Increases in Wheelchair Breakdowns, Repairs, and Adverse Consequences for People with Traumatic Spinal Cord Injury

Abstract

Objective The aims of this study were to report the current incidence of wheelchair breakdowns, repairs, and consequences and to compare current data with historical data. Design A convenience sample survey of 723 participants with spinal cord injury who use a wheelchair for more than 40 hrs/wk treated at a Spinal Cord Injury Model Systems center was conducted. Results Significant increases were found in the number of participants reporting repairs (7.8%) and adverse consequences (23.5%) in a 6-mo period (2006Y2011) compared with historical data (2004Y2006) (P G 0.001). When examining current data, minorities experienced a greater frequency and higher number of reported consequences (P = 0.03). Power wheelchair users reported a higher number of repairs and consequences than did manual wheelchair users (P G 0.001). Wheelchairs equipped with seat functions were associated with a greater frequency of adverse consequences (P = 0.01). Repairs did not vary across funding source, but individuals with wheelchairs provided by Medicare and Medicaid reported a higher frequency of consequences than did the combined group of the Department of Vocational Rehabilitation, Worker’s Compensation, and the Veterans Administration (P = 0.034 and P = 0.013, respectively). Conclusions The incidence and consequences of repairs are increasing from what was already a very high statistic in this United States population. Further investigation into causality is required, and intervention is needed to reverse this potential trend.

Quantitative Exploratory Evaluation of the Frequency, Causes and Consequences of Rehabilitation Wheelchair Breakdowns delivered at a Paediatric Clinic in Mexico

“…More than one-third of the study sample (35%) reported at least one repair in the previous 6 months, which falls in the range of earlier studies (Fitzgerald et al, 2005 ;McClure et al, 2009 ;Worobey et al, 2012). The results are similar to those of other studies wherein no significant relationship was found between the age of WCs and the number of repairs done (Fitzgerald et al, 2005).…”

“…injury) by 33% (n=109) of participants in one study (Gaal et al, 1997). Adverse consequences due to WC breakdown, such as being stranded at home, were reported by 20% -31% of participants who reported at least one repair (McClure et al, 2009;Worobey et al, 2012). Neither of these studies found correlation between WC age and the number of repairs (Fitzgerald et al, 2005;McClure et al, 2009).…”

“…This is especially true in developing countries where access to WCs is generally limited to imported ones, replacement parts are almost impossible or too costly to find, and users often do not have a back-up WC, thereby reducing their mobility and community participation for an undetermined period of time (Hotchkiss, 1987). In developed countries several studies have investigated, in both manual (light or ultra light-weight) and power WCs, the prevalence of WC failures, repairs and related adverse events such as injuries and participation reduction (Gaal et al, 1997;Fitzgerald et al, 2005;McClure et al, 2009;Chen et al, 2011;Worobey et al, 2012). Self-reported WC repairs over a 6-month period ranged from 26% to 53% of the participants in several studies (Fitzgerald et al, 2005;McClure et al, 2009;Worobey et al, 2012).…”

Evaluation of lightweight wheelchairs using ANSI/RESNA testing standards

“…With a total of 2,213 subjects in their study, McClure et al found that 44.8 percent of fulltime wheelchair users required repairs over a 6 mo period [9]. Most recently, an article by Worobey et al reported failure rates of 52.6 percent from 726 subjects in the community [10]. The increasing rate of incidents, coupled with the time required to schedule and perform repairs, makes it clear that wheelchair reliability is getting worse and affects quality of life and safety.…”

“…These advances in design and manufacturing, along with the fact that the ANSI/RESNA durability standards have remained the same, should have resulted in higher quality, better durability, and cost-benefit. Nevertheless, as discussed earlier, wheelchair failures have been increasingly reported in the community over the last 15 yr [8][9][10].…”