip n puff or switches in the headrest for example, and Rascal or 3rd party cushions whichever your doctor or therapist prefers.
The picture shows a tilt in space on a 330 powerchair base, it can be used on other chairs also.

Here is an excellent article that explains a great deal about Tilt in Space, and Tilt or Recline:

Tilt in Space versus Recline: New Trends in an Old Debate

This article appeared in the June 2000 edition of Technology Special Interest Section Quarterly and was reprinted with permission of the American Occupational Therapy Association. If you wish to cite the article use the following as your reference: Lange, M. L. (2000, June). Tilt in space versus recline--New trends in an old debate. Technology Special Interest Section quarterly, 10, 1-3.
by Michelle L. Lange, OTR, ABDA, ATP
Tilt versus recline is an old debate that has reemerged as new products, theory, and clinicians have entered the field of positioning. In general, a trend toward more tilt-in-space system recommendations versus recline system recommendations is evident. More specifically, many facilities recommend almost solely tilt or solely recline systems. Are we in a rut? Is this because of a lack of knowledge of the options? Do valid reasons exist for such exclusivity? The difference appears to be because of the patient population and primarily involves conditions, age, and living situation.
This article will discuss why certain facilities tend to lean toward one option or the other. The article will present indications and contraindications for each system, including typical conditions and age ranges for each. Finally, the article will clarify when and why to consider each option for a client. This cannot be a "cookbook" approach; a qualified seating specialist must weigh many factors.
Most of us change our positions throughout the day. We sit up tall and tuck our feet under our chairs for awhile and then we slouch and stretch our legs out. Not doing so leaves you feeling like you just sat through a double feature at the theatre. Tilt systems (which change a person's orientation in space while maintaining fixed hip, knee, and ankle angles) and recline systems (which change a person's seat-to-back angle) have traditionally been for clients requiring pressure relief. Today, these systems are useful for many more reasons.

Tilt Systems

A tilt system provides a change of orientation and thus redistributes pressure from one area (e.g., the buttocks and posterior thighs) to another area (e.g., the posterior trunk and head) and maintains physical angles at the hips, knees, and ankles.

Indications

To distribute pressure to reduce risk of pressure sores, increase comfort, and increase sitting tolerance.
To elicit extensor tone. Maintaining the physical angles can inhibit muscle tone, and increasing the seat-to-back angle often elicits extensor tone.
To maintain posture. Changing the physical angles can lead to a loss of posture that one cannot regain by reducing a recline mechanism, and sometimes the client must be removed and repositioned after reclining.
To prevent sheer. No matter what the brochure says, all recline systems have some sheer that causes friction or dragging of the tissues, particularly on the posterior trunk. This is particularly important in an intimate seating system such as a molded seat. The components may move out of position during recline. Have you ever sat in the dentist chair while reclining, and your head fell off the headpad? Your body was no longer in alignment with the components of the dentist chair.
To maintain proper position of related devices such as a communication device, computer, and access switches. This can include the powered wheelchair access method as well.
To maintain a fixed seat-to-back angle. Some seating systems are one-piece systems (e.g., the sitting support orthosis) and cannot accommodate a change in seat-to-back angle.
When range-of-motion limitations prohibit a recline system, such as hip flexors, hamstrings, or even heterotopic ossification.

Contraindications

If the client spends much of the day at a workstation. If a client moves up close to a table, then he or she must move away from the table to tilt or the footrests may contact the table, possibly even tip it over, or at least hurt the client's feet. Most tilt systems do not include a stop switch if the client contacts an obstacle.
If the client is at high risk for pressure sores. Tilt systems generally tilt to 450, although some tilt as far as 55g. This is not as much pressure relief as 180 degrees of recline. The pressure distribution pattern is different for tilt systems and recline systems.
If the client is having bladder-emptying problems or wears a leg bag. Remaining in a fixed position (i.e., hips at 90g) can constrict the bladder, and tilting with a leg bag can lead to leakage.
If the client leaves items on the tray. Any items left on the tray during a tilt will slip and fall.
If the seat-to-floor height is too high with a tilt system. Many tilt systems raise the seat-to-floor height, which affects transfers and the ability get under tables.

Conditions

Tilt systems are often for persons with

cerebral palsy;
muscle diseases, particularly with an intimate seating system;
head injuries, particularly if extensor tone is elicited when opening the seat-to-back angle; and
spinal cord injuries, particularly in the pediatric population.
Pediatric patients with a spinal cord injury often have more extensor tone than adults, although adults can be susceptible to extensor spasms when the seat-to-back angle is open (increased beyond 90 degrees). Pediatric patients are more susceptible to scoliosis than adults because they are still growing and thus require more aggressive seating, which is contraindicated with a recline system.

Age

A client of any age who meets the indications above would benefit from a tilt system. However, most clients who receive tilt systems are children. Most pediatric mobility bases (dependent mobility bases, manual and powered wheelchairs) offer a tilt system. Some dependent mobility bases (strollers) include a recline system. As a result, because of product availability alone, most pediatric patients are in a tilt system versus a recline system. Children are more likely to need a tilt system if they have abnormal muscle tone. Abnormal muscle tone in a growing body often leads to orthopedic consequences such as scoliosis, which generally requires a more aggressive seating system. Again, the sheer of a recline system is contraindicated with this type of seating.

Case Study

The following case study highlights some of the issues related to a tilt system. Pete has cerebral palsy, is in his teens, and has had orthopedic surgery on his hips and several tendon releases of the hamstrings and hip adductors. He attends high school, where he must sit in his wheelchair from the time he gets on the bus in the morning until he arrives home at night. He is rarely out of his wheelchair during the day and, as a result, often does not have a diaper change until he is home. His sitting tolerance was only 2 hr, at which point he would indicate that he wanted to get out of the wheelchair.
We recommended a powered tilt system that could be retrofitted to his current powered wheelchair. Pete's sitting tolerance eventually increased to a full day. He operates his tilt independently with a lever switch by his right forearm. He tends to make 5 to 10 degree changes at least every 15 minutes. Two to three times daily, he will tilt a full 45 degrees for 10 to 15 min.
Pete needed changes in position to shift his weight to extend comfort and sitting tolerance. Typically, tilt systems are to prevent pressure sores. He has never developed a pressure sore and has sensation (unlike most clients who are at risk for breakdown). However, he has reason to be uncomfortable: Pete is quite thin; has obvious bony prominences; experiences pain and numbness in his hips, back, and posterior thighs; and is seated so aggressively that he cannot move his hips. So why does he not experience skin breakdown? His extensor tone does provide changes in his pressure distribution, even if his bottom does not appear to be moving around.
A recline system was inappropriate because Pete did not have sufficient hip extension to recline far. Pete is not a candidate for elevating leg rests (which are often recommended in conjunction with a recline system) because his hamstrings are tight. Increasing knee extension would have caused his pelvis to slide forward into a posterior tilt and cause discomfort. Pete uses a communication device. By mounting this above the tilt mechanism of the wheelchair, the device was located appropriately regardless of Pete's position in space. With a recline system, Pete would have moved away from the communication device as he reclined. This change in distance would have affected his visual regard of the device and his access, which was directly touching the screen.

Commonalties Between Tilt and Recline Systems

Before we explore recline systems, let us examine the similarities between the two systems to prevent redundancy. Both tilt and recline systems can provide pressure relief, increased blood flow, increased head and trunk control, increased positioning for function and access, easier transfers, improved sleep and rest, and increased vestibular stimulation; minimize fluctuations in muscle tone; improve feeding, respiratory function, and visual field; and regulate blood pressure.
Neither a tilt system nor recline system is appropriate if the client displays abnormal reflexes in a more supine posture (i.e., tonic labyrinthine) because this can be elicited regardless of hip position. If the client drives a powered wheelchair with an access method behind the head (e.g., ASL Electronic Head Array, Adaptive Switch Laboratories, Spicewood, TX), then this must be disengaged before tilting or reclining back so that the client can truly rest the head. Disengage this feature by switching modes through the wheelchair electronics or by fuming off the power to the access method without turning off the power to a powered tilt or recline system. If the client has a vent tray, then the tilt or recline system must not "run into" the vent during the weight shift cycle. If the vent must remain upright at all times, then a special pendulum type mount is necessary and generally attaches to the back of the wheelchair.
Tilt and recline systems are available in manual and powered versions but not on all wheelchairs. Combination tilt and recline systems are available as well. These systems do not always offer a full 1809 recline and are more expensive than a single system. If a fixed recline is necessary to accommodate hip flexor contractures or a kyphosis, then adjust the back canes rather than ordering a combination tilt and recline system.

Recline Systems

Recline systems provide a change in orientation by opening the seat-to-back angle and, in combination with elevating legrests, open the knee angle as well. Recline systems may include a reduced sheer back that moves down as the seat-to-back angle opens. Sometimes the armrests slide back as the seat-to-back angle opens to help prevent the arms from slipping.
Indications

To distribute pressure to reduce the risk of pressure sores, increase comfort, or increase sitting tolerance.
To provide passive range of motion at the hips and knees.
When a contoured seat is not necessary.
When a client uses a tray for eating or work and needs to shift position regularly without disturbing the setup.
To ease transfers. Sometimes a fully reclined position can help with transfers.
To assist bowel and bladder function. Intermittent catheterization is easier in a reclined position.
To alleviate orthostatic hypotension.
For aesthetic reasons. Many adults prefer the recline system, which they may view as less intrusive in a social or work setting.
Elevating legrests may assist with edema control and increased circulation in the lower extremities.

Contraindications

Persons with spasticity. Opening the seat-to-back angle can elicit flexor or extensor spasms that may alter the patient's positioning.
Persons with limited range of motion at the hips or knees. A recline system may go beyond available range and pull the client out of position.
Persons with a contoured seating system. Newer recline systems greatly decrease sheer; however, only a tilt-in-space system can fully alleviate sheering forces.

Conditions

Recline systems are often for persons with:  spinal cord injuries (this is the leading population using recline wheelchairs and generally includes persons with quadriplegia who cannot independently perform weight shifts [i.e., wheelchair push-up] and for whom changes in seat-to-back angle do not affect spasticity), head injuries, and muscle diseases.

Ages

In the past, adult manual and powered wheelchairs often offered a recliner and, less often, a tilt-in-space version. Nowadays, more adult tilt-in-space bases are available, both in manual and powered wheelchairs, than recliners. Adults buy most recliners. Most of the pediatric recliners are temporary, and clients use them on a rental basis (e.g., to accommodate a hip Spica cast after surgery).

Case Study

The following case study highlights some of the issues related to a recline system. Jake has a spinal cord injury at C5 with resultant quadriplegia. He is in his mid-20s and plans to return to school to get a bachelor's degree in business administration and then go to work. His school day will entail sitting for approximately 6 to 7 hr without a transfer. Because of the need for early morning care (e.g., bowel program, grooming, breakfast, and transportation schedules), Jake begins his day in the early morning hours and is in his wheelchair for a total of 10 to 12 hr.
Jake is unable to do his own weight shifts, so we ordered a recline system primarily to maintain his skin integrity. At the time of discharge, Jake was able to tolerate a full day of sitting with good skin integrity. He was doing independent recline weight shifts every 30 to 45 min with a toggle switch.
Another benefit of the recline system is passive range of motion to Jake's hips and knees with each weight shift. The recline position provides Jake comfort and relaxation. Jake does not require transfers from his wheelchair throughout the day because he can fully recline with his legs elevated for short periods of time. Jake has a suprapubic catheter, so no intermittent catheterization is necessary. Jake's spasticity can pull him out of an optimal position at times, so his reclining system includes a flat back that allows for easier repositioning as necessary by caregivers.
Jake uses a tray that is mounted on the base of his powered wheelchair. He uses this to hold his personal computer, and it provides a surface for his meals while he is away from home. With the recline system, he is able to freely change his position, do his weight shifts, and return to his work setup (the tray is static) without having to remove the tray. In a tilt system, the items would have fallen off the

Summary

Clients are using both tilt systems and recline systems more frequently as they discover increasing benefits of their use. Each system has advantages and disadvantages for clients. Tilt systems, in general, work best for those clients who have aggressive seating needs, high tone, or orthopedic limitations. Recline systems, in general, work best for those clients who have sufficient range of motion, can benefit from a passive stretch, require a full weight shift because of high pressure risk, and need to recline away from a work surface rather than risking items on a tray slipping and leg bags leaking. The decision of tilt system versus recline system is more closely related to condition and age than clinician bias. H

Acknowledgments

I thank Colleen M. Knoll, OTR, for her contributions.

Suggested Readings

Kreutz, D. (1997, March). Power tilt, recline or both. TeamRehab Report, 29-32 (This article and all the issues of TeamRehab Report are archived with permission of the publisher on WheelchairNet.)
Kreutz, D., & Taylor, S. J. (1996). Medical and functional considerations of power tilt and recline systems. Presentation from MedTrade, Atlanta, GA.
Leonard, R. B. (1995). To tilt or recline. Topics in Spinal Cord Injury Rehabilitation, 1(1), 17-22.
Pfaff, K. (1993, October). Recline and tilt: Making the right match. TeamRehab Report, , 23-27. (This article and all the issues of TeamRehab Report are archived with permission of the publisher on WheelchairNet.)
Ross, R. (1996, November). To tilt or to recline? That is the question. New Mobility, 34-36.
Michelle L. Lange, OTR, ABDA, ATP, is Clinical Director, the Assistive Technology Clinics of The Children's Hospital of Denver, 1056 East 19th Avenue B410, Denver, CO 80218, and Editor of the Technology Special Interest Section Quarterly.
Last Updated: 3-2-2006
Lee Murray

WE-GO at the VA

Have been taking the WE-GO into the VA's and showing to the therapists. To use Syracuse as an example, four or five of the OT's looked at it, rode in it and drove each other around in it. They were very impressed and said they had never seen anything like it, but that it would definitely fill a need. Then I showed it to the guys in Prosthetics and they also said it was unique and there were vets that they knew could benefit from it.

Lee Murray

You'll see ads for Dish Network

If you're a TV addict like I am, I highly recommend Dish Network. I came to them from Direct TV, because when we were redoing the porch two years ago, the dishes needed to be moved. Direct TV who I was using then, and had been since 1998 or 99, told me it would be two to three weeks for them to do it, even though I'd see one of their trucks on our road two or three times a day, and it would only take 30 or 45 minutes. They just didn't care if we went without TV or not, and I was expected to pay anyway. So I got mad and told them what they could do with their service in words I can't repeat here.
Dish Network is much better, if I need something they're here within a day or so, not two or three weeks. Prices are similar, but more HD channels. Even if Dish was more expensive, after the way Direct treated me so arrogantly, a loyal customer, I'd never go back with them. If you're looking for good product, decent prices, and great service, check out Dish Network.

Lee Murray

More Useful Links

Links to the Multiple Sclerosis Association, Muscular Dystrophy Association, and Disabled Online:

LINK TO MS ASSOCIATION

LINK TO MD ASSOCIATION

DISABLED ONLINE

Link to Veterans of Foreign Wars (VFW)

This is also a great site:

LINK TO VFW

Link to the American Legion

A great link:

LINK TO AMERICAN LEGION

Link to AARP

Lots of great info on this website:

AARP WEBSITE

Lee Murray

What's the biggest danger of ANY three wheel scooter? Tipping Over...

Enter the 600/700Balance scooter.  Many people are afraid of three wheel scooters because they feel tippy. A Rascal is less so because at 25 inches wide it's wider than many, for instance the Golden Companion is narrower and I personally know of several people who've tipped them over, one guy was still in the cast from breaking his arm. Rascals always came with tip wheels on both sides of their three wheels to help prevent tipping.  I actually talked many people out of a four wheel in favor of a three wheel by standing on one side of the platform and jumping up and down, at the time I weighed over 200 pounds, and rarely could  get the tip wheel to touch the ground. That sold a lot of three wheelers. But, still, if you tried hard enough you could tip even it. This was a concern to Rascal, and the owner, who holds several patents, so he decided to see if he could improve the design, and he did.  They widened the platform slightly, made the tip wheels larger and moved them out to the front corners. They are also magnetically centered.  Now when the scooter turns or tips the front mounted tip wheels touch down and effectively change it to a four wheel scooter. I was given an opportunity to try it out while it was in development and was challenged to tip it if I could, I tried, driving through the building as fast as I could and turning sharp, spinning in circles. I couldn't tip it.  I was told by one of the managers that they had put one of the new B fronts on a rear section that would do 10mph and almost took out some file cabinets but could not make it tip over. 
Last spring it was released as the 600B or Balance. I took one around to the VA hospitals, to everybody that tried it I said, "I have 20.00 that says you can't tip it."  Many of them were good sized, and really tried, but I never had to pay the 20.00.  The owner of Rascal has told us that he believes this design will obsolete the four wheel scooter, by giving the manueverability of a three wheel, and the stability and safety of a four wheel. Now we also have a smaller unit originally called the 300B, now the called the700B, it's 4 inches shorter and even more manueverable.  Here is an overview of the 600B put out by Rascal:

The Rascal Balance 3-Wheel Mobility Scooter

“Ride with Confidence”

The Rascal Company has led the industry in technological breakthroughs in personal electric vehicle technology for 35 years. Michael Flowers founded The Rascal Company with his late father, Francis, and is co-inventor of the original Rascal 3-wheeler. He is also the inventor of the

two vehicle-in-one Rascal ConvertAbleÒ and the powerfolding Rascal AutoGo.  The new Rascal Balance 3-wheeler features magnetic self-centering, stabilizer wheels.

Remarking on his latest invention, Flowers says: “4-wheeled scooters are stable, but are not

maneuverable and are uncomfortable for larger riders. 3-wheelers can tip sideways in sharp

turns, which is disconcerting and sometimes dangerous. The Rascal Balance is different. It's

comfortable and stable, plus it’s easy to maneuver in tight spots like stores and riding in crowds.

The Rascal Balance makes you feel better and safer!”

The magnetic stabilizer™ is a major technological breakthrough. It is currently offered on 2 new

models in 2 different sizes – 300 B, mid-size, 43” long and 600 B, full-size, 46” long.

The stabilizer technology automatically deploys when the Rascal Balance turns at any reasonable

speed. As the front wheel turns, the outside stabilizer wheel touches down on the riding surface.

The centrifugal force immediately releases the magnetic field holding the stabilizer fork and

wheel in place. At this point, the 3-wheeler becomes a 4-wheeler.

As the Rascal Balance turns, the stabilizer wheel follows the identical path of the steerable wheel.

When the front wheel is turned in a straight direction, the stabilizer wheel automatically returns to

its normal position above the riding surface and the magnets lock the fork and wheel back in

place.

These maneuverable Rascal 3-wheelers also feature a superior frame-forward™ design. This

frame design provides maximum comfort in lower body posture. There is a much larger foot and

leg accommodation range when compared to most other 3-wheelers and especially their 4-

wheeler counterparts. They provide all of the benefits of current Rascal 300 and 600 3-and-4

wheelers combined:

• Safety

• Comfort

• Ease-of-use

• Maneuverability

• Style

No other 3-wheeler provides all of these important benefits in one package! There’s a new

Rascal Balance model that will provide outstanding comfort whether the Rascal rider is 4’6” or 6’6”.

FAQs for the Rascal Balance

1. What is the Rascal Balance?

It’s a highly maneuverable, stable, comfortable and easy to use 3-wheeled mobility vehicle for personal use. The Rascal Balance is The Rascal Company’s solution to having to choose between safety (4- wheelers) and comfort (3-wheelers). Both of the Rascal Balance 3-Wheelers incorporate Frame-Forward™ Design and Self-Centering Magnetic Stabilizer™ Technology.

2. What makes The Rascal Balance different from its predecessor, the Rascal 600T?

The 600T has long been known as the industry leading 3-wheeler for style, comfort, handling, durability, weight bearing capacity and stability. With the Rascal Balance, The Rascal Company has made the best even better with the addition of our unique Frame-Forward Design and Self-Centering Magnetic Stabilizer Wheels.

3. What is Frame-Forward Design?

Frame-Forward Design improves your seated posture because it provides added foot room and comfort for a wide range of customers. It allows leg extension and improves vehicular weight distribution.

4. Why is Posture so Important?

Similar to automobile seating, the comfort of a scooter seat is a direct result of hip, knee and ankle position. Also known as body posture, most people base their buying decision primarily on seating comfort. Anatomical studies indicate the angles at the joints of the hip, knee and ankle should be greater than 90° to maintain a comfortable, seated body posture. Although a couple of degrees may not seem to make a big difference, it may be what causes a person to feel comfortable or become prematurely fatigued or deal with induced pain from poor seated position.  The Rascal Balance superior postural positioning provides users with a minimum of 90° joint angles at the hip, knee, and ankle. This is a direct result of how the ergonomic adjustable seat, the adjustable dash and adjustable handlebar, and the roomy Frame-Forward designs interact with each other to perfectly fit riders of various weights and sizes!

Lee Murray

The WE-GO An answer for those people in wheelchairs that need

to be pushed, usually by much smaller wives. I can't tell you how many times I've delivered a scooter to a large man who says he got it because his wife, who usually weighs in around a hundred pounds soaking wet, can't push him anymore.  Many times she has disabilities of her own.  You also see people who work in the hospitals, men and women, pushing patients around. The WE-GO is designed to answer both of these situations. It is an attendant controlled powerchair. The patient sits in it and his wife or the hospital employee uses the attendant control handlebar to drive the chair where they need to go. Here is information direct from Rascal about the WE-GO development.

Background of the Rascal We Go Development

Purpose of Development of New Technology

For over a century manual wheelchairs have been the primary way to move temporarily or permanently disabled people in healthcare facilities. The New Rascal We Go is designed to replace manual wheelchairs, manual transport chairs, power wheelchairs with expensive companion controlled joysticks, and, in some situations, cumbersome gurneys and stretchers, as a means of transporting people who require mobility assistance. The patent pending Rascal We Go provides top level convenience, comfort and safety for patients and caregivers/companions alike.

Risk of Injury from Existing Technology

The number of healthcare workers who experience painful back injuries from transferring and transporting patients in wheelchairs is well documented (“Big Patients, Higher Cost”, Philadelphia Inquirer March 10, 2008; Safe Patient Handling and Movement: A Practical Guide for Health Care Professionals, Nelson, A. Ed. (2006); Patient Safety Center of Inquiry of the Veterans Administration Medical Center (www.visn8.med.va.gov/patientsafetycenter/)). Hundreds of thousands of hours of lost work time occur each year due to the multitude of neck, shoulder, leg, and back injuries caused by employees pushing patients in manual wheelchairs (A Back Injury Prevention Guide for Healthcare Workers, Cal/OSHA; US Department of Labor, Bureau of Labor Statistics, News Release, “Nonfatal Occupational Injuries and Illnesses Requiring Days Away from Work, 2006,” November 8, 2007. Accessible at www.bls.gov/iif/).

Because most manual wheelchairs are designed to be self-propelled and not designed to be pushed from behind, the handles for attendants are not ergonomically positioned. In fact, the handles should be turned 90º for comfort. Carpel Tunnel injuries are one symptom of this poor position for manual wheelchair’s push handles. Most caregivers must bend over to reach the handles to push a wheelchair. As a result, back, neck, and shoulder injuries are common.
The Rascal We Go has an automatic parking brake so it won’t accidentally roll away like a wheelchair, without their wheel locks engaged. Hills and inclines are a breeze for The Rascal We Go’s powerful electric motor. The automatic regenerative braking provides another level of safety because it automatically and instantly brakes when the attendant releases the power lever, even on inclines.
The manual wheelchair is also a source of ankle injury for caregivers and transporters. Because the attendant’s feet end up under the wheelchair as the attendant walks behind it, the outside of the ankle bone hits against the ends of the wheelchair frame. This type of injury is painful.
Because the manual wheelchair’s push handles are part of the seat frame, the pushing and turning forces of the attendant are conducted directly to the upper torso of the patient. For anyone in pain, these forces are magnified and cause even a short trip in a wheelchair to be an uncomfortable experience for the patient.
The wheelchair seat is obvious as a poor ergonomic design. The canvas or vinyl material is slung between the two side frame members to form a back and bottom seating surface. This puts the body in a hunched forward position and transfers most of the body weight to the area of the buttocks most prone to bed sores.
Manual wheelchairs are also dangerous for patient transfer for both the attendant and patient. Because each wheel must be physically locked, one at a time, wheels often go unlocked. When a transfer is attempted without the wheels locked, patient may fall and attendant strains may often occur.
In addition, most manual wheelchairs have fixed armrests and their seats are 17” – 19” off of the floor. Healthcare workers must physically lift non-ambulatory patients in and out of their beds which sit about 26” – 28” off the floor and into the lower wheelchair seat at 17” – 19”.

Inhibitors to Use of a Wheelchair as a Patient Transporters

Some electric wheelchairs are equipped with joystick controls behind the chair for use by companions or transporters. Unfortunately, trying to control a joystick while seated is hard enough, but, controlling one while walking is nearly impossible. Electric wheelchairs with attendant controls are very expensive starting at $6,000 for basic models.
Temporary or permanently disabled or injured people do not like being pushed around in a wheelchair. The stigma of their disability and the guilt caused by their dependence on their relatives and friends to push them is demeaning. Therefore, the manual wheelchair is disliked by both the companion and the individual with a disability.
Many elderly people are fearful of crashing an electric scooter or powerchair and, as a result, are afraid to use them. The Rascal We Go eliminates the fear many people have of operating power mobility vehicles, especially in crowds found in malls, sporting events, and in larger public venues. Often this leads to inactivity outside the home and increased danger of accidental falls from walking inside their homes. These falls lead to even greater injury and disability for the patient.
People who suffer vision loss are often pushed around in manual wheelchairs especially in supermarkets and shopping malls where falling accidentally is a problem. Because most electric wheelchairs require the patient to also be the operator, powered mobility has never before been an option for people who suffer vision impairment.

Rascal We Go - The Best Transport Solution

Healthcare workers, especially nurses who are in great demand, recognize the risks of pushing people around in manual wheelchairs and gurneys. Airport and Healthcare Facility wheelchair transporters fear jetways and inclines inside terminals because of the potential for injury to themselves and the traveler. Until now, there hasn’t been another solution.
The Rascal We Go Companion Controlled Portable Power Wheelchair fills the gap between the wheelchair and the electric wheelchair with rear-mounted controls. In fact, it is easier to maneuver than both a manual wheelchair and an electric wheelchair. Not only does the Rascal We Go improve the comfort and dignity for wheelchair users, it also saves injuries to both the patient or rider and the transporter/companion. The Rascal We Go is the “Companion’s Mobility Solution”, and the “Transporter’s Mobility Solution”.
The Rascal We Go is designed to be easily transported by disassembling without tools and DOES NOT REQUIRE the removal of your rear van seat or the multitude of scooter travel accessories like electric trunk lifts and carrier racks. When disassembled, which takes only seconds; it fits in the trunk of most compact cars with ease. It also meets airline FAA regulations for free shipping as a power mobility vehicle.
The Rascal We Go uses mobility scooter technology which is mass-produced so its price is reasonable and affordable. The savings alone from the elimination of transporter/caregiver injuries or expensive trips to emergency wards from a manual wheelchair run away on a ramp will pay off quickly for healthcare and airport facilities, as well as, consumers.
The Rascal We Go is patent pending because of its unique technology.

Selling Scooters

I just want to mention that I sell mostly, but NOT only, to the VA hospitals. I also sell to those who need a scooter or something else, but are not Veterans. In these cases sometimes Medicare or Medicaid may pay, all or part of the cost. But usually the buyer pays, sometimes with private insurance, more often in cash, or by check, or credit card.  There may also be financing available.
Many people are concerned about what they perceive as high cost. I'm the first to admit Rascal's, and all other scooters for that matter, are not cheap.  But what of value is? I always say that whatever it is, if you don't need it, whether it's a dollar or ten thousand, it costs too much. But, if you need it, really need it, that's different.
Rascal Insurance Services can be a great deal of help. If you think that your insurance would pay for your scooter, give me a call and I will come out, if you're in upstate NY and do the evaluation. If elsewhere I will get in touch with Rascal and arrange for another rep to help you.  I've copied the Insurance Services Faqs from the Rascal website below, I did put in my phone number.

Rascal Insurance Services

Since 1974, Rascal has been helping make people's lives better by providing a complete line of Power Chairs, scooters, accessories, and transport systems. Our expert staff has over 20 years of insurance claims processing experience and will help you every step of the way. We'll work with your physician, handle the  paperwork, and deliver to your home if you qualify.

For information or to schedule an evaluation, email me at lmurray@citlink.net

CANADA RESIDENTS: see the Ontario Assistive Devices Program (ADP) Coverage and Payment criteria for mobility products.

Frequently Answered Questions

We've put together a list of the most commonly asked questions from our customers. Please feel free to email me with any additional questions.

1. What portion of the cost does Medicare* pay?

If you qualify, Medicare may cover up to 80% of the allowable cost, and your supplemental insurance may pay the remaining 20%. In most cases, our customers pay little to nothing* for their powerchairs or scooters.

2. What kind of doctors can qualify me for a powerchair or scooter?

Any doctor that is familiar with your medical condition can complete the paperwork for power mobility, with the exception of a Podiatrist, Psychiatrist, or a Chiropractor.

3. Will my doctor select a powerchair or scooter?

Your doctor will work with our Rascal Insurance Services Team to determine the model that is most appropriate for your medical needs.

4. How do I get an evaluation?

A knowledgeable Mobility Consultant will work with you and assess your needs. In most cases, prior to delivery of your vehicle your mobility consultant will conduct an environmental and safety inspection and complete a pre-qualification application that includes information about your health history and life style. Simply call to schedule an appointment at your convenience.

*Medicare or private insurance may cover the entire purchase price of a power mobility vehicle. Little or no out-of-pocket expense is based on Medicare paying 80% and secondary insurance paying the remaining 20% of the cost. You may not be eligible for these benefits.

Rascal Convertible Scooters

Rascal convertible scooters are unique from every other scooter on the market in that because of the patented feature of convertible front sections it can easily be changed from a three wheel scooter to a four wheel scooter and/or back. Most scooters on the market can be broken down to some degree for transport, but in addition to that due to the patented feature, the Rascal can be changed from three to four wheels and is the only one that can be. This link shows the

Rascal demonstrating the convertible feature

Currently there are just two front sections. Originally there were three different front sections: the three wheel, the four wheel and the convertible section. The convertible was a powerchair front that put the front wheels behind your feet, turning your scooter into a powerchair. Primarily for use in the house and limited use outside. As I said it was discontinued, and a new chair the WE-GO which I'll talk about soon has just been brought out, to replace it. Also, the 600T three wheel front shown above has been replaced by the 600B/700B three wheel fronts, which I'll also talk about soon.

Lee Murray

To Veterans Alone

I just wanted to say that if you happen to be a veteran of any of the Armed Services, whether or not you use the VA hospitals for your medical care, and let me say right here if you aren't you should, (at least up here in upstate NY where I've seen what they do), they're great, as good or better than private hospitals. Anyway, if you're a veteran, and need a scooter, or powerchair, or anything like a lift for your vehicle, a ramp for your house, or pretty much any other mobility item, before you even consider buying yourself, go to the VA. They will determine your needs and from what I've seen take care of them. Best case the VA gets it for you, worst case they say no for some reason and you get it for yourself. Isn't it worth the trip?

Lee Murray

Rascal Products

You can see the Rascal product line at www.rascalscooters.com or click on the link:

Rascal Products

Lee Murray

Hello, and Welcome to my new blog.

This is new to me and I really don't have a clue, so I'll, make that we'll, learn as we go. My name is Lee Murray, and I live in upstate New York. I sell, yes SELL, Rascal scooters, powerchairs, vehicle lifts, and other products mostly to the VA hospitals in Albany, Syracuse, Canandaigua, Rochester, and Bath NY. Rascal scooters and powerchairs are truely phenominal machines, that liberate those who need help getting around for a variety of reasons, some serious, some less serious and some very very serious. I'm proud to have worked with this company for the last 11 years, since 1998. Hopefully I can use this blog to introduce others who need them, or know someone who needs them, to the miracle that's Rascal.

Lee Murray