Retraining on how to correctly use walking aids requires rote learning. Consistent training is required over a period of around a month. Regular reinforcement is required especially if there is a recommencement of the task after a break.
Non-Weight-Bearing Adherence
Within ACL 4 High, many people realise that their normal activity performance is impaired by a physical disability. They will usually cooperate with alternatives to walking.
Their learning of a transfer sequence with safety precautions is slow and by rote.
They follow a demonstration and usually try to follow it invariantly (e.g. avoiding falls caused by hypertension by always getting up slowly) with standby for minimum assistance to ensure safety.
Ambulatory with Support Required
They are better able to learn the steps required to use a pick-up front-wheeled walker.
The person might be able to make spontaneous adjustment in position, duration, or strength for better effect (reducing downward pressure on walker with wheels for better mobility), but the adjustment may not be sustained without cueing.
They can probably learn a few new steps to use canes (e.g. a cane with standing assist grip, quad-base canes). Negotiating corners and environmental barriers in large spaces will probably be difficult to impossible.
Within ACL 4.8, they might pay attention to a verbal explanation of a visible safety hazard.
Transfers
Depending on their physical disability, balance might be steady enough to discontinue the use of a safety belt within ACL 4 High.
Transfers in and out of a wheelchair are a hazard because they rarely remember to lock their brakes.
If the person requires hoisting for transfers, someone else will need to be in-charge of the procedure. The person will likely not comprehend the falls risk involved as secondary consequences do not capture their attention.
Wheelchair Use
If this is a new skill, demonstration of how they can push forward and back is the beginning. Within ACL 4, they will learn to move in a straight line but not a diagonal line. Turning sharp corners may not be possible within ACL 4.
Getting people to lock their brakes is also nearly impossible within ACL 4. People have tried bright yellow tape on longer handles, but the success rate is low. Standby supervision to lock the brakes is usually required. Telling them to lock the brakes 1,000 times is rarely successful in teaching them to do it spontaneously because they cannot imagine unintended movement of the wheelchair. As a result, independent transfers in and out of the chair are always a hazard within ACL 4.