Service delivery for complex rehabilitation technology: a scoping review

Abstract

Purpose

Complex rehabilitation technologies (CRT) support independence for individuals with disabilities by enabling mobility for function, employment, education, and independent living. CRT service delivery is evolving, with changes to funding, provider qualifications, consumer needs, and technological advances. This scoping review investigated service delivery processes for individuals with disabilities who have a mobility impairment, while specifically identifying best practices, barriers, and unique features of health delivery policies and practices.

Methods

We used a framework described by Colquhoun et. al. for conducting scoping reviews, a six-step process that includes: 1) identifying the research question, 2) identifying studies, 3) selecting studies 4) data charting, 5) reporting results and 6) consultation. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was also used for reporting results of the review.

Results

Common categories were identified and organised into a hierarchical structure of four categories and 16 sub-categories. The primary categories included “policy”, “consumer”, “service delivery”, and “wheeled mobility devices”. The sub-categories described funding sources, consumer and professional populations, service delivery guidelines, and types of mobility devices. Analysis indicated the data were from 21 countries and 14 combinations of funding sources, and the articles were primarily descriptive studies.

Conclusion

This scoping review identified evidence from various countries, health systems, and stakeholder. Currently, this process does not proactively address the needs of individuals with mobility disabilities. The scoping review provides the foundation for the development of a novel policy on the provision of CRT services and devices to address these needs.

Implications for Rehabilitation

• Examination of national and international service delivery practices in diverse clinical and funding environments indicate various challenges and opportunities for improvement.

• CRT consumers are negatively impacted by current service delivery practices, including long wait times, lack of specialised clinical expertise, and limited consumer education opportunities.

• More consistent and widespread research is needed within the CRT provision industry to grow evidence-based practice related to complex rehabilitation technology and individuals with disabilities.

Keywords:

• Service delivery
• wheeled mobility device
• scoping review
• wheelchair
• policy

Acknowledgements

The authors would like to recognize Melissa Wright (U of M), Mark Schmeler (Pitt), Dr. Brad Dicianno (Pitt) and Anna Biszaha (OSU) for their contributions to this project.

Disclosure statement

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

Notes

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2 CINAHL database: EBSCO [Internet]. EBSCO Information Services, Inc. | www.ebsco.com. Available from: https://www.ebsco.com/products/research-databases/cinahl-database

3 Scopus [Internet] Available from: https://www.scopus.com/

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5 Embase. Available from: https://www.embase.com/

6 IEEE Xplore. Available from: https://ieeexplore.ieee.org/xplore/home.jsp

7 Elsevier. Ei Compendex: Most complete engineering database [Internet]. Elsevier.com. Available from: https://www.elsevier.com/solutions/engineering-village/content/compendex

8 Inspec: EBSCO [Internet]. EBSCO Information Services, Inc. www.ebsco.com. Available from: https://www.ebsco.com/products/research-databases/inspec

9 RESNA. Available from: https://www.resna.org/

10 International Seating Symposium. Available from: https://www.iss.pitt.edu/

11 Canadian Seating & Mobility Conference. Available from: https://www.csmc.ca/

12 Oceania Seating Symposium. Available from: http://oceaniaseatingsymposium.com/

13 PubMed [Internet]. National Center for Biotechnology Information. U.S. National Library of Medicine; [cited 2021Oct18]. Available from: https://pubmed.ncbi.nlm.nih.gov/

14 CINAHL database: EBSCO [Internet]. EBSCO Information Services, Inc. | www.ebsco.com. [cited 2021Oct18]. Available from: https://www.ebsco.com/products/research-databases/cinahl-database

Additional information

Funding

The contents of this publication were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research [NIDILRR grant number 90DPGE0014-01-00]. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.