In last month's column, I discussed the growing use of power mobility devices in the U.S. and the need to offset any reduction in energy expenditure that might be associated with the transition from a manual wheelchair or other assistive mobility aid to a power chair by increasing physical activity. A few readers thought the article was a direct condemnation of all power mobility devices and that people should not use or rely on them. That is certainly not the case. In fact, I often suggest to friends and family members a balance between use of non-power mobility aids (manual wheelchairs, crutches, canes, walkers) and power mobility devices (i.e., scooters, power wheelchairs), especially when traveling longer distances to offset some of the repetitive stress associated with an altered gait or extensive pushing of a manual wheelchair. To set the record straight (and many thanks to those of you who took the time to send me an email voicing your concerns about the negative tone of the column), I am in no way advocating for a decline in the use of power mobility devices. The focus of the article, however, was to highlight their growing use in the U.S. and to encourage new users of power mobility devices and professionals who recommend them to consider ways to offset the possible decline in energy expenditure by increasing physical activity in small, incremental ways throughout the day.

Photo of a person in wheelchair crossing a street

Is there that much of a risk in gaining weight when transferring from a manual wheelchair to a power wheelchair, or going from walking with an assistive aid to using a scooter or other power mobility device more often? Well several years ago I recall a presentation by Dr. Jim Hill, one of the leading authorities on weight control and obesity, who said that if we could get Americans to increase their daily physical activity by 100 extra calories a day (e.g., the equivalent of two Oreo cookies!), we could reverse the obesity epidemic in this country. An additional 100 calories a day would add up to 700 calories a week or a loss of 1 pound every five weeks (There are approximately 3,500 calories in 1 pound of fat.). In one year that would add up to a 10-pound weight loss, and in two to five years account for the 20 to 50 pounds that many Americans gain during their adult years. The underlying message is that it is very easy to gain weight and even slight alterations in physical activity -- such as what I described in my last column -- could result in a small surplus of calories that over time could lead to weight gain and obesity, along with other health complications that are associated with excess body weight.

We typically don't gain weight in bunches; rather, we do it in very small increments with slight unnoticeable changes in diet or physical activity, which over time leads to an increase in body weight and in some people, obesity. This is why some experts refer to it as creeping obesity. Any change in energy expenditure, even a slight one, will lead to a surplus of a few extra calories a day and over a period of months and years result in a significant increase in body weight.

There is no need for alarm among new users of a power mobility device or for those who have been using one for many years or all their lives. The key is to recognize that there may be a slight decline in the number of calories you are burning up when you were using a non-power mobility device, or for those using power mobility devices all their lives to recognize that avoiding weight gain may require some additional physical activity.

In next month's column I'll discuss some of the simple ways you can increase your daily physical activity.

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Please send any questions or comments to Jim Rimmer, NCHPAD Director at jrimmer@uic.edu.