Comorbidities and medical complexities of mobility device users: a retrospective study

Abstract

Objective

To determine the medical complexities and comorbidities of individuals who utilise wheeled mobility devices. As well as, to examine costly events including the number of urinary tract infections (UTIs), hospitalizations, urgent care(UC)/emergency department (ED) visits that are commonly seen in this population over a period of time one year prior to and one year post receiving their wheeled mobility equipment.

Design/Setting

A retrospective data review of 857 individual medical charts at a Level 1 Trauma Hospital and Clinic System

Participants

330 male and female (24–92 years old) mobility device users with a wide range of diagnoses, of which: 56 used manual wheelchairs (MWC),138 scooters (POV), 123 power wheelchairs without integrated standing (PWC), and 13 power wheelchairs with integrated standing (iS-PWC).

Results

Overall, 92% (n = 304) had at least three medical comorbidities and medical complexities. The most common comorbidity was pain (91%). A change was noted in a lower incidence of UTIs in those using an iS-PWC, respectively 23% with at least 1 UTI in the year prior to and 8% in the year after the mobility device evaluation.

Conclusions

The large number of comorbidities and medical complexities amongst all mobility device users is concerning. The burden and the accompanying healthcare costs of this population is high. The potential that iS-PWC and other interventions could have on reducing these issues should be explored further.

Implications of rehabilitation

• Regardless of a person's primary diagnosis or the wheeled mobility device they use, 100% have at least one and 92% have at least three comorbidities and medical complexities if they spend the majority of their day sitting

• The high healthcare cost situations such as Emergency Department visits, Urgent Care visits, hospitalizations, and Urinary Tract Infections are present across those that use all mobility device types and the means to potentially reduce these incidences should be further explored

• The introduction of integrated standing within a power wheelchair, as a means to minimize the frequency of comorbidities and medical complications, should also be investigated further

Keywords:

• Sitting position
• wheelchairs
• mobility limitation
• standing position
• comorbidity
• urinary tract infections
• hospitalization
• disabled persons

Acknowledgements

Dedicated to the memory of Brandon Edmondson, OTR, ATP.

Disclosure statement

Ashley Detterbeck is a Regional Clinical Education Manager for Permobil. Carla Nooijen is a Senior Researcher for Permobil. The sponsor for this research project is Permobil, AB. Permobil has been advised in the study design in order to incorporate a perspective from a wheelchair company. Mobility device brands were not identified in this study and this study included mobility devices of all manufacturing brands.