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.

Exploring Mobility Options for Children With Physical Disabilities: A Focus on Powered Mobility

“…As Tefft et al (2011) pointed out, some studies have indicated that parents may initially be hesitant or opposed to exploring powered mobility for their young children (Bottos et al, 2001;Guerette, Tefft, & Furumasu, 2005;Wiart, Darrah, Hollis, Cook, & May, 2004). However, studies have also described how the use of powered mobility resulted in positive reactions by parents as they experienced the freedom and independence the wheelchair provided their children (Bottos et al, 2001;Wiart et al, 2004).…”

Distrofia muscular de Duchenne. Perspectivas desde la rehabilitación

“…En la fase ambulatoria tardía es necesario el uso de una manual ultraliviana, con asiento y espalda sólido con soportes laterales para mantener el alineamiento espinal, evitar la progresión de escoliosis y adicionalmente, apoyapies en neutro para así evitar deformidades en cuello de pie. Finalmente, en la etapa no ambulatoria temprana, una silla de ruedas manual con asiento y espaldar personalizados y sistema de basculación es una condición previa a la formulación de silla de ruedas eléctrica (118)(119)(120)(121)(122). Si el paciente requiere una silla de ruedas eléctrica antes de indicarla, se deben tomar en consideración varios aspectos: el económico, el familiar, el del paciente (compromiso cognitivo del paciente) y el de la movilización (falta de transporte acondicionado para silla de ruedas, caracterís-ticas del terreno, barreras arquitectónicas, etc)…”

Current Status of the Utilization of Powered Wheelchair in Preschool Children with Locomotive Disability in Japan

“…Guerette et al 7) indicated that there are 4 factors inhibiting PWC provision to preschool children with disabilities, that is, cognitive, physical, behavioral, and family-living environment factors. Because 6 children with disabilities had reached a developmental stage at which they could operate a PWC, the factors that inhibited PWC prescription may not directly involve the children themselves.…”

“…Given this background, early provision of a PWC as a means of independent locomotion to children with impaired self-propelled locomotion during the preschool period reportedly activates exploratory activities, promotes mental and motor development, expands the range of play activities, and increases opportunities to play roles as children [2][3][4][5][6] . However, it has also been reported that the PWC is rarely introduced to preschool children with disabilities [6][7][8] .…”

“…Thus, we analyzed various developmental indicators necessary for determining whether preschool children can safely operate a PWC indoors and revealed that children at a certain minimum developmental age can, in fact, use a PWC indoors 14) . However, no sufficiently extensive survey has been conducted in either Japan or overseas on PWC prescription for preschool children with disabilities on the basis of indicators including developmental age and ability to operate a PWC [6][7][8] . Thus, the present study aimed to elucidate the actual state of PWC prescription for preschool children with disabilities in Japan and to determine the approximate number of preschool children with disabilities who would potentially benefit from PWC use, by setting criteria for developmental indicators considered to determine the ability to operate a PWC.…”