Wheelchair users’ satisfaction after provision using the WHO 8-step guidelines: A pilot study

Abstract

Background

Wheelchairs are vital for the successful rehabilitation and inclusion of people with mobility disabilities; 10% of the population with disabilities needs a wheelchair, but only 15% have access to an adequate one. Not user-configured wheelchairs may lead to postural deformities and pressure ulcers, thus negatively impact user satisfaction, wheelchair skills, and quality of life.

Objective

To assess the impact of the 8-step “Guidelines on the provision of manual wheelchairs in less-resourced settings” from the World Health Organization (WHO) on user satisfaction, wheelchair skills, and quality of life of Mexican manual wheelchair users.

Methods

12 wheelchair users with spinal cord injury that received rehabilitation were recruited. Volunteers were provided a wheelchair and cushion following the WHO 8-step guidelines. Assessment of QUEST, WHOQOL-Bref, and WST-Q was performed at the beginning of the study and 12 months later.

Results

Significant improvement was observed in terms of satisfaction (QUEST; P = 0.009) after receiving the wheelchair and the foam cushion (QUEST; P = 0.004). WHOQol-Bref did not denote significant differences. For the dimensions assessed by the WST-Q scores, a significant 10.9% improvement was observed in both, capacity (P = 0.022) and performance (P = 0.009).

Conclusions

The application of the WHO 8-step guidelines for wheelchair provision may contribute to increase user satisfaction regarding the wheelchair and cushion devices as well as the prescription process as determined by the QUEST. According to the WST-Q, functional capacity and mobility may also be improved by following the 8-step guidelines.

Keywords:

• Wheelchair prescription
• Quality of life
• WHO 8-step guidelines for wheelchair provision
• QUEST
• User satisfaction

Acknowledgements

The authors would like to thank Emilio Mendieta-Morales for his contribution during the assessment sessions.

Disclaimer statements

Contributors I.Q.-U., A.A.-M., V.B.-R., A.M.-H. conceptualized and designed the study, G.R.-R. analyzed and performed data interpretation, drafted the initial manuscript, and approved the final manuscript as submitted. A.A.-M., L.N.-C. and V.B.-R. reviewed the medical records. I.Q.-U. and G.R.-R. Critically reviewed the manuscript for important intellectual content and approved the final manuscript as submitted. A.A.-M. and G.R.-R. were responsible for the final content; conceptualized and designed the study, performed data interpretation, reviewed and revised the manuscript, and approved the final manuscript as submitted.

Funding This work was supported by The National Council of Science and Technology of Mexico (CONACyT) [Grant Numbers: CONACyT-Salud-2013-1-202273 and CONACyT-Salud-2018-1-A3-S-44273].

Conflicts of interest Authors have no conflict of interests to declare.

Data availability statement

Datasets are available from the corresponding author upon reasonable request and will be submitted complying the personal data protection laws from Mexico.