Wheelchair Mobility Confidence Scale for Dutch youth using a manual wheelchair
Marleen E. SolManon BloemenOlaf VerschurenPaula W. RushtonJohanna M. A. Visser‐MeilyJanke F. de Groot
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Purpose: The objective of this study was to develop a questionnaire to assess confidence in wheelchair mobility in Dutch youth (WheelCon-Mobility Dutch Youth).Methods: (1) A forward–backward translation process was used to translate the original WheelCon-M from English to Dutch. (2) Items related to wheelchair mobility in Dutch youth were selected and adapted based on focus groups with youth, parents and health care professionals to create the WheelCon-Mobility Dutch Youth. (3) The WheelCon-Mobility Dutch Youth and the Utrecht Pediatric Wheelchair Mobility Skills Test 2.0 (UP-WMST 2.0) were administered to 62 participants to evaluate internal consistency and construct validity.Results: Translation and cultural adaptation led to general adaptations in instructions, sentence structure and response scale. At the item level, 24 items were included with (n = 17) and without (n = 7) adaptation, 10 items were deleted and 7 new items were included. The WheelCon-Mobility Dutch Youth had an excellent Cronbach's alpha of 0.924 and a significant correlation (r = 0.44, p < .001) with the UP-WMST 2.0.Conclusions: This study resulted in the adaptation of the WheelCon-M into the WheelCon-Mobility for Dutch youth using a manual wheelchair. Our study suggests there is evidence supporting the internal consistency and construct validity of the WheelCon-Mobility Dutch Youth.Implications for RehabilitationThe WheelCon-Mobility Dutch Youth is a newly developed tool for assessing confidence in wheelchair mobility in Dutch youth using a manual wheelchair.It is important to assess performance and confidence in wheelchair mobility in paediatric rehabilitation.Keywords:
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Evaluation of wheelchair performance (capacity and skills) is crucial in the investigation of wheeled mobility in people with a spinal cord injury (SCI). Manual wheelchair use is a complex combination of skills, which together determine overall functioning, daily activities, participation, and quality of life. The evaluation of wheelchair performance requires a systematic biophysical approach that appreciates the importance of the individual elements of the wheelchair-user combination: the wheelchair, the wheelchair-user interface, and the user, as well as the environment. Measurement technologies and outcomes of experimental and observational studies will highlight the importance of a well-balanced individual wheelchair performance.
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Manual wheelchair propulsion combined with other stresses to the upper extremities may result in secondary injury. Possible solutions would be to devise alternative methods of propulsion, such as a pushrim-activated, power-assist wheelchair (PAPAW). The goals of this study were to examine the usage of the PAPAW in a real world setting and to characterize the driving habits of manual wheelchair users. Feedback was also obtained regarding subjects' opinions with respect to the PAPAW: their likes and dislikes. A PAPAW was provided to subjects for 2 weeks. Usage (average and total distance traveled and velocity) was tracked for both the PAPAW and the subjects' own wheelchairs. Significant differences in usage were not seen between the personal wheelchairs or the PAPAW. As a result, weeks were combined to provide an overall examination of driving characteristics. The average distance traveled over an average day was 1,671.4 ± 314.8 m with an average velocity of 0.44 ± 0.09 m/second. This pilot study provides an idea of manual wheelchair usage in a population of individuals with spinal cord injury. The lack of significant findings between the PAPAW and the subjects' own wheelchairs may be a function of study methodology such as sample size and length of follow-up in the new wheelchair. Future studies should expand upon the pilot work completed here, strengthening the design.
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The ramped kerbs of sidewalk which are accessible in a hand-propelled wheelchairs, motorized wheelchairs and wheelchair helpers are discussed experimentally. The experiment was done by using equipment which could be adjusted in level area width and ramp gradients. The walking time and subjective evaluations were used as an index of the walking fatigue. The ramped kerbs for all wheelchair users and wheelchair helpers without difficulty are designed appropriately, provided hand-propelled wheelchair users whose arms has been paralyzed are taken in acount. If a level area which allow wheelchair to pass should be provided at side of the ramped kerbs, there is a large decrease in walking fatigue.
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A wheelchair with an assistive power unit employing a differential gear is now under development. The wheelchair is specially aimed at those who have little residual power to drive a manual wheelchair, but often use a powered wheelchair. People who have C5 or C6 level spinal cord injury or the aged who have lower limb impairment are initially considered. The purpose is to encourage them to keep their residual ability or even to improve it by adjusting the assistive power. In addition to performance tests following JIS test procedures, 11 subjects, manual wheelchair users, tried the prototype and found its operation easy and that it is helpful while ascending or descending a slope. >
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Although engaging in an active lifestyle is beneficial for maintaining quality of life, a majority of wheelchair users are inactive. This study investigated the mobility characteristics and activity levels of manual wheelchair users in the residential setting and at the National Veterans Wheelchair Games (NVWG). Demographic factors that may have influenced activity in the home environment were also identified. Fifty-two manual wheelchair users completed a brief survey, and their activity was monitored with a custom data logger over a period of 13 or 20 days. We found that they traveled a mean +/- standard deviation of 2,457.0 +/- 1,195.7 m/d at a speed of 0.79 +/- 0.19 m/s for 8.3 +/- 3.3 h/d while using their primary wheelchair in the home environment. No significant differences in mobility characteristics or activity levels were found for level of spinal cord injury or disability. We also found that subjects traveled significantly farther and faster and were active for more hours during an average day at the NVWG than in the home environment (p < 0.001). We found that manual wheelchair users who were employed covered more distance, accumulated more minutes, and traveled a greater average maximum distance between consecutive stops than those who were unemployed. Results from this study provide a better understanding of the activity levels achieved by manual wheelchair users and insight into factors that may influence this activity.
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We systematically examined the standard of care for wheelchair provision, factors associated with wheelchair choice, disparities in access to wheelchair technology, and the impact of wheelchair use on quality of life among individuals with spinal cord injury (ISCI), participants of the National Model Spinal Cord Injury Systems (NMSCIS). We administered the Assistive Technology Survey developed by the consensus of the directors of the NMSCIS to a convenient sample of 635 adult full-time wheelchair users who met the eligibility criteria for the NMSCIS in 2 separate data collection periods. About 97% of manual and 54% power wheelchair users had customizable wheelchairs, lending evidence to show that ultralight weight customizable manual wheelchairs and customizable power wheelchairs with programmable controls are the standard of care for wheelchair users with SCI. Power wheelchair users were significantly older (p=0.000) than manual wheelchair users. However, regardless to the level of SCI, manual wheelchair users were able to use manual wheelchairs for an average of more than 10 years. Although the socioeconomic statuses (SES) of manual and power wheelchair users were similar, minorities with lower SES had less access to customizable wheelchairs and additional wheelchairs. We were not able to establish an association between the types and design features of wheelchair used on quality of life. Quality of life outcomes were measured in terms of physical/structural barriers, mobility, physical independence, social integration, and life satisfaction; all of these measures are part of the Craig Hospital Inventory of Environmental Factors, the Craig Handicap Assessment and Reporting Technique, and the Satisfaction With Life Scale. However, we were able to conclude that having additional wheelchairs significantly enhanced mobility for wheelchair users. The results of our study generated new knowledge for the field of SCI rehabilitation by elucidating the standard of care for wheelchair provision, the characteristics of wheelchair users with SCI, and the impact of wheelchair use for this population. Furthermore, this study also provided policy makers with valuable data to address disparities in access to customizable wheelchairs and the lack of insurance coverage for additional wheelchairs.
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Cooper RA, Tolerico M, Kaminski BA, Spaeth D, Ding D, Cooper R: Quantifying wheelchair activity of children: a pilot study. Am J Phys Med Rehabil 2008;87:977–983. Objective: The purpose of this study was to investigate mobility-related wheelchair activity of children in their community setting. Design: Mobility-related wheelchair activity data from 18 community- dwelling children (9 manual and 9 electric powered) were collected using custom-designed data logging devices. The children were between 8 and 17 yrs of age and independently used a wheelchair as their primary means of mobility. A data logging device was installed on their wheelchair for 7 days. However, because the device was attached and removed at different times of the day, the first and last days of the study period were not analyzed. Therefore, a total of 5 days of data were used to investigate wheelchair activity. Results: Overall, the children who used manual wheelchairs traveled on an average of 1602.31 m/day (SD, 976.78) at a speed of 0.67 m/sec (SD, 0.12), and the children who used electric-powered wheelchairs drove 1752.42 m/day (SD, 835.14) at a speed of 0.75 m/sec (SD, 0.35). It was also calculated that the average daily number of starts/ stops per thousand meters the manual and electric-powered wheelchair users completed were 166.77 (SD, 64.32) and 112.53 (SD, 62.27), respectively. A comparison of mobility-related wheelchair activity revealed a significant (P = 0.008) difference in the average daily distance traveled between genders, with the boys traveling further than the girls. Conclusions: The mobility data obtained from the children wheelchair users suggest that one possible factor of variability among wheelchair activity is between genders. The data collected provide us with direction for future research in this area.
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Evaluation of wheelchair performance (capacity and skills) is crucial in the investigation of wheeled mobility in people with a spinal cord injury (SCI). Manual wheelchair use is a complex combination of skills, which together determine overall functioning, daily activities, participation, and quality of life. The evaluation of wheelchair performance requires a systematic biophysical approach that appreciates the importance of the individual elements of the wheelchair-user combination: the wheelchair, the wheelchair-user interface, and the user, as well as the environment. Measurement technologies and outcomes of experimental and observational studies will highlight the importance of a well-balanced individual wheelchair performance.
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