Standing power wheelchairs and their use by children and youth with mobility limitations: an interrupted time series

Abstract

 

Standing power wheelchairs (PWSDs) expand positioning and mobility options for individuals with motor impairments. Although more available, little is known about how PWSDs are used in everyday life.

Purpose

to describe children’s use of PWSDs in the first three months post-wheelchair delivery and the impacts on satisfaction with participation in daily life.

Materials and Methods

An interrupted time series of purposefully sampled children aged 5–18 years who were receiving a PWSD. The Wheelchair Outcome Measure for Young People (WhOM-YP) documented satisfaction with patient-reported meaningful participation outcomes. Data loggers objectively measured wheelchair mobility outcomes including distance travelled, bouts of mobility, and duration. Data were measured over two sessions pre-wheelchair-delivery and at one week, one month and three months post-wheelchair-delivery.

Results

Six children aged 7–18 years participated, four diagnosed with cerebral palsy, two with spina bifida. Analyses of individual data illustrated positive change in overall WhOM-YP satisfaction scores after PWSD provision though change varied across time, as did, distance, bouts of mobility and duration of use. Participants identified 14 in-home and 16 out-of-home unique participation outcomes, although several commonalities existed.

Conclusion

PWSDs hold promise for increasing children’s satisfaction with participation in daily life, in addition to possibly increasing mobility outcomes.

IMPLICATIONS FOR REHABILITATION

• For children with mobility limitations, PWSDs may promote participation in daily life and increased mobility.

• Data logger technology provides valuable information about children’s PWSD use and how this varies over time.

• Benefits and challenges exist with implementing PWSD and data logger technologies.

• When implementing PWSD use, it is critical to consider context, training and support needs of clients and caregivers.

Keywords:

• Rehabilitation
• occupational therapy
• assistive technology
• paediatric
• disability
• positioning

Acknowledgements

This study couldn’t have taken place without the effort and commitment of many who were involved. Our research team acknowledge the resources provided by the Research Rehabilitation Program at GF Strong Rehabilitation Centre, British Columbia Institute of Technology (BCIT), Sunny Hill Health Centre for Children and the British Columbia Children’s Hospital, Ranger Wheelchairs Ltd, Omni instruments & Canada Research Chairs. We recognize the contributions of our participants, and the assistance of therapists, educators, administrators and support staff from child development and rehabilitation centres, school districts, and medical equipment manufacturers and suppliers that assisted with recruitment and organization of research sessions. Most notably, Dan Leland, and Johanne Mattie, engineers from BCIT, and Lori Roxborough Associate Director Therapy Department, Sunny Hill Health Centre for Children provided invaluable input into the study design and implementation.

Author contributions

Dr. Field initiated the idea and designed the study in collaboration with all other authors. This study was conducted in partial fulfilment of her PhD studies with Dr. Miller, her PhD supervisor, providing additional guidance in study design and analysis considerations. Dr. Borisoff and Franco Chan provided technical expertise and use of data logger technologies. Roslyn Livingstone, OT, was involved in study design, recruitment and knowledge dissemination activities.

Disclosure statement

We, as a group do not have an affiliation (financial or otherwise) with an equipment, medical device or communications organization, with the exception of Jaimie Borisoff who had an affiliation with PDG Mobility in the role of consulting product manager, manual wheelchairs, at the time of the study.

Additional information

Funding

Financial assistance for this study was provided in part by the Canadian Institutes of Health Research and the Canadian Occupational Therapy Foundation.