Need and availability of assistive devices to compensate for impaired hand function of individuals with tetraplegia

Abstract

Context/Objective: To evaluate the availability and self-declared unmet need of assistive devices to compensate for impaired hand function of individuals with tetraplegia in Switzerland.

Design: Cross-sectional survey.

Setting: Community.

Participants: Individuals with tetraplegia, aged 16 years or older, living in Switzerland.

Interventions: not applicable.

Outcome Measures: The self-report availability and unmet need of 18 assistive devices for impaired hand function was analyzed descriptively. The availability of devices was further evaluated stratified by sex, age, SCI severity, independence in grooming, time since injury, living situation, working status, and income. Associations between availability of devices and person characteristics were investigated using logistic regression analysis.

Results: Overall 32.7% of participants had any assistive device for impaired hand function at their disposal. The most frequent devices were adapted cutlery (14.8%), type supports (14.1%), environmental control systems (11.4%), and writing orthosis (10.6%). In the bivariate analysis several factors showed significant associations with at least one assistive device. Nevertheless, when controlling for potential confounding in multivariate analysis only independence in grooming (adapted cutlery, environmental control systems, type support, speech recognition software), SCI severity (writing orthosis, type support), and sex (adapted kitchenware) remained significantly associated with the availability of the mentioned assistive devices. The self-declared unmet need was generally low (0.7% - 4.3%), except for adapted kitchenware with a moderate unmet need (8.9%).

Conclusion: This study indicates that most individuals with tetraplegia in Switzerland are adequately supplied with assistive devices to compensate for impaired hand function. The availability depends mainly on SCI severity and independence in grooming.

Keywords:

• Assistive devices
• Hand function
• Spinal cord injury
• Tetraplegia
• Need

Acknowledgements

This study has been financed in the framework of the Swiss Spinal Cord Injury Cohort Study (SwiSCI, www.swisci.ch), supported by the Swiss Paraplegic Foundation. The members of the Swiss Spinal Cord Injury Cohort Study (SwiSCI, www.swisci.ch) Steering Committee are: Xavier Jordan, Bertrand Léger (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Thomas Troger (Swiss Paraplegic Association, Nottwil); Daniel Joggi (Swiss Paraplegic Foundation, Nottwil); Hardy Landolt (Representative of persons with SCI, Glarus); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Martin Brinkhof (SwiSCI Study Center at Swiss Paraplegic Research, Nottwil).

Disclaimer statements

Contributors All authors contributed to conception and design of the present study. SW performed the statistical analyses. All authors interpreted the data. SW and UA drafted the manuscript. All authors critically revised the manuscript and gave final approval of the version to be published.

Declaration of interest None.

Funding None.

Conflicts of interest None.

Ethics approval The SwiSCI study was approved by the ethics committee of the Canton of Lucerne (the location of the main study center) and subsequently endorsed by the ethics committees of the Cantons Zürich, Basel-Stadt and Valais.

ORCID

Stephanie Wäckerlin https://orcid.org/0000-0002-6559-9072

Armin Gemperli https://orcid.org/0000-0002-2363-0625

Ursina Arnet https://orcid.org/0000-0003-1101-4267