Experts’ opinion on manual wheelchair adjustments for adults with diabetes

Abstract

Diabetes is a global health concern that can lead to mobility limitations necessitating a wheelchair. However, there are currently no guidelines for wheelchair adjustments tailored to the diabetic population.

Purpose: To describe relevant manual wheelchair adjustments for adults with diabetes, and to explore how these adjustments apply to populations living in less-resourced countries.

Methods: Semi-structured interviews were conducted with 13 wheelchair experts from five different countries working with adult with diabetes. Interviews were analyzed using the constant comparison method.

Results: The most frequently mentioned wheelchair adjustments were related to neuropathies, skin integrity, decreased strength and amputations. Air cushions were preferred for managing seat sores. Lightweight wheelchairs could be advantageous for people with decreased strength and endurance. In less-resourced settings, wheelchair adjustment decisions prioritized durability and low maintenance.

Discussion: The recommendation of lightweight wheelchairs for adults with diabetes may be limited by the lack of adjustment possibilities compared to regular weight wheelchairs. In less-resourced settings, prioritizing durability and low maintenance may limit prevention and management of conditions associated to diabetes.

Conclusion: This study represents a first step towards the development of guidelines for manual wheelchair adjustments specifically tailored to adults with diabetes, in a global health context.

Implications of rehabilitation

• When prescribing manual wheelchairs to persons with diabetes, expert clinicians agree that skin integrity, neuropathies and decreased strength are their primary concerns.

• Compromises are often necessary when adjusting a wheelchair for a person with diabetes, due to the complexity of their symptoms: same modification can be indicated for one symptom but contraindicated for another.

• Diabetes prevalence is high in less-resourced settings. There is a need for increased availability of affordable wheelchair equipment that is durable, reliable and adapted to persons with diabetes.

Keywords:

• Wheelchair adjustments
• guidelines
• diabetes
• expert opinion
• qualitative research

Acknowledgements

The authors would like to thank McGill University, Motivation Australia and Constance-Lethbridge Rehabilitation Centre for their contribution in recruiting participants. Special thanks are extended to Lauren Flaherty, Elsje Scheffler and Andréanne Guindon for their support in this project.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

This work was supported by McGill University, Motivation Australia and Constance-Lethbridge Rehabilitation Centre.