Physical therapy treatment time during inpatient spinal cord injury rehabilitation

Taylor-Schroeder, Sally; LaBarbera, Jacqueline; McDowell, Shari; Zanca, Jeanne M.; Natale, Audrey; Mumma, Sherry L.; Gassaway, Julie; Backus, Deborah

doi:10.1179/107902611x12971826988057

Cited by 65 publications

(56 citation statements)

References 37 publications

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“…This is a longer length of inpatient hospital stay than provided in some countries. 22 One benefit of longer inpatient hospital stay is that it provides sufficient time and opportunity for careful consideration of equipment needs. In addition, in Australia, equipment is only prescribed by the treating physiotherapists and occupational therapists responsible for daily therapy.…”

Section: Discussionmentioning

confidence: 99%

How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

et al. 2012

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Background and purpose: The purpose of this study was to determine the amount and type of equipment prescribed to aid mobility and self-care for patients with spinal cord injuries (SCI) in Australia and to determine how frequently the equipment is used 1 year later and whether patients are satisfied with it. Methods: A consecutive series of 61 patients admitted for rehabilitation to two Sydney SCI units were recruited. All mobility and self-care equipment worth more than $AU50 prescribed by therapists before patients' discharge was recorded. This included wheelchairs, commodes, shower chairs, hoists, electric beds, pressure-relieving cushions, bed mattresses, slideboards, walking aids, orthoses, electrical stimulation systems and other pieces of notable exercise equipment. Patients were interviewed 1 year later and asked about each piece of equipment they had been prescribed. Specifically, they were asked about how frequently they had used each piece of equipment and whether they were satisfied with it. Data were analysed using descriptive statistics. Results: Three hundred and fourteen pieces of equipment, including 68 wheelchairs, were prescribed for the 61 patients. Most of the equipment (226/314) was used more than 20 times in the 2 months preceding the 1-year review. Most patients were satisfied or highly satisfied with the majority of equipment prescribed, although patients were very dissatisfied or only partly dissatisfied with 18/314 pieces of equipment. Discussion: Patients were generally satisfied with the equipment they were prescribed. There was a small amount of equipment prescribed that was not used 1 year later or with which patients were dissatisfied.

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Section: Discussionmentioning

confidence: 99%

How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

et al. 2012

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“…The mean WST-Q T3-T2 change scores for the Intervention group were −0.3% (95% Confidence Interval [CI] −2.7 to 2.1%) for capacity (t [48] = −0.25, p = 0.800) and −4.8% (95% CI −9.5 to −0.1%) for performance (t[48] = −2.01, p = 0.047).…”

Section: Retentionmentioning

confidence: 99%

“…[34][35][36][37][38][39][40][41][42] However, the reported prevalence of formal wheelchair skills training is low. [43][44][45][46][47][48][49][50] The Wheelchair Skills Training Program (WSTP) 51 is a training protocol that draws on both the wheelchair literature (how to perform the skills) and the principles of motor skill learning (how to teach the skills). 52 The value of wheelchair skills training with respect to increased capacity has been well documented for manual wheelchair use.…”

mentioning

confidence: 99%

Effectiveness of a Wheelchair Skills Training Program for Powered Wheelchair Users: A Randomized Controlled Trial

Kirby

Miller

Routhier

et al. 2015

Archives of Physical Medicine and Rehabilitation

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Objectives-To test the hypothesis that powered wheelchair users who receive the Wheelchair Skills Training Program (WSTP) improve their wheelchair skills in comparison with a Control group that receives standard care. Our secondary objectives were to assess goal achievement, satisfaction with training, retention, injury rate, confidence with wheelchair use and participation. Design-Randomized controlled trial (RCT). Setting-Rehabilitation centers and communities.Participants-116 powered wheelchair users. Intervention-Five 30-minute WSTP training sessions.Main Outcome Measures-Assessments were done at baseline (T1), post-training (T2) and 3 months post-training (T3) using the Wheelchair Skills Test Questionnaire (WST-Q 4.1), Goal Attainment Score (GAS), Satisfaction Questionnaire, Injury Rate, Wheelchair Use Confidence Scale for Power Wheelchair Users (WheelCon) and Life Space Assessment (LSA).Results-There was no significant T2-T1 difference between the groups for WST-Q capacity scores (p = 0.600) but the difference for WST-Q performance scores was significant (p = 0.016) with a relative (T2/T1 x 100%) improvement of the median score for the Intervention group of 10.8%. The mean (SD) GAS for the Intervention group after training was 92.8% (11.4) and satisfaction with training was high. The WST-Q gain was not retained at T3. There was no clinically significant difference between the groups in injury rate and no statistically significant differences in WheelCon or LSA scores at T3.Conclusions-Powered wheelchair users who receive formal wheelchair skills training demonstrate modest transient post-training improvements in their WST-Q performance scores, they have substantial improvements on individualized goals and they are positive about training. KeywordsWheelchair; rehabilitation; training; motor skills; RCT Of people who use wheelchairs (excluding scooters) in North America, ~13% use powered wheelchairs. [1][2][3] Powered wheelchairs can have a positive impact on well-being, self-esteem, pain, activity and participation. [4][5][6][7][8][9][10][11][12][13][14][15] However, powered wheelchairs are not without problems. 11,16 There can be functional difficulties with powered wheelchair use, such as difficulty maneuvering in indoor spaces, difficulty in handling for caregivers, and difficulty transporting the powered mobility devices in vehicles. 8 CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript usefulness of power wheelchairs for some users. 17,18 Safety is also an issue for users of manual and powered wheelchairs, with 5-18% of community-dwelling wheelchair users experiencing wheelchair-related injuries each year. [19][20][21][22][23][24][25] A high proportion of wheelchairs require repairs in the first 6 months after they are provided. 26,27 Wheelchair abandonment can occur when users are faced with such difficulties. 7,[28][29][30][31] One important aspect of the wheelchair-provision process that has become increasingly well recognized is training in wheelchair use. 32 There is...

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“…[5] Consequently, nurses and staff often spend a significant amount of time assisting these patients with basic functions which limits their time to provide clinical care. [6,7] To provide better care to and optimize the experience with inpatient care for Veterans with SCI/D, Veterans Affairs Medical Centers (VAMCs) are exploring the value of implementing ECUs in SCI Centers. Feedback from this study may influence future roll-outs of ECUs to other SCI Centers.…”

Section: Figure 1 An Example Of An Ecumentioning

confidence: 99%

Evaluating the roll-out of environmental control units in Veterans Affairs Spinal Cord Injury Centers: Workflow observations

Bidassie

Vallette

James

et al. 2017

IJH

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Objective: Evaluate the value of providing environmental control units (ECUs) to Veterans with spinal cord injuries and/or disorders (SCI/D) in Veterans Affairs Medical Centers (VAMCs). Design: Industrial engineers observed SCI/D staff (support) and Veterans (use) with ECUs at four participating VAMC Spinal Cord Injury (SCI) Centers. Measure(s)/Analysis: Standardized data collection efforts included: 1) time study (trend analysis) and 2) open-ended, semistructured interviews on Strengths-Weaknesses-Opportunities-Threats (SWOT) feedback (qualitative analysis). Results: From 59 interactions, reasons for ECU downtime were troubleshooting (n = 30, 51%), repairs/replacements (n = 10, 17%), and 29% combined for patient education (n = 8), set-up (n = 5), and admission (n = 4). ECU strengths were functionality (n = 23, 70%) and 30% (n = 10) combined for patient independence and staff satisfaction. Functionality was both a weakness (n = 43, 78%) and opportunity (n = 29, 66%). Threats were functionality (n = 8, 50%), staff satisfaction (n = 3, 19%), and maintenance (n = 5, 31%). When ECUs were functioning properly, Veterans participated in leisurely activities (e.g., games, television), had increased control of their environment (e.g., bed, lights), and clinicians spent less time troubleshooting the ECU, hence, increasing clinical care availability. Conclusions: ECUs minimized physical limitation challenges, and may improve safety, comfort level, and general satisfaction with care of Veterans with SCI/D who often spend much of their time in bed when hospitalized. Veterans and staff reported that the ECUs added value by increasing patient independence and social support including communication with loved ones. Functionality strengths and weaknesses influenced the Veterans'/staff's perceptions of ECU value. Therefore, ECU training/maintenance education and dedicated non-clinical support staff are recommended prior to future ECU roll-out.

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Physical therapy treatment time during inpatient spinal cord injury rehabilitation

Cited by 65 publications

References 37 publications

How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?

Effectiveness of a Wheelchair Skills Training Program for Powered Wheelchair Users: A Randomized Controlled Trial

Evaluating the roll-out of environmental control units in Veterans Affairs Spinal Cord Injury Centers: Workflow observations

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