Shinpei Mitsui
CIL (Center for Independent Living) Hoshizora, and
member of Ehime Liaison Committee for People with Spinal Cord Injuries

I have C4 spinal cord injuries (total quadriplegia). When I was a senior high school student, I jumped into the sea and broke my neck. After around three years of life in an institution, I encountered a group called the Center for Independent Living. I learned that even with a disability, I could live independently in the local community, and since eight years ago, I have been living in the community, with the involvement of carers.

Since I have total quadriplegia, I have no sensation or ability to move from the neck downwards. I am supported by carers in all aspects of daily life, from dressing and transfers to going out. The support of carers is essential to my daily life, but my worry is that they may develop lower back pain. This is an issue which I have to consider if I want them to continue supporting me for many years. So I would like to introduce some tips about points which I and my group are implementing to reduce the strain on the lower backs of carers.

The first is to put on a waist belt when they start their caring shift. Constricting the abdomen increases internal abdominal muscle pressure. This stabilizes the area around the lower back, prevents the wearer from losing their balance under the weight of heavy loads in the course of their work, and reduces the strain on the lower back. It is said that small things add up, and I believe that there will be quite different results in ten years’ time depending on whether a person wears a waist belt or not (Photo 1).

Photo 1: Wearing a waist belt significantly reduces the load

Next is to use a lift during transfers. I use a mobile hoist (Picture 2). This is always necessary to raise and lower me, as I am 180 cm tall and weigh 100 kg. One carer is with me at a time, so it would be almost impossible for them to transfer me without it. I live in a rented house, so I chose a mobile hoist, but there are also lifts which run along the ceiling or which can be attached to the bed, so you can choose one according to the construction of the house and to your wishes.

Photo 2: Using a mobile hoist (Patient Lifter KQ-781, Paramount Bed Co., Ltd.)

The final point is the wearing of assistive suits. These are apparently used not only for care work but also for agricultural tasks carried out in a squatting position and for heavy manual labour on construction sites; and they are quite effective. They look time-consuming to put on and heavy to wear, but the ones our group uses can be easily put on in ten seconds and weigh 3.8 kg, so they are very easy to use. They provide extra power when squatting on the bed or transferring or lifting up people who do not use lifts. They do not need charging, just adjustment of the air, so they do not require maintenance and can be taken outside (Picture 3). We expect that they will be put to use in various situations, such as on holidays or business trips when the bed in the accommodation is low or it is difficult to take along a lift. Some people find them effective, while others do not, so why not start by renting or trying one out? 

Photo 3: Assistive suits provide extra power when lifting (Muscle Suit Every soft-fit, Innophys Co., Ltd.)

These things cost money, but if you look, there are subsidy schemes for lifts and assistive suits, so they are no longer impossibly expensive, but instead are becoming familiar items. I hope to go on trying whatever good products become available in order to create a better environment in which my carers and I can support each other.