Use of a dynamic arm support to drive a power wheelchair: a case report

Abstract

Purpose

Dynamic arm supports (DAS) can assist individuals with severe upper limb disabilities who use a wheelchair to accomplish their daily activities. The objective of this case series was to assess the potential of a DAS to improve power wheelchair (PWC) control in real-life contexts and to describe the integration process. A secondary objective was to explore factors that may influence the DAS integration process.

Methods

This case series includes four participants fitted with the Kinova DAS O110. A one-year follow-up was planned for each participant with qualitative and quantitative data collection to assess DAS outcomes. Assessment methods were selected to cover the three vantages of assistive technology outcomes assessment: effectiveness, subjective well-being, and social significance.

Results

Among the four participants, one used the DAS to help with his wheelchair control for at least 12 months (successful integration). For him, the DAS led to significantly improved wheelchair skills and an important positive psychosocial impact. He was, however, only able to use the DAS for PWC control (no effects on other daily activities), and could not use it in some contexts because the device increased his PWC width. As for the other participants, they stopped using the DAS for different reasons, including a DAS-related adverse event.

Conclusion

This study demonstrated that a wheelchair-bound DAS has the potential to improve PWC use, but successful integration requires specific factors. The service delivery process and the environmental accessibility are crucial for the successful integration of such a device and to avoid safety issues.

IMPLICATIONS FOR REHABILITATION

• No study deeply assessed the impacts of dynamic arm support on power wheelchair control, and the associated facilitators and obstacles.

• A wheelchair-bound dynamic arm support has the potential to improve power wheelchair control for individuals with upper limb disabilities and to lead to positive psychosocial impacts if some conditions conductive to successful integration are met.

• The service delivery process and the environmental accessibility appear as crucial aspects for the successful integration of a new device, such as dynamic arm support and avoiding safety issues.

Keywords:

• Dynamic arm support
• power wheelchair
• assistive technology outcome assessment
• delivery process
• case report

Acknowledgements

The authors would like to thank therapists, technical assistants, and Kinova Robotics for their support in the integration process, as well as participants.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

ACL and FR are supported by Research Scholar grants from the Fonds de recherche du Québec-Santé. [grant numbers 268341 and 296761, respectively]. At the time of the study, JB was supported by a Mitacs Elevate scholarship [grant number IT11616], in partnership with Kinova Robotics. Kinova Robotics provided technical support for the set-up of each participant’s dynamic arm support. This study was funded by Société Inclusive, an intersectoral initiative of the Fonds de recherche du Québec.