Factors Influencing Incidence of Wheelchair Repairs and Consequences Among Individuals with Spinal Cord Injury

Abstract Objective Investigate frequency and consequences of wheelchair repairs, looking at the relationship to usage, components, out-of-pocket costs, number of days impacting the user, and factors associated with the need for repairs or consequences. Design Survey, cross-sectional. Setting Nine spinal cord injury (SCI) Model Systems Centers. Participants 533 wheelchair users with SCI. Interventions N/A. Main Outcome Measures Cost and incidence of wheelchair repairs and consequences and wheelchair usage within the past 6 months. Results 310 participants (56%) reported repairs of which 127 (42%) experienced at least one adverse consequence lasting a median [IQR] of 5 [2,17.3] days. Repair rates were highest for the seating system, electronics, and the tires. Participants were most often stranded at home or forced to use a backup chair. Median out-of-pocket costs were $150 [50, 620]. Active users, based on type of mobility and terrain, experienced more repairs and consequences than less active users. Repairs were more common among those who were Black (odds ratio: 2.42) or power wheelchair (PWC) users (odds ratio:1.84) while consequences were more common among those who were Black (OR:2.27), PWC (OR:2.08) or power assist (OR:2.76) users, or those who had public insurance (OR:1.70). Conclusions Wheelchair repairs continue to impact over 50% of wheelchair users with significant financial and personal cost. High repair rates limited participation inside and outside the home. Consequences lasted >2 weeks for many and may be minimized by a working backup chair. Disparities exist based on participant and wheelchair factors; repairs and adverse consequences appear to hit those most vulnerable with the least financial resources. Costs may be a barrier to repair completion for some individuals. This ongoing problem of high repair rates and their associated impact require action such as higher standards, access to quicker service and better training of user on wheelchair maintenance and repair.