The differences in demographics, fear of falling, transfer quality and participation enfranchisement between manual and power wheelchair users with multiple sclerosis and spinal cord injury

Abstract

Purpose

To examine the differences in demographics, fear of falling (FOF), transfer quality and participation enfranchisement between manual and power wheelchair users with multiple sclerosis (MS) and spinal cord injury (SCI).

Materials and methods

Secondary data analysis including 126 manual or power wheelchair users with MS and SCI (median age, 53.00 years, IQR = 24.00). Demographic information including age, gender, height, weight and disability duration was collected. Body mass index (BMI) was calculated for all participants. Participation enfranchisement was examined using both subscales (Importance and Control) of the enfranchisement scale of the Community Participation Indicator (CPI). FOF was assessed using the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) and transfer quality was assessed using the Transfer Assessment Instrument (TAI) 3.0 and 4.0. Mann–Whitney’s U-tests or independent samples t-tests and chi-square were used to analyse the differences between continuous variables and categorical variables, respectively.

Results

Fifty-seven percent of participants were manual wheelchair users. There were significant differences in most demographic information except for weight and disability duration. Significant differences were also found for BMI (t = 1.06, p = 0.04), CPI-Importance (U = 1282.50, p < 0.01), CPI-Control (U = 1165.50, p < 0.01) and SCI-FCS (t = 4.08, p < 0.01). Manual wheelchair users outperformed power wheelchair users in all outcomes analysed except the TAI (p = 0.18).

Conclusions

Power wheelchairs users presented with a higher BMI, reported lower participation enfranchisement, and reported higher levels of FOF compared to manual wheelchair users. The findings may help clinicians to develop targeted rehabilitation goals specific for power and manual wheelchair users with MS and SCI.

Implications for Rehabilitation

• Significant functional differences exist between manual and power wheelchair users.

• Compared to manual wheelchair users, power wheelchair users had higher body mass index, reported lower community participation and reported higher levels of fear of falling.

• These findings can help clinicians to develop targeted interventions specific for power and manual wheelchair users.

Keywords:

• Wheelchairs
• community participation
• accidental falls
• transfers
• spinal cord injuries
• multiple sclerosis

Acknowledgements

The authors would like to thank Dr. Jacob J. Sosnoff, Dr. Deborah Backus and Dr. Elizabeth Peterson for their contribution to the obtention of part of the data presented in this work.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by the National Multiple Sclerosis Society (Grant Number: RG-1701-26862), the Illinois Physical Therapy Association (Grant Number: IPTF 098442) and the Craig H. Neilsen Foundation, Psychological Research Grants (Grant Number: 323277).