Lessons learned from a pediatric powered mobility lending program

Abstract

Purpose

To evaluate children’s characteristics and impact of a powered wheelchair lending program including comparisons of diagnostic sub-groups, and validation of a predictive model of powered mobility proficiency.

Methods and Materials

This retrospective study included 172 children who participated in the ALYN powered mobility lending program from 3/2009-7/2022. Demographics and functional levels were measured via questionnaires; driving proficiency was evaluated when the wheelchair was returned, and parents and children were interviewed following their participation in the program.

Results

Two diagnostic groups were identified: cerebral palsy (CP) (n = 136, median = 9.75 yrs) and other neuromuscular diseases (NMD) (n = 30, median = 5.83 yrs). They differed significantly in the age they commenced PM training, the male/female ratio, walking ability and access mode. Fifty-seven percent of the participants with CP achieved powered mobility proficiency, a rate that was significantly lower than the 73% proficiency found for the NMD group. Four significant predictors were identified: communication, manual wheelchair operation, access mode and go-stop upon request. They predicted proficiency in approximately 80% of cases. Overall feedback from the parents and children indicated that their personal and family’s quality of life improved as a result of their child’s ability to use a powered wheelchair.

Conclusions

A lending program provides children with opportunities to improve mobility skills in an appropriate powered wheelchair. Children who can communicate verbally, propel a manual wheelchair, use a joystick and go-stop upon request are significantly more likely to become proficient drivers; however, many who were unable to complete these tasks also improved and even became proficient drivers.

Implications for Rehabilitation

• Children who are able to engage in verbal communication, propel a manual wheelchair for short distances, use a joystick and go-stop upon request are significantly likely to become a proficient powered wheelchair drivers.

• Children with cerebral palsy who have greater physical challenges (e.g., cannot walk at all or propel a manual wheelchair) can reach powered mobility proficiency following practice with a powered wheelchair borrowed from a lending program, although at a lower rate than those with other neuromuscular diseases; additional training strategies should be developed to increase the percent success for children with cerebral palsy.

• A multivariate logistic regression was able to correctly predict whether a child will become proficient driver in 80% of case.

• Training with a powered wheelchair from the lending program enabled parents to observe their children’s independent mobility in their home environment; they reported improvement in the family’s quality of life.

Keywords:

• Powered wheelchair
• proficiency
• multivariate logistic regression
• cerebral palsy
• neuromuscular disease

Acknowledgements

We would like to thank the children and families that participated in the lending program. We would also like to thank the National Insurance Fund and private donors that made the program possible through their funding.

Disclosure statement

The authors have no conflict of interest.

Additional information

Funding

This study was funded by the PARC Research Center, ALYN Hospital. The research center was funded by the Helmsley Foundation- grant number 2207-05386.