TY - JOUR
T1 - Patterns in wheeled mobility skills training, equipment evaluation, and utilization
T2 - Findings from the SCIRehab project
AU - Taylor, Sally
AU - Gassaway, Julie
AU - Heisler-Varriale, Lauren A.
AU - Kozlowski, Allan
AU - Teeter, Laura
AU - Labarbera, Jacqueline
AU - Vargas, Carolyn
AU - Natale, Audrey
AU - Swirsky, Alison
N1 - Funding Information:
SCIRehab is a multi-year, practice-based evidence (PBE) research collaboration funded by the National Institute on Disability and Rehabilitation Research in the United States Department of Education. PBE methodology utilizes an observational cohort design focusing on treatment process and relates naturally occurring variation in treatment to outcomes, after controlling for patient demographic and injury characteristics (referred to as patient characteristics). Unlike a randomized controlled trial, a control group is not compared to an experimental group. PBE is effective in enabling research to take place in environments where it would be inappropriate to withhold treatment. (Horn & Gassaway 2007, 2010). SCIRehab has been described previously (Gassaway, Whiteneck, & Dijkers, 2009; Whiteneck & Gassaway, 2013; Whiteneck et al., 2011; Whiteneck, Gassaway, Dijkers, & Jha, 2009).In summary, it quantified the type and dosage of multi-disciplinary interventions provided during SCI inpatient rehabilitation following traumatic SCI with the intention of associating these interventions with outcomes at the time of rehabilitation discharge and at one-year post injury, after controlling for patient characteristics. Patients 12 years of age or older who gave informed consent were enrolled when admitted for initial inpatient rehabilitation following traumatic SCI at one of six SCI rehabilitation specialty centers. Patient characteristics were obtained from review of the medical record either as part of the SCI Model Systems protocol or in a database designed specifically for this study. The International Standards of Neurological Classification of SCI (ISNCSCI) and its American Spinal Injury Association Impairment Scale (AIS) were used to describe the NLI and completeness of injury (Marino, 2003).
Funding Information:
The contents of this article were developed under grants from the National Institute on Disability and Rehabilitation Research, Office of Rehabilitative Services, U.S. Department of Education, to Craig Hospital (grant numbers H133A060103 and H133N060005), the National Rehabilitation Hospital (grant number H133N060028), Rehabilitation Institute of Chicago (grant number H133N060014), Mount Sinai School of Medicine (grant number H133N060027), and to Shepherd Center (grant number H133N060009). The opinions contained in this publication are those of the grantees and do not necessarily reflect those of the U.S. Department of Education.
Publisher Copyright:
© 2014 RESNA.
PY - 2015/4/3
Y1 - 2015/4/3
N2 - Patients with traumatic spinal cord injury (SCI) participate in manual and power wheelchair (WC) skills training during inpatient rehabilitation; wheeled mobility evaluations aim to optimize use, fit, and function of equipment following discharge. Occupational and physical therapists documented treatment sessions during inpatient rehabilitation to describe types and quantity of WC skills training and adaptive equipment (AE) provided by neurological level of injury. Most patients participated in WC skills training; variation in type and frequency exists. Propulsion/driving skills were practiced most frequently. A majority of patients participated in equipment evaluations; assessment/prescription and fitting were performed frequently; mat evaluations were done infrequently. Most patients received mobility equipment in a timely manner; they continued to use their WC and were satisfied with its fit and function at the one-year injury anniversary. High levels of respondent satisfaction with fit and function of WCs suggest clinicians are prescribing mobility devices adequately and accurately supplementing information obtained during equipment assessment and fitting sessions with information from general treatment sessions. Variation in type and frequency of WC training provided by level of SCI and in types of WC prescribed use provides a foundation for future research to relate treatment modalities with functional and participation outcomes.
AB - Patients with traumatic spinal cord injury (SCI) participate in manual and power wheelchair (WC) skills training during inpatient rehabilitation; wheeled mobility evaluations aim to optimize use, fit, and function of equipment following discharge. Occupational and physical therapists documented treatment sessions during inpatient rehabilitation to describe types and quantity of WC skills training and adaptive equipment (AE) provided by neurological level of injury. Most patients participated in WC skills training; variation in type and frequency exists. Propulsion/driving skills were practiced most frequently. A majority of patients participated in equipment evaluations; assessment/prescription and fitting were performed frequently; mat evaluations were done infrequently. Most patients received mobility equipment in a timely manner; they continued to use their WC and were satisfied with its fit and function at the one-year injury anniversary. High levels of respondent satisfaction with fit and function of WCs suggest clinicians are prescribing mobility devices adequately and accurately supplementing information obtained during equipment assessment and fitting sessions with information from general treatment sessions. Variation in type and frequency of WC training provided by level of SCI and in types of WC prescribed use provides a foundation for future research to relate treatment modalities with functional and participation outcomes.
KW - equipment evaluation
KW - manual wheelchair
KW - occupational therapy
KW - paraplegia
KW - physical therapy
KW - power wheelchair
KW - rehabilitation research
KW - spinal cord injury
KW - tetraplegia
KW - wheeled mobility
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U2 - 10.1080/10400435.2014.978511
DO - 10.1080/10400435.2014.978511
M3 - Article
C2 - 26132349
AN - SCOPUS:84929163896
SN - 1040-0435
VL - 27
SP - 59
EP - 68
JO - Assistive Technology
JF - Assistive Technology
IS - 2
ER -