Pediatric powered wheelchairs: results of a national survey of providers.
ABSTRACT A national survey of providers of pediatric powered wheelchairs was conducted to collect background data on these professionals and to develop a "model" of their current assessment and recommendation practices. Data collected in the survey included provider demographics, frequency of powered wheelchair provision to young children, common reasons for not recommending a powered wheelchair, reasons why a child who is recommended a powered wheelchair does not receive one, current pediatric powered wheelchair assessment and recommendation practices, and subjective data regarding the efficacy of these practices and the impact of powered wheelchairs on children. Respondents rated the frequency with which they performed various wheelchair assessment and recommendation practices, and these ratings were analyzed to determine activities that were performed frequently. These activities were then combined into common "factors" using factor analysis, and the results of the factor analysis were used to create a model of current pediatric powered wheelchair assessment and recommendation practices. A total of 140 surveys were received from providers in 46 states. Of these providers, 54% were clinicians (e.g., physical therapists, occupational therapists), and 46% were suppliers (e.g., Rehabilitation Technology Specialists), representing a variety of geographic locations and facility types. The 3 major reasons for not recommending a powered wheelchair included cognitive, physical, and behavioral factors. The 3 major reasons why a child who is recommended a powered wheelchair does not receive one included funding issues, lack of family support, and transportation issues. The model of current pediatric powered wheelchair provision includes 4 assessment factors: Preliminary Clinical Assessment, Intake, Advanced Clinical Assessment, and Consideration of Other Factors. Typical recommendations include both therapeutic and nonclinical interventions. A modified version of this model, which addresses some issues identified in the survey that limit wheelchair recommendations, is currently being tested at 4 clinical sites.
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ABSTRACT: Powered mobility has been found to have positive effects on young children with severe physical disabilities, but the impact on the family has been less well documented. We evaluated the impact of early powered mobility on parental stress, negative emotions, perceived social interactions, and parental satisfaction with wheelchair characteristics such as size and durability. The participants were parents of 23 children with disabilities-10 with orthopedic disabilities (average age 30.1 months) and 13 with cerebral palsy (average age 47.0 months). Pretest assessments were completed two times: at initial wheelchair evaluation and at wheelchair delivery. A posttest assessment was completed after each child had used the wheelchair for 4-6 months. Parents reported a lower perceived level of stress at the time of wheelchair delivery, although the magnitude of this effect was fairly small, standardized mean difference (δ) = .27. They also reported an increased satisfaction with their child's social and play skills (δ = .38), ability to go where desired (δ = .86), sleep/wake pattern (δ = .61), and belief that the general public accepts their child (δ = .39) after several months using the wheelchair. Parents reported an increase in interactions within the family at the time of wheelchair delivery (δ = .66). There was no decrease in negative emotions. Parents were satisfied with most factors relating to the wheelchair itself, with areas of concern being wheelchair size and difficulty adjusting the wheelchair. The findings suggest that self-initiated powered mobility for a young child had a positive impact on the family.Physical & Occupational Therapy in Pediatrics 11/2010; 31(1):4-15. DOI:10.3109/01942638.2010.529005 · 1.42 Impact Factor
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ABSTRACT: PURPOSE: Power mobility is a critical assistive technology for many children with special needs. Our previous work suggests that certain infants younger than the age 1 year of age can participate in formal power mobility training. KEY POINTS: This case report describes the feasibility of providing a power mobility training program with a young infant with spina bifida. Specifically, we longitudinally quantified the infant's driving ability with a joystick-controlled device (UD1), using UD1's onboard computer and video camera from an infant's age of 7 to 12 months. During the training period, the infant improved in all driving variables. The infant's Bayley III cognition and language scores also increased at a rate greater than his chronological age. CONCLUSIONS/IMPLICATIONS FOR CLINICAL PRACTICE: These results suggest that power mobility training within the first year of life may be appropriate for certain populations at risk of immobility.Pediatric physical therapy: the official publication of the Section on Pediatrics of the American Physical Therapy Association 01/2009; 21(4):362-8. DOI:10.1097/PEP.0b013e3181bfae4c · 1.29 Impact Factor
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ABSTRACT: Purpose – The purpose of this paper is to present powered-wheelchair transducers and systems that provide more control, reduced veer on slopes, and improved energy conservation, while reducing effort. They are especially significant for people with movement disorders who lack sufficient hand-grasp and release ability or sufficient targeting skill to use joysticks. Design/methodology/approach – Laboratory test rigs are created to test proportional switches and teach potential users. Then, trials are conducted with a rolling road and in real situations. Caster angle-measurement is selected to provide feedback to minimize drift away from a chosen course and an electronic solution was created to match driver control to caster-steering-position. A case study is described as an example. Findings – Results and advantages are presented from changing from using a set of digital-switches to a set of new variable-switches and then adding a sensor system to prevent veer on slopes. Systems have been tested for nearly two years and shown to assist powered-wheelchair-users with poor targeting skills. Research limitations/implications – The research used wheelchairs with caster-wheels but the systems could easily be used on other wheelchairs. Practical implications – Simple input-devices are presented that isolate gross motor function and are tolerant to involuntary movements (proportional-switches). A sensor system is presented that assists users in steering across sloping or uneven ground. Originality/value – Proportional-switches and sensors are shown to reduce veer and provide more control over turn and forward speed and turn radius while reducing frustration and improving energy conservation. The simple and affordable systems could be created and attached to many standard powered-wheelchairs in many organisations.Industrial Robot 03/2010; 37(2):157-167. DOI:10.1108/01439911011018939 · 0.62 Impact Factor