Powered Mobility Devices

Powered mobility should be prescribed following assessment of the person, device, tasks and environments. The assessment should address physical ability, cognition, vision, perception, judgement, device control, seating, transfers, road and path safety, charging, storage, transport and support needs.

Overview

Powered mobility devices use an electric motor to support mobility.

This note covers:

• Powered wheelchairs
• Mobility scooters
• Compact or portable scooters
• Mid-size and large scooters
• Alternative controls
• POMODATT assessment and training
• Risk management
• Device selection
• Training and review

Manual wheelchairs and power-assist add-ons are covered in:

• Wheelchairs

Main Types

Powered Wheelchair

A powered wheelchair is controlled using a joystick or another access method.

Common drive configurations include:

• Rear-wheel drive
• Mid-wheel drive
• Front-wheel drive

Possible seating functions include:

• Tilt-in-space
• Recline
• Elevating leg rests
• Seat elevation
• Standing
• Powered backrest and foot support

May Suit

• A person unable to propel a manual wheelchair effectively
• A person requiring independent indoor and community mobility
• A person with complex postural or pressure-care needs
• A person requiring alternative controls
• A person needing a small turning circle indoors
• A person requiring powered seating functions

Benefits

• Supports independent mobility
• Can reduce upper-limb effort
• May provide complex seating and positioning
• Can support pressure relief
• May provide better indoor access than a large scooter
• Can be adapted for switches, head controls or attendant control
• May support full-day mobility

Limitations

• Heavy
• Requires charging and battery management
• Often requires accessible vehicle transport
• Can damage walls, doors or furniture
• May be difficult to recover after a breakdown
• Requires regular servicing
• Can create significant injury risk if used without adequate control
• Some models have limited outdoor range or ground clearance

Mobility Scooter

A mobility scooter usually has:

• Tiller steering
• Three or four wheels
• A swivel seat
• Hand controls
• A battery and charger
• A platform for the feet

May Suit

• A person who can transfer on and off the seat
• A person with adequate sitting balance
• A person who can use both hands for tiller control
• A person with adequate vision, cognition and judgement
• A person who can walk short distances but cannot manage community distances
• A person who can store and charge the scooter safely

Benefits

• Supports community access
• Often has longer range than compact powered wheelchairs
• May carry shopping
• Familiar steering style
• Portable models may dismantle for car transport
• Can reduce fatigue and falls risk associated with long-distance walking

Limitations

• Larger turning circle
• Requires arm reach and tiller control
• Less adaptable for complex seating
• Can be difficult in small homes
• Transfers may be difficult
• May tip on slopes, kerbs or uneven surfaces
• Portable scooters may be less stable outdoors
• Heavy components may be unsafe to lift into a vehicle

Powered Wheelchair vs Mobility Scooter

How to Choose a Powered Mobility Device

Selection should consider:

• Mobility goals
• Indoor and outdoor use
• Required range
• Required speed
• Turning space
• Terrain
• Slopes
• Kerbs and crossings
• Seating and posture
• Pressure injury risk
• Transfer method
• Hand function
• Upper-limb reach
• Vision
• Cognition
• Judgement
• Reaction time
• Device control
• Charging
• Storage
• Transport
• Carer support
• Recovery after breakdown
• Cost and maintenance

Consider a Powered Wheelchair When

• The device must be used inside the home
• A small turning circle is required
• The person cannot use tiller steering
• Complex seating is required
• Pressure relief is required
• Alternative controls are required
• The person will use the device for much of the day
• Independent mobility is required despite significant physical impairment

Consider a Mobility Scooter When

• The main goal is outdoor community mobility
• The person can transfer safely
• The person has adequate sitting balance
• The person can use tiller steering
• The person can turn the head and scan the environment
• The home has suitable storage
• The route has adequate width and surfaces
• Seating needs are basic
• The scooter can be transported or used from home

Consider Manual Mobility Instead When

• The person does not have adequate control for powered mobility
• Risk cannot be reduced through training, controls or supervision
• The environment is too confined
• Charging cannot be managed
• A powered device would not meet the main mobility goal
• A manual wheelchair with attendant support is safer and sufficient
• The need is short-term

POMODATT

What Is POMODATT?

POMODATT stands for:

Powered Mobility Device Assessment Training Tool

It is a standardised occupational therapy assessment and training tool for powered wheelchairs and mobility scooters.

It is designed to help an occupational therapist:

• Assess competence to operate a powered mobility device
• Identify strengths and limitations
• Identify training needs
• Structure practical driving assessment
• Provide guided training
• Document performance
• Support clinical decision-making

POMODATT includes:

• An initial interview
• Part A: cognitive skills
• Part B: physical and psychosocial skills
• Part C: driving skills and behaviours

The outcome is a profile of the person’s abilities and areas requiring training, modification, supervision or further assessment.

Why POMODATT Is Used

Powered mobility devices can cause serious harm if the user cannot control speed, direction, stopping, scanning or judgement.

POMODATT may be used to:

• Provide a consistent assessment process
• Reduce reliance on informal observation alone
• Identify hidden cognitive or perceptual problems
• Assess real driving performance
• Identify whether training improves performance
• Match device controls to the person
• Assess safety in relevant environments
• Document clinical reasoning
• Inform funding or prescribing reports
• Support risk-management decisions
• Establish review and supervision recommendations

Is POMODATT Legally Required?

POMODATT is not a universal legal requirement for every powered wheelchair or mobility scooter user.

It may be required or expected when:

• The prescribing service uses it as part of policy
• A funding body requests a structured assessment
• The person presents with cognitive, visual, physical or behavioural risk
• There is uncertainty about driving competence
• There has been a crash, near miss or functional decline
• A residential service requires documented competence
• The device is complex or high risk
• A clinician needs objective evidence to support the prescription

The need for POMODATT should be determined by the occupational therapist, service requirements and the person’s risk profile.

Reasons a Structured Assessment Is Required

A structured powered-mobility assessment is important because safe driving involves more than moving a joystick or tiller.

The person must be able to:

• Understand the device
• Start and stop safely
• Control speed
• Steer accurately
• Scan for hazards
• Judge distance
• Give way
• Follow road and pedestrian rules
• Manage distractions
• Plan routes
• Respond to unexpected events
• Recognise limitations
• Manage fatigue
• Charge and maintain the device
• Seek help after a breakdown

A person may perform well in a quiet showroom but have difficulty in:

• Crowded shopping centres
• Narrow doorways
• Road crossings
• Slopes
• Shared paths
• Low light
• Unfamiliar routes
• Busy car parks
• Areas with children or pets
• Situations requiring divided attention

POMODATT Assessment Areas

Initial Interview

The initial interview may explore:

• Mobility goals
• Previous device use
• Driving history
• Medical history
• Medication
• Falls
• Vision
• Cognition
• Fatigue
• Pain
• Seizure history
• Substance use
• Support network
• Intended routes
• Storage and charging
• Insight into risk

Part A: Cognitive Skills

Consider:

• Attention
• Concentration
• Memory
• Following instructions
• Problem-solving
• Planning
• Sequencing
• Insight
• Safety awareness
• Impulse control
• Hazard perception
• Divided attention
• Response to feedback
• Learning from mistakes

Part B: Physical and Psychosocial Skills

Consider:

• Sitting balance
• Posture
• Reach
• Hand control
• Strength
• Coordination
• Reaction time
• Vision
• Hearing
• Sensation
• Fatigue
• Pain
• Confidence
• Anxiety
• Motivation
• Risk-taking
• Behaviour
• Ability to transfer
• Ability to access controls

Part C: Driving Skills and Behaviours

Assess:

• Starting
• Stopping
• Speed control
• Straight-line driving
• Turning
• Reversing
• Doorways
• Narrow spaces
• Obstacle avoidance
• Pedestrian awareness
• Road crossings
• Kerbs
• Slopes
• Ramps
• Surface changes
• Parking
• Approaching tables
• Lift access
• Emergency response
• Behaviour in complex environments

Possible POMODATT Outcomes

Outcomes may include:

• Safe and independent
• Safe with training
• Safe with device modification
• Safe in limited environments
• Safe with supervision
• Requires further assessment
• Requires medical or vision review
• Not currently safe
• Alternative mobility recommended

The assessment should describe the conditions under which the person is safe.

Examples:

• Indoors only
• Familiar routes only
• Daylight only
• No road crossings
• Supervised community use
• Reduced speed setting
• Attendant control required
• Review after training

Risks of Powered Mobility Devices

Collision

The device may collide with:

• Pedestrians
• Furniture
• Doors
• Walls
• Vehicles
• Pets
• Other mobility devices

Risk increases with:

• Excessive speed
• Poor scanning
• Reduced reaction time
• Inattention
• Narrow spaces
• Crowded environments
• Visual impairment
• Cognitive impairment

Tipping

A device may tip due to:

• Excessive slope
• Cross-slope travel
• Sudden turns
• High speed
• Kerbs
• Uneven ground
• Incorrect tyre pressure
• Poor weight distribution
• Heavy bags
• Incorrect seating position
• Unapproved accessories

Falls During Transfers

Risk increases with:

• Seat height mismatch
• Swivel seat not locked
• Footplates obstructing transfer
• Device moving during transfer
• Poor balance
• Unsafe transfer method
• Inadequate grab support

Driving Off an Edge

Examples:

• Kerb
• Step
• Platform
• Ramp edge
• Train platform
• Unprotected drop

Risk increases with:

• Reduced vision
• Inattention
• Poor depth perception
• Reversing
• Low light
• Distraction
• Incorrect route choice

Road and Crossing Risk

Risks include:

• Poor visibility to drivers
• Crossing too slowly
• Misjudging traffic
• Using unsafe road sections
• Crossing at poor locations
• Entering the road when the footpath is blocked
• Limited battery range during travel

Cognitive and Behavioural Risk

Consider:

• Dementia
• Delirium
• Impulsivity
• Poor insight
• Disinhibition
• Aggression
• Wandering
• Reduced judgement
• Difficulty following rules
• Fluctuating cognition
• Medication effects

Diagnosis alone does not determine safety. Functional performance must be assessed.

Visual and Perceptual Risk

Consider:

• Visual acuity
• Visual fields
• Depth perception
• Contrast sensitivity
• Neglect
• Double vision
• Low-light vision
• Ability to scan
• Ability to judge gaps

Physical Risk

Consider:

• Reduced hand control
• Tremor
• Spasticity
• Involuntary movement
• Weakness
• Poor sitting balance
• Fatigue
• Pain
• Reduced head control
• Delayed reaction time

Pressure and Posture Risk

Powered mobility may increase sitting duration.

Assess:

• Cushion
• Back support
• Pelvic position
• Foot support
• Tilt and recline
• Pressure relief
• Skin checks
• Continence
• Heat and moisture
• Transfer frequency

See:

• Cushions
• Pressure Injury Prevention and Management

Battery and Charging Risk

Risks include:

• Battery failure
• Incorrect charger
• Damaged cable
• Charging near exits
• Charging in wet areas
• Heat
• Fire
• Unapproved battery replacement
• Poor ventilation
• Trip hazards
• Deep discharge
• Loss of mobility during power failure

Charging Safety

• Use the approved charger
• Follow manufacturer instructions
• Charge in a dry, ventilated area
• Keep cables clear
• Do not cover the charger
• Do not use damaged batteries or cables
• Keep away from flames and heat
• Do not modify the battery system
• Maintain a backup plan
• Check airline and transport rules before travel

Environmental Risks

Assess:

• Door width
• Turning space
• Ramp gradient
• Cross-fall
• Kerbs
• Gravel
• Grass
• Wet surfaces
• Loose rugs
• Thresholds
• Lifts
• Shopping aisles
• Public toilets
• Road crossings
• Lighting
• Storage
• Charging location

Weather Risks

Consider:

• Rain
• Heat
• Cold
• Glare
• Wind
• Flooding
• Wet brakes
• Reduced traction
• Battery performance
• Electronic control protection

Community Safety

The user should understand:

• Pedestrian priority
• Speed adjustment
• Shared path etiquette
• Road crossing
• Visibility
• Night use
• Use of lights
• Use of a horn
• Safe parking
• Route planning
• Emergency contact
• Battery range

South Australian Road Considerations

In South Australia, mobility scooters are treated as motorised wheelchairs for road-rule purposes.

A person using a qualifying motorised wheelchair is generally treated as a pedestrian and must follow pedestrian rules.

Key points include:

• Do not travel faster than 10 km/h on level ground
• Use the footpath where available and safe
• Use the road only in limited circumstances
• Adjust speed for pedestrians and conditions
• The device must be designed for a person with mobility impairment
• Device weight and construction requirements may apply

Check current South Australian Government guidance before prescribing or training because legal requirements can change.

Device Selection Considerations

Drive Configuration

Mid-Wheel Drive

Benefits:

• Small turning circle
• Good indoor manoeuvrability
• Turns around the user’s centre

Limitations:

• Can rock over uneven surfaces
• Front and rear castors may catch
• Requires training for ramps and thresholds

Rear-Wheel Drive

Benefits:

• Directional stability
• Predictable outdoor tracking
• Familiar handling

Limitations:

• Larger turning circle
• Rear swing during turns
• Less manoeuvrable indoors

Front-Wheel Drive

Benefits:

• Good obstacle approach
• Front access
• Can suit some outdoor terrain

Limitations:

• Rear swing
• Steering can feel different
• Requires space during turns

Controls

Options include:

• Standard joystick
• Compact joystick
• Attendant control
• Head control
• Chin control
• Switch control
• Sip-and-puff
• Tray-mounted control
• Foot control
• Mini-proportional joystick

Assess:

• Access
• Accuracy
• Force
• Range of movement
• Fatigue
• Mounting
• Emergency access
• Ability to stop
• Ability to switch modes

Scooter Size

Portable Scooter

May suit:

• Car transport
• Smooth surfaces
• Short trips
• Users able to dismantle or manage components

Risks:

• Lower stability
• Smaller wheels
• Limited range
• Heavy individual parts
• Reduced comfort

Mid-Size Scooter

May suit:

• Local community access
• Moderate outdoor terrain
• Users needing more stability and range

Risks:

• Greater storage space
• Heavier
• Often unsuitable for manual boot lifting

Large Scooter

May suit:

• Longer outdoor travel
• Rougher surfaces
• Higher comfort requirements

Risks:

• Large turning circle
• High weight
• Limited indoor access
• Vehicle transport difficulty
• Greater tipping risk if misused on slopes

Transport

Assess:

• Vehicle type
• Ramp or hoist
• Scooter dismantling
• Heaviest component
• Battery removal
• Wheelchair tie-down points
• Occupied transport approval
• Head clearance
• Combined device and occupant weight
• Public transport access
• Airline battery requirements

A powered wheelchair should only be used as a vehicle seat when it is designed, tested and secured for occupied transport.

Training

Training should be graded.

Basic Training

• Power on and off
• Speed control
• Stop
• Straight driving
• Turns
• Reverse
• Parking
• Charging
• Emergency release

Intermediate Training

• Doorways
• Lifts
• Tables
• Narrow spaces
• Thresholds
• Ramps
• Crowds
• Shopping

Community Training

• Footpaths
• Shared paths
• Crossings
• Slopes
• Surface changes
• Route planning
• Low light
• Breakdowns
• Public transport

Training should occur in the environments the person will use.

Risk Controls

Possible controls include:

• Reduced maximum speed
• Restricted drive profile
• Alternative joystick
• Guarded controls
• Attendant control
• Anti-tip features
• Seat belt or positioning belt when clinically indicated
• Mirrors
• Lights
• Horn
• High-visibility flag
• Route restriction
• Supervision
• Familiar routes
• Daylight-only use
• Environmental modification
• Further training
• Regular review

Restrictions should be proportionate and should preserve independence where possible.

Trial Checklist

• [ ] Device matches mobility goals
• [ ] Seat dimensions are correct
• [ ] Posture is supported
• [ ] Pressure care is adequate
• [ ] Transfers are safe
• [ ] Controls are accessible
• [ ] User can stop reliably
• [ ] User can control speed
• [ ] User can turn and reverse
• [ ] User scans for hazards
• [ ] Doorways are accessible
• [ ] Home turning space is adequate
• [ ] Ramps and thresholds are manageable
• [ ] Community route has been assessed
• [ ] Charging is safe
• [ ] Storage is secure
• [ ] Transport is feasible
• [ ] Carer understands emergency freewheel
• [ ] Breakdown plan is available
• [ ] Training needs are documented
• [ ] POMODATT or another structured assessment is completed when indicated

Emergency and Breakdown Plan

Document:

• Emergency contact
• Supplier contact
• Roadside assistance
• Manual freewheel method
• Safe pushing method
• Battery failure plan
• Mobile phone access
• Weather plan
• Medication access
• Backup mobility
• Recovery from community locations

Maintenance

Check:

• Tyres
• Castors
• Brakes
• Motors
• Controls
• Joystick boot
• Cables
• Batteries
• Charger
• Seat functions
• Foot supports
• Armrests
• Lights
• Horn
• Suspension
• Anti-tippers
• Frame
• Error codes

Follow the manufacturer’s service schedule.

Review Triggers

• Crash or near miss
• New cognitive change
• Delirium
• Vision change
• New weakness or tremor
• Medication change
• Falls
• Change in posture
• Pressure injury
• Change in transfers
• New environment
• New route
• Device modification
• Repeated battery failure
• Unsafe speed
• Family or staff concern
• Change in judgement
• Hospital admission
• Progressive condition

Client and Carer Instructions

Before Driving

• Check battery level.
• Check tyres and controls.
• Confirm the seat and foot supports.
• Remove loose items.
• Plan the route.
• Carry a phone or alert device.

While Driving

• Use a safe speed.
• Give way to pedestrians.
• Slow before turns.
• Avoid steep slopes.
• Cross roads at safe locations.
• Keep away from edges.
• Stop when fatigued or unwell.

Stop Using and Seek Review When

• Control becomes unreliable
• The device pulls to one side
• Brakes or stopping are affected
• Cognition or vision changes
• A crash or near miss occurs
• The user becomes lost
• The device tips
• Transfers become unsafe
• The battery or charger is damaged

Related Notes

• Wheelchairs
• Cushions
• Pressure Injury Prevention and Management
• Vehicle Access and Wheelchair Loading
• Home Access and Ramps
• Community Mobility Assessment

References

• Powered Mobility Device Assessment Training Tool. What is PoMoDATT?: https://pomodatt.com/
• Powered Mobility Device Assessment Training Tool. Using the PoMoDATT: https://pomodatt.com/using-the-pomodatt/
• Townsend K, Unsworth C. PoMoDATT Administration Manual: https://pomodatt.com/wp-content/uploads/2016/11/pomodatt-manual.pdf
• Townsend K, Unsworth C. PoMoDATT Administration Forms: https://pomodatt.com/wp-content/uploads/2016/11/pomodatt-forms.pdf
• Occupational Therapy Australia. VicRoads Motorised Mobility Device Resources for OTs: https://otaus.com.au/resources/vicroads-mmd-resources-ots
• Occupational Therapy Australia. Motorised Mobility Device Resources for Consumers: https://otaus.com.au/resources/vicroads-mmd-resources-consumers
• Government of South Australia. Motorised Wheelchairs: https://www.sa.gov.au/topics/driving-and-transport/vehicles/vehicle-standards-and-modifications/motorised-wheelchairs
• My Licence South Australia. Sharing the Road: https://mylicence.sa.gov.au/safe-driving-tips/sharing-the-road
• South Australian Equipment Program. Powered Mobility Practical Assessment Form: https://equipmentprogram.sa.gov.au/__data/assets/word_doc/0013/21028/powered-mobility-practical-assessment-form.doc
• Relevant manufacturer instructions, Australian Standards and organisational procedures