Curbs and steps:

Managing steps, stairs and curbs can be a challenge when getting out and about. There are some easy techniques that can help you manage these situations when out in public. If you are struggling with steps and stairs the Physiotherapy team are here to support you, please ask for an assessment.

  • If possible use a handrail or bannister close to the step for support. If you are using a walking stick use this on the opposite side to the handrail.
  • Take one step at a time and try not to rush, take your time.
  • Going up steps or stairs the ‘stronger’ leg goes up first. Going down steps or stairs the ‘weaker’ leg goes down first.
  • If using a walking stick when going down stairs the stick should go down first, followed by weaker leg, then stronger leg. When going up stairs the stronger leg goes up first, followed by the weaker leg then then walking stick – the walking stick can be used to support yourself from the lower step. This is a good video: https://youtu.be/qSzP6MVT9Vg.

Car transfers:

If you are struggling with mobility especially over longer distances you may want to consider applying for a blue badge. This can ensure you are able to park close to our destination and maximise your independence when travelling. To apply for a blue badge follow this link: https://www.herefordshire.gov.uk/parking-1/blue-badge-scheme which provides step by step instructions to support you with your application. If you are struggling with car transfers, our Occupational Therapy team are here to support you. They can complete an assessment of your car transfers to offer guidance and techniques to help you ensure your transfer is safe.

  • Make sure that the car is parked away from any curbs or steps. Ensure that the car is parked on level ground and not on a slope.
  • To make the transfer as easy as possible sit in the passenger seat in the front of the car. Push the seat back as far as it will go.
  • Back up to the passenger seat of the car with your back to the car, keep going until you feel the seat or sill of the car at the back of your legs.
  • Put your left hand on the top of the seat and your right hand on the dashboard, alternatively you can open the car window and hold the window frame with your right hand (make sure someone is holding the door to prevent it closing). Please speak to the Occupational Therapy if you are struggling as they may be able to advise aids you can purchase to help with car transfers.
  • Slowly sit down onto the seat. You may wish to place a plastic bag onto the seat prior to sitting down, the may help you when turning and bringing your legs into the car. If you do use a plastic bag ensure this is removed prior to the car moving.
  • Carefully lift your legs into the car. The can be done with either with your legs together or one at a time depending on which technique suits you best.
  • To transfer out of the car, reverse the above instructions.

Community transport:

Many of the taxi companies in Hereford have wheelchair accessible vehicles. However, community transport schemes can also help you get out and about around Herefordshire. These services are run by volunteers and supported by Herefordshire council. These services need to be booked in advance - at least 48 hours prior to travelling. Community transport options may be useful if no public transport options are available or you struggle with your mobility and cannot use public transport easily. Please contact the transport provider first, however, these services can accommodate wheelchairs. More information is available on the Herefordshire Council website: https://www.herefordshire.gov.uk/public-transport-1/community-transport. There are seven main providers:

Hospital Transport:

Some people may be eligible for non-emergency patient transport services. These services provide transport free of charge to and from hospital for people who may need extra support during their journey or who really struggle with their mobility. These services can accommodate wheelchairs and stretchers. In Herefordshire this service is provided by E-Zec medical and the eligibility is based on medical need. You must be registered with a Herefordshire or Worcestershire GP. For more information regarding eligibility and services offered please click on the following link to the patient advice leaflet: https://herefordshireandworcestershireccg.nhs.uk/policies/non-emergency-patient-transport-service-pts/331-non-emergency-patient-transport-nepts-patient-leaflet/file.

Driving with MS:

Below are some useful links to the MS Society ‘Driving and DVLA webpage and a ‘Motoring with MS’ information booklet published by RIDC. Please also note many of the taxi ranks in Herefordshire have wheelchair accessible vehicles.

https://www.mssociety.org.uk/care-and-support/everyday-living/getting-around/driving-and-dvla

https://www.mssociety.org.uk/sites/default/files/2020-10/Motoring-with-MS-April-2016.pdf

Mobility aids:

If you feel you are struggling with your mobility, a Physiotherapist can assess you for the most appropriate aid, and can fit this aid to you to ensure it is the correct size and height. The Physiotherapy team can also support you to build confidence with outdoor mobility as needed.

Types of walking aid –

  • Walking sticks
  • Fisher walking sticks
  • Quad sticks
  • Elbow crutches
  • Axillary crutches
  • Gutter crutches
  • Wheeled or static zimmer frames – these should be used indoors as they are not designed for outdoor use on uneven terrain.
  • Three or four wheeled walkers – these can be used outside much more easily than wheeled zimmer frames. Some of these walkers are have a seat that can be used to rest when out and about.
  • Gutter frames
  • Furniture walking - in your own environment.

Measuring for walking sticks –

  • Align handles of walking stick with wrist crease.
  • The height of the aid should allow the elbow to be in 15-30°
  • Adjust the height by pressing in both buttons and slide the inner tube up and down as appropriate. Make sure both buttons are clicked through the holes to ensure the walking aid is safe and secure.

Safety checks for mobility aids –

  • Check for significant signs of wear and tear, loose screws and parts borrowed from other mobility aids. Any mobility aids that have any of these should not be used.
  • Check for wear and tear on the ferrules – these are the grey attachments at the feet of the mobility aid which are in contact with the floor. If these are worn they do not provide the stability needed to be safe when mobilising.
  • Check that both pins are fully clicked through the leg/tubes of the walking aid. These pins are used to adjust the height of the walking aid. If these pins are not fully clicked through the mobility aid will not be stable when weight is put through it.
  • When using elbow crutches ensure they are a matching pair to make sure the heights can be adjusted equally.
  • Check for loose handles.
  • Check for bent or damaged frames.
  • Check wheels are aligned and turning correctly when pushed forwards.