Patient and equipment profile for wheelchair seating clinic provision

Abstract

Purpose: To characterise the provision of wheelchair seating both pre- and post-clinical intervention and compare and contrast the two largest diagnostic groups. Method: The case notes of those attending a wheelchair seating clinic for adults over a defined period were reviewed retrospectively. A classification system was devised that delineates between the complexity and type of equipment to gain a better understanding of provision. Results: 146 patients were included; mean age 45 years (SD 16); 53.4% male. The two most prevalent primary medical diagnoses were cerebral palsy (CP) and multiple sclerosis (MS); 48.6% and 20.5%, respectively. The MS group, in comparison to the CP group, were significantly more likely to be older, new to seating provision, have been seen more recently, have a powered wheelchair, self-propel their manual wheelchair, have low rather than high complexity equipment and have their equipment changed following assessment. Conclusions: The equipment classification system will allow results from different studies to be readily compared. The results for those with CP and MS reflect the respective stable and progressive nature of these conditions. Referrals for those with MS should be prioritised. Wheelchair seating users with MS should be reassessed ∼18 months after provision.

Implications for Rehabilitation

• A detailed classification of wheelchair seating equipment based on a recognised standard vocabulary, such as the one proposed, is required to gain a better understanding of provision.

• Wheelchair seating equipment budget and staffing levels should reflect the diagnostic make up of a service's patient population.

• Referrals for people with MS should be prioritised as their current wheelchair seating provision is more likely not to be meeting their needs.

• People with MS should have a clinical review 18 months after wheelchair seating provision.

• Cerebral palsy
• multiple sclerosis
• postural support
• seating clinic
• service delivery
• wheelchairs

Acknowledgements

The authors would like to thank all their colleagues who worked in the Seating Assessment Clinic during the period of the study.