Wheelchair Breakdowns Are Associated With Pain, Pressure Injuries, Rehospitalization, and Self-Perceived Health in Full-Time Wheelchair Users With Spinal Cord Injury

Nathan S. Hogaboom; Lynn A. Worobey; Bethlyn V. Houlihan; Allen W. Heinemann; Michael L. Boninger

doi:10.1016/j.apmr.2018.04.002

Wheelchair Breakdowns Are Associated With Pain, Pressure Injuries, Rehospitalization, and Self-Perceived Health in Full-Time Wheelchair Users With Spinal Cord Injury

Nathan S. Hogaboom, Lynn A. Worobey^*, Bethlyn V. Houlihan, Allen W. Heinemann, Michael L. Boninger

^*Corresponding author for this work

Physical Medicine and Rehabilitation

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Objectives: To evaluate the relation between wheelchair breakdowns, their immediate consequences, and secondary health complications after spinal cord injury. “Immediate consequences” occur when part of a wheelchair breaks and leaves an individual stranded or injured, or causes him or her to miss medical appointments, work, or school. Design: Survey, cross-sectional. Setting: Spinal Cord Injury Model Systems Centers. Participants: Full-time wheelchair users (N=771) with SCI from 9 Spinal Cord Injury Model Systems Centers, with data collected between 2011 and 2016. Interventions: Not applicable. Main Outcome Measures: Incidence of self-reported wheelchair breakdowns within the past 6 months that did or did not result in immediate consequences (ie, injury, being stranded, missing a medical appointment, or an inability to attend school/work); self-perceived health status scale; pain severity numerical rating scale; rehospitalizations; and self-reported pressure injury development within the past 12 months. Results: A total of 610 participants with complete data sets were included in the analyses. When compared to those who reported no breakdowns, participants who reported 1 or more immediate consequences had worse secondary complications: higher self-perceived health status and pain scores (partial −η²=.009-.012, P<.05), and higher odds of rehospitalization (odds ratio: 1.86, P<.05) and pressure injury development (odds ratio: 1.73, P<.05). Secondary health complications were not different in those who reported no immediate consequences compared to those who reported no breakdown. Conclusions: Wheelchair breakdowns that resulted in injury, being stranded, missing medical appointments, and/or an inability to attend work/school appear to have far-reaching impacts on health and secondary injury. Preventing wheelchair breakdowns, through either better maintenance or manufacturing, may be a means of decreasing secondary disability.

Original language	English (US)
Pages (from-to)	1949-1956
Number of pages	8
Journal	Archives of physical medicine and rehabilitation
Volume	99
Issue number	10
DOIs	https://doi.org/10.1016/j.apmr.2018.04.002
State	Published - Oct 2018

Funding

Supported by resources and the use of facilities at the Human Engineering Research Laboratories, VA Pittsburgh Healthcare System. The contents of this paper do not represent the views of the Department of Veterans Affairs or the US Government. This project was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (grant no. 90SI5008). NIDILRR is a Center within the Administration for Community Living (ACL) in the Department of Health and Human Services (HHS). The contents of this paper do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the federal government. This material is based upon work supported by the National Science Foundation Graduate Research Fellowship (grant no. 1247842) and Integrative Graduate Education and Research Training Fellowship (DGE grant no. 1144584). The contents of this publication do not necessarily reflect the view of the National Science Foundation.

Keywords

Pain
Pressure ulcer
Rehabilitation
Spinal cord injuries
Wheelchairs

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation

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10.1016/j.apmr.2018.04.002

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Hogaboom, N. S., Worobey, L. A., Houlihan, B. V., Heinemann, A. W., & Boninger, M. L. (2018). Wheelchair Breakdowns Are Associated With Pain, Pressure Injuries, Rehospitalization, and Self-Perceived Health in Full-Time Wheelchair Users With Spinal Cord Injury. Archives of physical medicine and rehabilitation, 99(10), 1949-1956. https://doi.org/10.1016/j.apmr.2018.04.002

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title = "Wheelchair Breakdowns Are Associated With Pain, Pressure Injuries, Rehospitalization, and Self-Perceived Health in Full-Time Wheelchair Users With Spinal Cord Injury",

abstract = "Objectives: To evaluate the relation between wheelchair breakdowns, their immediate consequences, and secondary health complications after spinal cord injury. “Immediate consequences” occur when part of a wheelchair breaks and leaves an individual stranded or injured, or causes him or her to miss medical appointments, work, or school. Design: Survey, cross-sectional. Setting: Spinal Cord Injury Model Systems Centers. Participants: Full-time wheelchair users (N=771) with SCI from 9 Spinal Cord Injury Model Systems Centers, with data collected between 2011 and 2016. Interventions: Not applicable. Main Outcome Measures: Incidence of self-reported wheelchair breakdowns within the past 6 months that did or did not result in immediate consequences (ie, injury, being stranded, missing a medical appointment, or an inability to attend school/work); self-perceived health status scale; pain severity numerical rating scale; rehospitalizations; and self-reported pressure injury development within the past 12 months. Results: A total of 610 participants with complete data sets were included in the analyses. When compared to those who reported no breakdowns, participants who reported 1 or more immediate consequences had worse secondary complications: higher self-perceived health status and pain scores (partial −η2=.009-.012, P<.05), and higher odds of rehospitalization (odds ratio: 1.86, P<.05) and pressure injury development (odds ratio: 1.73, P<.05). Secondary health complications were not different in those who reported no immediate consequences compared to those who reported no breakdown. Conclusions: Wheelchair breakdowns that resulted in injury, being stranded, missing medical appointments, and/or an inability to attend work/school appear to have far-reaching impacts on health and secondary injury. Preventing wheelchair breakdowns, through either better maintenance or manufacturing, may be a means of decreasing secondary disability.",

keywords = "Pain, Pressure ulcer, Rehabilitation, Spinal cord injuries, Wheelchairs",

author = "Hogaboom, {Nathan S.} and Worobey, {Lynn A.} and Houlihan, {Bethlyn V.} and Heinemann, {Allen W.} and Boninger, {Michael L.}",

note = "Publisher Copyright: {\textcopyright} 2018 American Congress of Rehabilitation Medicine",

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Wheelchair Breakdowns Are Associated With Pain, Pressure Injuries, Rehospitalization, and Self-Perceived Health in Full-Time Wheelchair Users With Spinal Cord Injury. / Hogaboom, Nathan S.; Worobey, Lynn A.; Houlihan, Bethlyn V. et al.
In: Archives of physical medicine and rehabilitation, Vol. 99, No. 10, 10.2018, p. 1949-1956.

Research output: Contribution to journal › Article › peer-review

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AU - Hogaboom, Nathan S.

AU - Worobey, Lynn A.

AU - Houlihan, Bethlyn V.

AU - Heinemann, Allen W.

AU - Boninger, Michael L.

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N2 - Objectives: To evaluate the relation between wheelchair breakdowns, their immediate consequences, and secondary health complications after spinal cord injury. “Immediate consequences” occur when part of a wheelchair breaks and leaves an individual stranded or injured, or causes him or her to miss medical appointments, work, or school. Design: Survey, cross-sectional. Setting: Spinal Cord Injury Model Systems Centers. Participants: Full-time wheelchair users (N=771) with SCI from 9 Spinal Cord Injury Model Systems Centers, with data collected between 2011 and 2016. Interventions: Not applicable. Main Outcome Measures: Incidence of self-reported wheelchair breakdowns within the past 6 months that did or did not result in immediate consequences (ie, injury, being stranded, missing a medical appointment, or an inability to attend school/work); self-perceived health status scale; pain severity numerical rating scale; rehospitalizations; and self-reported pressure injury development within the past 12 months. Results: A total of 610 participants with complete data sets were included in the analyses. When compared to those who reported no breakdowns, participants who reported 1 or more immediate consequences had worse secondary complications: higher self-perceived health status and pain scores (partial −η2=.009-.012, P<.05), and higher odds of rehospitalization (odds ratio: 1.86, P<.05) and pressure injury development (odds ratio: 1.73, P<.05). Secondary health complications were not different in those who reported no immediate consequences compared to those who reported no breakdown. Conclusions: Wheelchair breakdowns that resulted in injury, being stranded, missing medical appointments, and/or an inability to attend work/school appear to have far-reaching impacts on health and secondary injury. Preventing wheelchair breakdowns, through either better maintenance or manufacturing, may be a means of decreasing secondary disability.

AB - Objectives: To evaluate the relation between wheelchair breakdowns, their immediate consequences, and secondary health complications after spinal cord injury. “Immediate consequences” occur when part of a wheelchair breaks and leaves an individual stranded or injured, or causes him or her to miss medical appointments, work, or school. Design: Survey, cross-sectional. Setting: Spinal Cord Injury Model Systems Centers. Participants: Full-time wheelchair users (N=771) with SCI from 9 Spinal Cord Injury Model Systems Centers, with data collected between 2011 and 2016. Interventions: Not applicable. Main Outcome Measures: Incidence of self-reported wheelchair breakdowns within the past 6 months that did or did not result in immediate consequences (ie, injury, being stranded, missing a medical appointment, or an inability to attend school/work); self-perceived health status scale; pain severity numerical rating scale; rehospitalizations; and self-reported pressure injury development within the past 12 months. Results: A total of 610 participants with complete data sets were included in the analyses. When compared to those who reported no breakdowns, participants who reported 1 or more immediate consequences had worse secondary complications: higher self-perceived health status and pain scores (partial −η2=.009-.012, P<.05), and higher odds of rehospitalization (odds ratio: 1.86, P<.05) and pressure injury development (odds ratio: 1.73, P<.05). Secondary health complications were not different in those who reported no immediate consequences compared to those who reported no breakdown. Conclusions: Wheelchair breakdowns that resulted in injury, being stranded, missing medical appointments, and/or an inability to attend work/school appear to have far-reaching impacts on health and secondary injury. Preventing wheelchair breakdowns, through either better maintenance or manufacturing, may be a means of decreasing secondary disability.

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KW - Pressure ulcer

KW - Rehabilitation

KW - Spinal cord injuries

KW - Wheelchairs

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Wheelchair Breakdowns Are Associated With Pain, Pressure Injuries, Rehospitalization, and Self-Perceived Health in Full-Time Wheelchair Users With Spinal Cord Injury

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