Influence of Cognitive Functioning on Powered Mobility Device Use: Protocol for a Systematic Review

Pellichero, Alice; Kenyon, Lisa K.; Best, Krista L.; Sorita, Éric; Lamontagne, Marie-Ève; Lavoie, Marie Denise; Routhier, François

doi:10.2196/16534

Cited by 7 publications

(6 citation statements)

References 40 publications

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“…Finally, number of studies suggest that subjective variables like cognitive and emotional development, mood, attention, fatigue, and stress are related to performance. 16,38,[46][47][48] The above-mentioned factors were not explored in the current study, thus future research on the impact of any subjective variables on PW mobility in DCP is strongly encouraged.…”

Section: Discussionmentioning

confidence: 99%

“…The chronological age of the participants showed no significant correlations with PW mobility performance. This might emphasize the importance to consider many other factors like cognitive and intellectual abilities 38 , readiness to drive the wheelchair and motivation levels 22 , training methods and opportunities 39 when assessing PW driving competences. The wide range in PW mobility experience and age, the small number of participants, and the lack of other abovementioned variables limit to an extent the interpretation of these results.…”

Section: Discussionmentioning

confidence: 99%

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Dystonia and choreoathetosis presence and severity in relation to powered wheelchair mobility performance in children and youth with dyskinetic cerebral palsy

Bekteshi

Konings

Nica

et al. 2020

European Journal of Paediatric Neurology

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Introduction: Power wheelchairs (PW) with head/foot steering systems are used as an alternative to joysticks in children with severe dyskinetic cerebral palsy (DCP). Mobility training programs are unstandardized to date, and insight on dystonia, choreoathetosis, and mobility performance may lead to greater independent mobility. Objective: To map the presence and severity of dystonia and choreoathetosis during PW mobility in DCP and their relation with mobility performance. Methods: Ten participants with DCP performed four PW mobility tasks using a head/foot steering system. Dystonia and choreoathetosis in the neck and arm regions were evaluated using the Dyskinesia Impairment Mobility Scale (DIMS). PW mobility performance was assessed using time-on-task and the number of errors during performance. The Wilcoxonsigned rank test and the Spearman's correlation coefficients were used to explore differences and correlations. Results: Median levels of dystonia (83.6%) were significantly higher (p<0.01) than median levels of choreoathetosis (34.4%). Positive significant correlations were found between the Arm Proximal DIMS and the PW mobility experience (rs=-0.92, p<0.001), and between the Arm Distal DIMS and the number of errors (rs=0.66, p=0.039) during mobility performance. Conclusions: Dystonia is more present and severe during PW mobility than choreoathetosis. The hypertonic hallmark of dystonia may mask the hyperkinetic hallmark of choreoathetosis, resulting in lower median levels. Results may suggest that with an increase in driving experience, children with DCP adopt deliberate strategies to minimize the negative impact of arm overflow movements on mobility performance, however, future research with bigger sample size and additional outcome measures is strongly encouraged.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dystonia and choreoathetosis presence and severity in relation to powered wheelchair mobility performance in children and youth with dyskinetic cerebral palsy

Bekteshi

Konings

Nica

et al. 2020

European Journal of Paediatric Neurology

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“…Other key issues agreed to be incompatible with continuing PMD use followed a similar theme of maintaining safety, including volitional misuse such as speeding or using the device as a weapon to bump others, substance overuse, failing to learn from errors, difficulty stopping and repeated incidents [ 48 ]. The guidelines developed by Mortenson, Miller [ 48 ], described practical, measurable behaviours for assessment, however isolating the underlying impairments, particularly when cognitive or visual in origin, can also assist with the application of appropriate interventions as outlined in subsequent studies [ 46 , 49 , 50 ]. In the current study, cognitive and visual impairments were alluded to by nurses in the incident reports, labelled as reduced attention, information processing, reaction time, insight, memory recall, judgement, and spatial awareness.…”

Section: Discussionmentioning

confidence: 99%

Powered mobility device use in residential aged care: a retrospective audit of incidents and injuries

2023

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Background Powered wheelchairs and motorised mobility scooters, collectively called powered mobility devices (PMD), are highly valued by older Australians, including those living in residential care, to facilitate personal and community mobility. The number of PMDs in residential aged care is expected to grow proportionally with that of the wider community, however, there is very little literature on supporting residents to use PMDs safely. Prior to developing such supports, it is important to understand the frequency and nature of any incidents experienced by residents whilst using a PMD. The aim of this study was to determine the number and characteristics of PMD use related incidents occurring in a group of residential aged care facilities in a single year in one state in Australia including incident type, severity, assessment, or training received and outcomes on follow-up for PMD users living in residential aged care. Methods Analysis of secondary data, including documentation of PMD incidents and injuries for one aged care provider group over 12 months retrospectively. Follow-up data were gathered 9–12 months post incident to review and record the outcome for each PMD user. Results No fatalities were recorded as a direct result of PMD use and 55 incidents, including collisions, tips, and falls, were attributed to 30 residents. Examination of demographics and incident characteristics found that 67% of residents who had incurred incidents were male, 67% were over 80 years of age, 97% had multiple diagnoses and 53% had not received training to use a PMD. Results from this study were extrapolated to project that 4,453 PMD use related incidents occur every year within Australian residential aged care facilities, with the potential for outcomes such as extended recovery, fatality, litigation, or loss of income. Conclusion This is the first time that detailed incident data on PMD use in residential aged care has been reviewed in an Australian context. Illuminating both the benefits and the potential risks of PMD use emphasizes the need to develop and improve support structures to promote safe PMD use in residential aged care.

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“…To ensure rigor this scoping review adhered to the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement’. The study protocol was registered a priori with the International Prospective Register of systematic reviews, (PROSPERO CRD42019118957) and a protocol was published [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Relationships between Cognitive Functioning and Powered Mobility Device Use: A Scoping Review

Pellichero

Kenyon

Best

et al. 2021

IJERPH

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Background. Powered mobility devices (PMD) promote independence, social participation, and quality of life for individuals with mobility limitations. However, some individuals would benefit from PMD, but may be precluded access. This is particularly true for those with cognitive impairments who may be perceived as unsafe and unable to use a PMD. This study explored the relationships between cognitive functioning and PMD use. The objectives were to identify cognitive functions necessary to use a PMD and describe available PMD training approaches. Methods. A scoping review was undertaken. Results. Seventeen studies were included. Four examined the predictive or correlational relationships between cognitive functioning and PMD use outcomes with intellectual functions, visual and visuospatial perception, attention, abstraction, judgement, organization and planning, problem solving, and memory identified as having a relation with PMD use outcome in at least one study. Thirteen others studied the influence of PMD provision or training on users’ PMD capacity and cognitive outcomes and reported significative improvements of PMD capacities after PMD training. Six studies found improved cognitive scores after PMD training. Conclusions. Cognitive functioning is required to use a PMD. Individuals with heterogeneous cognitive impairment can improve their PMD capacities. Results contribute to advancing knowledge for PMD provision.

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Influence of Cognitive Functioning on Powered Mobility Device Use: Protocol for a Systematic Review

Cited by 7 publications

References 40 publications

Dystonia and choreoathetosis presence and severity in relation to powered wheelchair mobility performance in children and youth with dyskinetic cerebral palsy

Dystonia and choreoathetosis presence and severity in relation to powered wheelchair mobility performance in children and youth with dyskinetic cerebral palsy

Powered mobility device use in residential aged care: a retrospective audit of incidents and injuries

Relationships between Cognitive Functioning and Powered Mobility Device Use: A Scoping Review

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