Highly motivated, gainfully employed, active, working to sustain good health practices. That’s the way that Penny J. Powers, PT, MS, ATP, at the Vanderbilt University Adult Seating & Mobility Clinic described client Anne Richardson, a part-time employee at Vanderbilt’s Divinity school library.

“She is a wife, mother and grandmother,” Penny added. “She is highly motivated to achieve the maximum level of independence with regards to mobility.”

Penny listed Anne’s clinical challenges: “Small-fiber peripheral neuropathy with neuropathic pain involving both lower extremities; osteoarthritis; impaired sensation in bilateral lower extremities; pain in upper extremities, wrists and hands resulting in functional impairments.”

Those impairments were significant, Penny added: “A history of falls; paresthesias; diminished ability to ambulate with and without assistive device secondary to the inability to weight bear (stand); decreased ability to propel a standard-weight or high-strength lightweight manual wheelchair.”

Penny said Anne “can independently self-propel an ultralightweight manual wheelchair with bilateral upper extremities and some foot propulsion.” But when in the community, Anne has relied on dependent mobility.