Patterns in Wheeled Mobility Skills Training, Equipment Evaluation, and Utilization: Findings from the SCIRehab Project

Abstract

Patients with traumatic spinal cord injury (SCI) participate in manual and power wheelchair (WC) skills training during inpatient rehabilitation; wheeled mobility evaluations aim to optimize use, fit, and function of equipment following discharge. Occupational and physical therapists documented treatment sessions during inpatient rehabilitation to describe types and quantity of WC skills training and adaptive equipment (AE) provided by neurological level of injury. Most patients participated in WC skills training; variation in type and frequency exists. Propulsion/driving skills were practiced most frequently. A majority of patients participated in equipment evaluations; assessment/prescription and fitting were performed frequently; mat evaluations were done infrequently. Most patients received mobility equipment in a timely manner; they continued to use their WC and were satisfied with its fit and function at the one-year injury anniversary. High levels of respondent satisfaction with fit and function of WCs suggest clinicians are prescribing mobility devices adequately and accurately supplementing information obtained during equipment assessment and fitting sessions with information from general treatment sessions. Variation in type and frequency of WC training provided by level of SCI and in types of WC prescribed use provides a foundation for future research to relate treatment modalities with functional and participation outcomes.

Keywords:

• spinal cord injury
• manual wheelchair
• power wheelchair
• wheeled mobility
• equipment evaluation
• physical therapy
• occupational therapy
• rehabilitation research
• paraplegia
• tetraplegia

Acknowledgments

Special thanks to Dr. Marcel Dijkers and Dr. Gale Whiteneck for their ongoing support of the SCIRehab project and for their feedback during the preparation of this manuscript.

A summary of this research for the first-year data set (n = 600 patients) was presented at the Combined Sections Meeting of the American Physical Therapy Association; February 8–12, 2012; Chicago, Illinois; the International Seating Symposium; March 7–9, 2012; Vancouver, British Columbia, Canada; and the American Occupational Therapy Association Conference; April 25–29, 2012; Indianapolis, Indiana.

The contents of this article were developed under grants from the National Institute on Disability and Rehabilitation Research, Office of Rehabilitative Services, U.S. Department of Education, to Craig Hospital (grant numbers H133A060103 and H133N060005), the National Rehabilitation Hospital (grant number H133N060028), Rehabilitation Institute of Chicago (grant number H133N060014), Mount Sinai School of Medicine (grant number H133N060027), and to Shepherd Center (grant number H133N060009). The opinions contained in this publication are those of the grantees and do not necessarily reflect those of the U.S. Department of Education.