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: To describe the impact of a mobility training program using the Smart Wheelchair on the driving skills and psychosocial outcomes of children with physical disabilities. A multiple case study design using mixed methods was used. Four children with physical disabilities were recruited through The Centre for Cerebral Palsy in Western Australia. The intervention was a 16 session Smart Wheelchair mobility training program. Data was collected using a quantitative driving skills assessment, field notes and qualitative parent interviews. Three out of four children gained independence in at least three driving skills or more, whilst one child was competent with verbal prompts. Three out of four mothers reported positive changes in their child's confidence, motivation and affect. The Smart Wheelchair has the ability to uncover learning potential and facilitate the recognition of abilities in children previously excluded from access to independent mobility. Given the significant limitation that restrictions in mobility pose to participation for children with physical disabilities, therapists must begin to understand the effectiveness of interventions such as the Smart Wheelchair. The descriptive findings of this study allow for future, more rigorous research, to be conducted on the effectiveness of the Smart Wheelchair as a mobility training tool.Disability and rehabilitation. Assistive technology 11/2011; 7(5):372-80.
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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. · 0.69 Impact Factor
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ABSTRACT: Powered mobility can have an important cognitive and psychosocial impact on young children who are unable to move independently. Twenty-three children with physical disabilities between the ages of 18 months and 6 years participated in this study. Data evaluating social skills, frequency of mobility play activities, frequency of interaction with toys/objects, and play/verbal developmental levels were collected at wheelchair evaluation, wheelchair delivery, and approximately 6 months later. Significant increases were found in parental perceptions of positive social skills for younger children after receiving a wheelchair; slightly older children showed improvements in social skills before the wheelchair was received; no changes were found in negative social skills. Parental ratings also indicated a significantly greater difficulty remaining engaged in tasks after receiving a wheelchair. A significant increase was noted in the number of mobility activities during indoor free play but no difference was seen in interaction with toys or objects. Improvement in the qualitative level of outdoor interactive free play was reported but there was no change in verbal interactions. This article discusses the potential positive impact of early powered mobility. These findings may be helpful in justifying the recommendation of powered mobility to young children and in justifying medical necessity of powered mobility for reimbursement by third party payers.Assistive technology: the official journal of RESNA 01/2013; 25(1):39-48; quiz 49-50. · 0.51 Impact Factor