Vulnerable populations are most likely to have negative consequences from a wheelchair breakdown, such as: B. Missing work or school or being stranded outside the home
East Hanover, NJ. July 2, 2021. According to a team of experts in spinal cord injury rehabilitation, 42 percent of wheelchair users with spinal cord injuries reported negative consequences associated with the need for wheelchair repair. The research team, made up of researchers on the spinal cord injury model system, found that this persistent problem requires actions such as higher standards of wheelchair performance, access to faster repair service, and improved user training on wheelchair maintenance and repair.
The article “Factors Influencing Incidence of Wheelchair Repairs and Consequences Among Individuals with Spinal Cord Injury” (doi: 10.1016 / j.apmr.2021.01.094) was published online in Physical Medicine and Rehabilitation Archives on April 9th, 2021.
Denise C. Fyffe, PhD, and Trevor A. Dyson-Hudson, MD, of the Kessler Foundation co-edited this manuscript with Lynn A. Worobey, PhD, DPT, ATP (lead author) and Michael L. Boninger, MD, of. authored University of Pittsburgh and Veterans Affairs Pittsburgh Healthcare System; Allen W. Heinemann, PhD, Shirley Ryan Ability Lab; Kim D. Anderson, PhD, of the MetroHealth Rehabilitation Institute; and Theresa Berner, OTR / L, ATP, from Wexner Medical Center at Ohio State University.
For many people with spinal cord injuries, wheelchairs are a lifeline. They enable mobility, which in turn facilitates independence and social commitment. In addition, wheelchairs help people manage pain and discomfort by allowing them to change position and manage the pressure. The importance of having a functioning wheelchair for this population, which last numbered 2.7 million in the United States in 2015, cannot be emphasized enough.
However, research shows that up to 88 percent of wheelchair users fail, leaving them unable to get to work, attend doctor’s appointments, attend educational courses, or have a social life outside of the home. In some cases, wheelchair failure can lead to injury, with people with spinal cord injuries being hospitalized almost twice as often as people with a functioning wheelchair.
There are currently no clinical or industry standards for expected wheelchair maintenance, and less than 50 percent of wheelchair users are trained in wheelchair maintenance. This lack of official guidance prevents the implementation of best practices that could significantly reduce the negative impacts related to wheelchairs and repair times.
In this study, researchers asked 533 wheelchair users at nine spinal cord injury centers in the United States about their experiences over the past six months. The research team wanted to determine how often wheelchair repairs are required and what the consequences of a repair are. how long these consequences were experienced; and whether there are trends in which users or what types of wheelchairs are more likely to need repair.
“We have identified a number of adverse consequences of not having a wheelchair that are consistent with the life experience of wheelchair users,” said co-author Dr. Dyson-Hudson, co-director of the Northern New Jersey Spinal Cord Injury System. “The list includes being stranded outside the home or at home, being injured, missing work, school, or a doctor’s appointment, or missing out on other social events. We hope that by learning more about the most common reasons for repairs, we can take targeted action to reduce the incidence of repairs and the associated costs and other consequences. “
The results showed that more than 50 percent of wheelchair users required wheelchair repairs within the last six months, which was associated with significant financial costs and personal consequences. Electric wheelchair users and blacks were more likely to have repairs and consequences. For many, the consequences lasted more than two weeks.
In addition, adverse consequences appear to hit those with the least financial resources, including users who rely on public insurance. Many participants reported that repair costs limited participation inside and outside the home to reduce the risk of damage to the wheelchair. Others reported that the repair costs prevented them from repairing the wheelchair altogether.
“Based on what we learned in the survey, there are some simple measures, like providing a borrowed wheelchair for people to be mobile while their chair is being repaired, that could reduce the negative effects,” said Dr. Dyson-Hudson. “Other moderators include increasing the speed of repairs, training staff in wheelchair maintenance and routinely planning follow-up appointments after a repair so that later problems can be identified early.”
Funding Sources: Funded by the Administration for Community Living (ACL), the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) (Grant # 90SI5014), and the National Institute of Child Health and Human Development (NICHD) (Grant K23HD096134) .
About the Spinal Cord Injury Model System: The Spinal Cord Injury Model Systems (SCIMS) are specialized spinal cord injury care programs that collect information and conduct research aimed at improving the long-term functional, professional, cognitive, and quality of life outcomes of people with spinal cord injury. Funding comes from five-year grants from the Administration for Community Living (ACL) National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR). The 2016-2021 scholarship cycle includes 14 SCIMS scholars. Each fellow contributes patient data to a national database maintained by the National SCI Statistical Center, which tracks the long-term outcomes of SCI and conducts research in medical rehabilitation, health and wellness, technology, service delivery, short and long-term interventions, and Systems research. Each SCI model system is tasked with disseminating information and research to patients, family members, health care providers, educators, policy makers, and the general public.
About the Kessler Foundation: The Kessler Foundation, a major nonprofit in the disability field, is a global leader in rehabilitation research with the goal of improving cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and brain injuries caused to improve and spinal cord. The Kessler Foundation is a nationwide leader in funding innovative programs that expand employment opportunities for people with disabilities. More information is available at KesslerFoundation.org.
For more information or to interview an expert, contact Carolann Murphy, 973.324.8382, [email protected]
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A pair of manual wheelchair users at the Kessler Foundation.
While wheelchairs allow mobility for many people with spinal cord injuries, the need for repairs and maintenance can affect their ability to engage with their community.
The logo of the National Spinal Cord Injury Model System, funded by the National Institute on Disability Independent Living and Rehabilitation Research.