Pain, fatigue, function and participation among long-term manual wheelchair users partnered with a mobility service dog

Abstract

Purpose: To assess the effects of a mobility service dog (MSD) on pain, fatigue, wheelchair-related functional tasks, participation and satisfaction among manual wheelchair users over a nine-month period.

Method: A longitudinal study with repeated assessment times before and three, six and nine months after intervention was achieved. Intervention consisted in partnering each participant with a MSD. The setting is a well-established provincial service dog training school and participants homes. A convenience sample of 24 long-term manual wheelchair users with a spinal cord injury was involved. Outcome measures were: Wheelchair User’s Shoulder Pain Index (WUSPI), Rate of Perceived Exertion (RPE), vitality scale from the SF-36, grip strength, Wheelchair Skills Test (WST), Canadian Occupational Performance Measure (COPM), Reintegration to Normal Living Index (RNLI), Life Space Assessment, Psychosocial Impact of Assistive Devices Scale (PIADS) and Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0).

Results: Shoulder and wrist pain as well as fatigue decreased significantly over time with the use of a MSD as evidenced by scores from WUSPI, RPE and SF-36 (feeling less worn out). Manual wheelchair propulsion skills (steep slopes, soft surfaces and thresholds) improved significantly over time as confirmed by the WST. Participation increased significantly over time as revealed by the COPM (for five occupations) and the RNLI (for five items). Satisfaction with the MSD was high over time (QUEST: nine items) and with a high positive psychosocial impact (PIADS: 10 items).

Conclusion: MSD represents a valuable mobility assistive technology option for manual wheelchair users.

IMPLICATIONS FOR REHABILITATION

•   For manual wheelchair users partenered with mobility service dog  • Shoulder pain and fatigue significantly decreased and continued to decrease between the third and sixth month and the ninth month.

•   • Performance with propelling the wheelchair up steep slopes increased from 41 to 88% and on soft surfaces increased from 53 to 100% after 3 months, respectively.

•   • Occupational performance satisfaction was significantly increased for mobility in relation with the transfers, navigating in a natural environment and picking up objects.

•   • High satisfaction towards psychosocial competency, psychosocial adequacy and self-esteem were reported at months three, six and nine.

Keywords:

• Assistance dog
• assistive device
• rehabilitation
• spinal cord injuries
• wheelchair

Acknowledgements

Hélène Corriveau, Lise Poissant, François Routhier and Michel Tousignant are original members of the ADMI group (Assistance Dog for Mobility Impairments group). The authors would like to thank our strategic partner, Noel Champagne, the research vice-president of Mira Foundation, who facilitated the recruitment of participants and Valérie Martin-Lemoyne (PT), a research professional, who completed most of the assessments at the various times. We are now considering them as ADMI group members.

Disclosure statement

Authors report no conflict of interest.

Funding

This project was funded by the Consortium for Research Development in Traumatology of the Fonds de la recherche du Québec–Santé (FRQ-S). Dany Gagnon co-chaired the Initiative for the Development of New Technologies and Practices in Rehabilitation (INSPIRE) funded by the Lindsay Rehabilitation Hospital Foundation.