Clinical measures of seated postural control in adults are not standardized and most are derived from in-house tools. The purpose of this study is to adapt a pediatric instrument to evaluate seated postural control in adult wheelchair users.
The new instrument is called the Seated Postural Control Measure for Adults (SPCMA) 1.0. Five preliminary versions were pretested with some 20 adults by two raters and a group of experts.
This instrument comprises three sections: Section 1, level of sitting scale for adults (1 item, 7-point ordinal scale); Section 2, static postural alignment (22 items, 7-point ordinal scale); and Section 3, postural alignment after a dynamic activity, propulsion of the wheelchair on flat terrain and an incline (22 items, 7-point ordinal scale).
The SPCMA for Adults 1.0 improves the quality and uniformity of evaluations done by different raters, which facilitates more rigorous follow-up of clients over time, communication between professionals, and objective verification of the attainment of intervention objectives.
The study aims were to examine (i) adolescents' attitudes towards family members who use a wheelchair in relation to other health problems and conditions, and (ii) the association between perceived wheelchair stigma and socio-demographic factors. Data were based on surveys from 2790 seventh to 12th grade students derived from the 2007 cycle of the Ontario Student Drug Use and Health Survey. Stigmatized attitudes towards a family member who required the use of a wheelchair (5.5%) were lower than those attitudes towards a family member who was addicted to drugs (68.3%), alcohol (54.9%), or gambling (53.7%), or who had mental illness (25.9%), and similar to those attitudes for a family member with asthma (2.2%). Grade level was the only significant negative correlate of the perceived wheelchair stigma. The perceived wheelchair stigma among the adolescents may not be a significant barrier towards community integration for wheelchair users.
To investigate user satisfaction with characteristics of powered scooters (scooters), frequency of use, and factors predicting daily scooter use.
Adult scooter users (n?=?59) in Denmark and Norway, mean age 74.5 (standard deviation 12.3) years.
Structured face-to-face interviews. The NOMO 1.0, the Quebec User Evaluation of Satisfaction with assistive devices (QUEST 2.0), and a study specific instrument were used to collect data. Descriptive statistics were applied, and regression analyzes were used to investigate predictors for daily scooter use. The International Classification of Functioning, Disability and Health (ICF) served as a framework for classifying variables and guiding the investigation.
Satisfaction with the scooter characteristics was high with most participants being very satisfied or quite satisfied (66.1-91.5%). Most scooters were used daily (36.2%) or several times a week (50.0%). User satisfaction with safety of the scooter [odds ratio (OR)?=?11.76, confidence interval (CI)?=?1.70-81.28] and reduced balance (OR?=?5.63, CI?=?0.90-35.39) increased the likelihood of daily use, while reduced function in back and/or legs (OR?=?.04, CI?=?0.00-0.75), tiredness (OR?=?.06, CI?=?0.01-0.51), and increased age (OR?=?.93, CI?=?0.87-1.00) reduced the likelihood of daily use. 52.8% of the variance was explained by these variables.
User satisfaction was high, and most scooters were used frequently. User satisfaction with safety, specific functional limitations and age were predictors for daily scooter use. Implications for Rehabilitation Scooters seem to be a beneficial intervention for people with mobility impairment: user satisfaction and frequency of use are high. Users' subjective feeling of safety should be secured in the service delivery process in order to support safe and frequent scooter use. Training of scooter skills should be considered in the service delivery process.
The rehabilitation field has not always been regarded as the most glamorous or commercially promising section of medical care. But changing attitudes and demographics in many industrial countries have led to increased recognition of opportunity to provide services for individuals with disabilities and those in need of chronic care. As hospitals are under increasing pressure to offer rehabilitation services, this article focuses on three different technologies developed in three different countries, Sweden, the United Kingdom, and the United States.
To explore how wheelchair-related factors, mobility, and participation are associated in a sample of long-term care residents who use wheelchairs as their primary means of mobility.
Eleven residential care facilities in the lower mainland of British Columbia, Canada.
One hundred forty-six self-responding residents and 118 proxy respondents: mean age 84 (range 60-103). Most were female (69%), and a small proportion (9%) drove a power wheelchair.
The Nursing Home Life Space Diameter Assessment was used to measure resident mobility, and the Late Life Function and Disability Instrument: Disability Component was used to measure participation frequency in daily activities.
Path analysis indicated that wheelchair-related factors were associated with participation frequency directly and indirectly through their relationship with mobility. The final model explained 46% of the variance in resident mobility and 53% of the variance in resident participation frequency. Wheelchair skills, which include the ability to transfer in and out of and propel a wheelchair, were important predictors of life-space mobility and frequency of participation, and life space mobility was a significant predictor of frequency of participation. Depression was associated with poorer wheelchair skills and mobility and less-frequent participation. Counterintuitively, perceived environmental barriers were positively associated with frequency of participation.
The findings suggest that, by addressing wheelchair-related factors, resident's mobility and participation may be improved, but the efficacy of this approach needs to be confirmed experimentally.
Cites: Arch Phys Med Rehabil. 2004 Mar;85(3):416-2315031827
BACKGROUND AND AIMS: The growing numbers of elderly people are expected to lead to an increasing demand for assistive devices. The purpose of this study was to examine changes in the use of assistive devices over time and their relation to dependence in daily activities among 90-year-old persons living at home. METHODS: This retrospective longitudinal study examined the 90-year-old population at the ages of 85 and 90, and 195 persons participated. RESULTS: 92% of the 90-year-old population used assistive devices at the age of 90, compared with 74% at the age of 85. Between this interval, 19% became new users, 73% were permanent users, and 7% did not make any use of assistive devices. There was a significantly higher proportion of device-users among those who were dependent in both personal daily activities (PADL) and instrumental activities of daily living (IADL) (98.5%, p
The purpose of this study was to develop a program evaluation tool through a client-centered approach. Client satisfaction questionnaires previously developed for service recipients of a pediatric seating clinic have reflected the professionals' views on what should be asked.
Seven parents and caregivers of recent service recipients of the seating clinic participated in tape-recorded semistructured interviews. They were asked their views on the seating clinic, how the service could be improved, and the quality of the seat received through the clinic.
Data were coded into nine themes related to the process and the product. Using these themes and the vocabulary used by the participants, we developed a satisfaction questionnaire. The validity of the questionnaire was evaluated by requesting feedback on clarity, content, and design from all participants and from a panel of five health professionals.
A client-centered approach can be used to develop a client satisfaction tool that reflects the needs of the users. Future work will involve testing the tool in the clinical setting.
We developed a new type of pelvic stabilization device designed to help children be better positioned in their wheelchairs. The device replaces a wheelchair lap belt by providing firm anterior pelvic support for the seated user. We developed, tested, and evaluated instructions for installing, fitting, and using the device to study its performance in "typical" community settings in Toronto, Canada. Each of four therapists worked with a local rehabilitation technology supplier to install and fit the device onto an adaptive wheelchair seating system for a young child between 5 and 10 years of age. Therapists assessed the system's positioning effects, and children used the system for 12-14 days. Following the trials, therapists, parents, and children reported their levels of satisfaction with the performance of the device as compared with the children's existing lap belts. Participating therapists confirmed that the device provided better anterior pelvic stability for their clients. Parents felt that their children were generally better positioned in their seats and thought that the device was easy to use. Children had similar perspectives. Suppliers were confident that they could readily install the devices following the instructions provided. Based on the opinions of participants and our inspection of the installed devices, we proposed that minor modifications be made to the product design and instructions for installation, fitting, and use.
Translation of the Spinal Cord Injury Falls Concern Scale (SCI-FCS); validation and investigation of psychometric properties.
Translation, adaptation and validation study.
Eighty-seven wheelchair users with chronic SCI attending follow-up at Rehab Station Stockholm/Spinalis, Sweden.
The SCI-FCS was translated to Swedish and culturally adapted according to guidelines. Construct validity was examined with the Mann-Whitney U-test, and psychometric properties with factor and Rasch analysis.
Participants generally reported low levels of concerns about falling. Participants with higher SCI-FCS scores also reported fear of falling, had been injured for a shorter time, reported symptoms of depression, anxiety and fatigue, and were unable to get up from the ground independently. Falls with or without injury the previous year, age, level of injury, sex and sitting balance did not differentiate the level of SCI-FCS score. The median SCI-FCS score was 21 (range 16-64). Cronbachs alpha (0.95), factor and Rasch analysis showed similar results of the Swedish as of the original version.
The Swedish SCI-FCS showed high internal consistency and similar measurement properties and structure as the original version. It showed discriminant ability for fear of falling, time since injury, symptoms of depression or anxiety, fatigue and ability to get up from the ground but not for age, gender or falls. Persons with shorter time since injury, psychological concerns, fatigue and decreased mobility were more concerned about falling. In a clinical setting, the SCI-FCS might help identifying issues to address to reduce the concerns about falling.