NDIA Accountability Project

Active-Passive Cycle Exercisers for Clients with Complex Physical Disabilities

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Assistive Technology

Submission 22

PO Box 419 Somers 3927

14 September 2018

Joint Standing Committee on the National Disability Insurance Scheme PO Box 6100 Parliament House Canberra ACT 2600

Dear Committee,

Re: Provision of Assistive Technology Under the NDIS

Peninsula Paediatric Physiotherapy is a small specialised physiotherapy service consisting of 3 physiotherapists working exclusively with children and young adults with complex physical and associated disabilities. As part of our service we submit many applications for Assistive Technology (AT) through NDIA funding. I personally have 24 “Pending” applications at the time of writing that have been submitted since May 2018.

We are all experiencing many of the same frustrations expressed in some of the other submissions, so I have decided not to repeat these same concerns. My submission today is to discuss specifically the need for the NDIA to fund Active-Passive Cycle Exercisers (e.g. Motomed, TheraTrainer) for NDIA clients in the instances where they are reasonable and necessary. Unfortunately, they are currently not funded through the NDIA under a “blanket ban”, described recently to me by one senior NDIA planner in an email: “The NDIA does not fund this type of equipment as it is not considered value for money and it does not meet the NDIA reasonable and necessary criteria.”

It really concerns me that any AT should be excluded from a client’s NDIA Plan, as disabled individuals have such specific needs and it is my job as a Registered NDIS AT Provider to fully explore all possible AT to help these individuals best meet their specific NDIS Plan Goals. Once appropriate AT has been selected, I then need to provide extensive justification to the NDIA about why an item was selected and at that point it should be decided whether an item truly does represent value for money and the NDIA reasonable and necessary criteria.

From my 21 years of experience working with clients with multiple and significant physical disabilities, I have found Active-Passive Cycle Exercisers to be sometimes the ONLY device that can exercise wheelchair bound individuals with severe spasticity and contractures. It is so simple for carers to use, with the machine doing all the work and in my extensive trials with these clients, they often exercise with Active-Passive Cycle Exercisers daily throughout the trial due to the complete lack of OH&S issues for their carers. Some of my clients have had Active-Passive Cycle Exercisers funded through DHHS Individual Support Packages or they have decided to self-fund them, as they can instantly see the benefits.

Assistive Technology

Submission 22

Some examples:

  • 16 year old client - weighs 120kgs and exercised almost every day on a Motomed over a 1 month trial. The NDIA is currently funding 2 carers to take her to the local hydrotherapy pool to exercise. The cost of funding 2 carers to take her to the pool each day to exercise would surely not represent better value for money in the long term than funding a Motomed.
  • 15 year old client, with severe spasticity who can hardly separate his legs when walking. He exercised on the trial Motomed device daily for 20-30 minutes and his legs become instantly loose. No carer or physio could ever achieve this through manual co-active exercise with him.
  • 20 year old wheelchair-bound client with severe spasticity and having constant painful spasms each day. Now that she exercises on the DHHS funded Motomed just 10 minutes a day, she no longer has any spasms and doesn’t have to continue taking expensive medication that has terrible side effects for her.
  • 8 year old client with Duchenne’s Muscular Dystrophy who was able to perform assisted exercise of his arms and legs 4 times a week when trialling a TheraTrainer Mobi device. A ground breaking study from the Netherlands proved in this population that assisted bicycle training delays functional deterioration in boys with Duchenne Muscular Dystrophy http://journals.sagepub.com/doi/abs/10.1177/1545968313496326

I could provide many more examples.

I need to point out that I always endeavour to use whatever works best for my individual clients, regardless of cost (an $8 resistance loop band from K-Mart is my number one prescribed exercise aid) and for most clients, an Active-Passive Cycle Exerciser would be a complete luxury item and their needs could be met elsewhere. But for some clients, there really is no other option. There are simply no devices available at a local gym or that can be purchased at a cheaper cost to help these individuals exercise their right to be able to exercise like the rest of us.

Surely, these individuals deserve full “Choice and Control” to be able to select how they can best meet their Health and Wellbeing Goals under the NDIS.

As you can tell, I am very passionate about advocating for my clients’ needs and would be happy to provide contact details for some of my clients and their carers to share their stories using the Motomed and TheraTrainer and the positive effect it has had on their lives.

Thanks you for taking the time to read my submission.

Yours sincerely,

Marty Hughes Owner and Principal Physiotherapist Peninsula Paediatric Physiotherapy