1
|
Ferretti EC, Curi HT, Andrade LF, Cooper RA, Soárez PCD. Conceptual mapping proposed to comprehend the effect of wheelchair mobility on social participation and quality of life: a systematic review. Disabil Rehabil Assist Technol 2024; 19:814-830. [PMID: 36260418 DOI: 10.1080/17483107.2022.2126904] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/11/2022] [Accepted: 09/15/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE To identify and synthesise the available evidence on the effect of mobility on social participation and quality of life (QoL) of wheelchairs (WC) on adults who use WC as their primary means of mobility. MATERIALS AND METHODS Systematic review undertaken in accordance with the Centre for Reviews and Dissemination Guidelines and registered in the PROSPERO International Prospective Register of Systematic reviews. Nine electronic databases (MEDLINE via PubMed, EMBASE, Cochrane Library, LILACS, CINAHL, PEDro, SCOPUS, Web of Science, and BVS ECOS) were searched with the following PICO eligibility criteria: (P) Population was individuals with mobility limitations that live in their community, aged 18 or older; (I) Intervention was mobility devices, such as manual and powered wheelchairs; (C) Comparators, not applied; (O) Outcome was factors that can be influenced by wheelchair use, such as: social participation, health-related quality of life and QOL. Critical appraisal of methodological quality of studies were undertaken. RESULTS A total of 18 studies were included. The proportion of studies evaluating the effects of mobility on participation was higher than to mobility on QoL. WC quality, device benefit (ease of repairs and maintenance), confidence using a WC and WC skills were key factors determining participation. The provision of WC according to the eight steps service proposed by the Word Health Organisation contributed to higher levels of physical health, WC satisfaction, hours using the WC and QoL enhancement. CONCLUSION Attention should be given to enhance WC service provision (with continuous service support) as well as professional continuing education.IMPLICATIONS FOR REHABILITATIONWheelchair technology is a key element in rehabilitation. Significant effort should be made to provide and maintain the wheelchair as a facilitator to participation. A great attention should be done to enhance wheelchair services as well as professional continuous education.Wheelchair skills are associated with participation and may be targeted in clinical intervention.
Collapse
Affiliation(s)
- Eliana Chaves Ferretti
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brazil
| | - Haidar Tafner Curi
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luana Foroni Andrade
- Departamento de Terapia Ocupacional, Universidade Federal de Sergipe, Lagarto, SE, Brazil
| | - Rory A Cooper
- Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
| | - Patrícia Coelho de Soárez
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
2
|
Charbonnet M, Sylvester L, Wang H, DeGrace BW. Provision of paediatric wheelchairs in low resource settings: a scoping review. Disabil Rehabil Assist Technol 2023; 18:1120-1138. [PMID: 34614386 DOI: 10.1080/17483107.2021.1986582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 09/23/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Inadequate wheelchair provision in children can lead to delays in growth and development, poorer health, and decreased participation. Wheelchair provision for children can be challenging, especially in low-resource settings, due to limited resources. Therefore, the purpose of the scoping review was to gain an understanding of the current state of paediatric wheelchair provision in low resource settings and identify factors, strategies, and gaps that can lead to more successful wheelchair provision. METHODS This scoping review used literature published after 2010, related to paediatric wheelchair provision in low resource settings. We searched online databases and grey literature and extracted data based on categories from the World Health Organisation Guidelines to wheelchair provision in low resource settings. RESULTS 34 articles were used to identify and analyse common themes and successful strategies related to wheelchair provision for children in low resource settings. Aspects of paediatric wheelchair provision were mentioned in the literature but were rarely the focus. End-user outcomes were the least represented category in the literature. CONCLUSION Based on the currently available evidence the overall state of a wheelchair for children is inadequate. Improvements in design and production, personnel capacity, and service delivery systems are recommended to promote best practices. The lack of child-focussed wheelchair provision and end-user involvement in the research process urgently needs to be addressed.Implications for RehabilitationIdentify best practiceIdentify gaps in knowledgeDetermine areas of need for future research.
Collapse
Affiliation(s)
- Monique Charbonnet
- Doctor of Science in Rehabilitation Program, University of Oklahoma-Health Science Center, Oklahoma City, OK, USA
| | - Lorraine Sylvester
- Department of Rehabilitation Science, University of Oklahoma-Health Science Center, Oklahoma City, OK, USA
| | - Hongwu Wang
- Department of Rehabilitation Science, University of Oklahoma-Health Science Center, Oklahoma City, OK, USA
| | - Beth W DeGrace
- Department of Rehabilitation Science, University of Oklahoma-Health Science Center, Oklahoma City, OK, USA
| |
Collapse
|
3
|
Kamalakannan S, Rushton PW, Giesbrecht E, Rusaw DF, Bouziane SA, Nadeau M, McKee J, Gowran RJ, Kirby RL, Pedersen JP, Tasiemski T, Burrola-Mendez Y, Tofanin M, Goldberg M, Pearlman J. Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review protocol. Disabil Rehabil Assist Technol 2020; 18:343-349. [PMID: 33301358 DOI: 10.1080/17483107.2020.1852325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE Appropriate wheelchair provision is necessary for addressing participation barriers experienced by individuals with mobility impairments. Health care professionals involved in the wheelchair service provision process require a specific set of skills and knowledge to enable wheelchair use that meets individual posture, mobility and daily living requirements. However, inconsistencies exist in academic programmes globally about providing comprehensive education and training programmes. The planned scoping review aims to review and synthesize the global literature on wheelchair service provision education for healthcare professional students, healthcare personnel and educators offered by universities, organizations and industries. METHODS This scoping review will be guided by the Joanna Briggs Institute (JBI) methodological framework. Comprehensive literature searches will be conducted on various global electronic databases on health to seek out how wheelchair service provision education is organized, integrated, implemented and evaluated. Two independent reviewers will perform eligibility decisions and key data extractions. Data from selected studies will be extracted and analysed using conventional content analysis. Information related to wheelchair service provision education including curriculum development, content, teaching methods, evaluation and models of integration will be synthesized. IMPLICATIONS AND DISSEMINATION The planned scoping review will be the first to examine all aspects of wheelchair service provision education across professionals, settings and countries. We anticipate that results will inform the content of a Wheelchair Educators' Package, and if appropriate, a follow-up systematic review. An article reporting the results of the scoping review will be submitted for publication to a scientific journal.Implications for RehabilitationA comprehensive examination of wheelchair service provision education could help develop strategies to address the unmet need for wheelchair services globally.Findings for this review will facilitate the planning and development of an evidence-based education package that could bridge the existing knowledge gaps related to safe and effective wheelchair service provision among health professionals involved.This review will also inform the potential barriers and enablers for effective integration and implementation of wheelchair service provision education worldwide.
Collapse
Affiliation(s)
- Sureshkumar Kamalakannan
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.,Public Health Foundation of India, Indian Institute of Public Health, Hyderabad, India
| | - Paula W Rushton
- School of Rehabilitation, Université de Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada
| | - Ed Giesbrecht
- Department of Occupational Therapy, University of Manitoba, Winnipeg, Canada
| | - David F Rusaw
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Melodie Nadeau
- Department of Biology, University of Concordia, Montréal, Canada
| | - Jennifer McKee
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Rosemary J Gowran
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology, University of Limerick, Limerick, Ireland
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
| | - Jessica P Pedersen
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Tomasz Tasiemski
- Department of Adapted Physical Activity, Poznań University of Physical Education, Poznań, Poland
| | - Yohali Burrola-Mendez
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.,Consejo Nacional de Ciencia y Tecnología (CONACyT), Ciudad de México, México
| | - Marco Tofanin
- Department of Neurosciences and Neurorehabilitation, Neurorehabilitation Unit, Bambino Gesù Children's Hospital, Rome, Italy
| | - Mary Goldberg
- International Society of Wheelchair Professionals, University of Pittsburgh, Pittsburgh, PA, USA.,Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
4
|
Cooper RA, Tuakli-Wosornu YA, Henderson GV, Quinby E, Dicianno BE, Tsang K, Ding D, Cooper R, Crytzer TM, Koontz AM, Rice I, Bleakney AW. Engineering and Technology in Wheelchair Sport. Phys Med Rehabil Clin N Am 2018; 29:347-369. [PMID: 29627093 DOI: 10.1016/j.pmr.2018.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Technologies capable of projecting injury and performance metrics to athletes and coaches are being developed. Wheelchair athletes must be cognizant of their upper limb health; therefore, systems must be designed to promote efficient transfer of energy to the handrims and evaluated for simultaneous effects on the upper limbs. This article is brief review of resources that help wheelchair users increase physiologic response to exercise, develop ideas for adaptive workout routines, locate accessible facilities and outdoor areas, and develop wheelchair sports-specific skills.
Collapse
Affiliation(s)
- Rory A Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA.
| | - Yetsa A Tuakli-Wosornu
- Yale University Orthopaedics & Rehabilitation, Yale Physicians Building, 800 Howard Avenue, New Haven, CT 06510, USA
| | - Geoffrey V Henderson
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Kaufmann Medical Building, Suite 201, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Eleanor Quinby
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh, Kaufmann Medical Building, Suite 201, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Brad E Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Kalai Tsang
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Dan Ding
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Rosemarie Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Theresa M Crytzer
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Alicia M Koontz
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, 6425 Penn Avenue, Suite 400, Pittsburgh, PA 15206, USA
| | - Ian Rice
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, Louise Freer Hall, 906 S. Goodwin Avenue, Urbana, IL 61801, USA
| | - Adam W Bleakney
- Disability Resources & Educational Services, University of Illinois at Urbana-Champaign, Urbana-Champaign, Illinois, 1207 S. Oak Street, Champaign, IL 61820, USA
| |
Collapse
|
5
|
Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Jiang Kwete X, Arreola-Ornelas H, Gómez-Dantés O, Rodriguez NM, Alleyne GAO, Connor SR, Hunter DJ, Lohman D, Radbruch L, Del Rocío Sáenz Madrigal M, Atun R, Foley KM, Frenk J, Jamison DT, Rajagopal MR. Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report. Lancet 2018; 391:1391-1454. [PMID: 29032993 DOI: 10.1016/s0140-6736(17)32513-8] [Citation(s) in RCA: 599] [Impact Index Per Article: 99.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Felicia Marie Knaul
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, USA; Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Coral Gables, FL, USA; Tómatelo a Pecho, A.C., Mexico City, Mexico; Fundación Mexicana para la Salud, A.C., Mexico City, Mexico.
| | | | - Eric L Krakauer
- Harvard Medical School, Boston, MA, USA; Massachusetts General Hospital, Boston, MA, USA; World Health Organization, Geneva, Switzerland
| | - Liliana De Lima
- International Association for Hospice and Palliative Care, Houston, TX, USA
| | - Afsan Bhadelia
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Xiaoxiao Jiang Kwete
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Héctor Arreola-Ornelas
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA; Tómatelo a Pecho, A.C., Mexico City, Mexico; Fundación Mexicana para la Salud, A.C., Mexico City, Mexico
| | | | - Natalia M Rodriguez
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, FL, USA
| | - George A O Alleyne
- Pan American Health Organization, Regional Office of WHO, Washington, DC, USA
| | | | - David J Hunter
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Diederik Lohman
- Health and Human Rights Division, Human Rights Watch, Maplewood, NJ, USA
| | - Lukas Radbruch
- International Association for Hospice and Palliative Care, Houston, TX, USA; Department of Palliative Medicine, University Hospital Bonn, Germany; The Malteser Hospital, Bonn, Germany
| | | | - Rifat Atun
- Harvard Medical School, Boston, MA, USA; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Julio Frenk
- Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Coral Gables, FL, USA; School of Business Administration, University of Miami, Coral Gables, FL, USA
| | | | - M R Rajagopal
- Trivandrum Institute of Palliative Sciences, WHO Collaborating Centre for Training and Policy on Access to Pain Relief, Pallium India, Kerala, India
| |
Collapse
|
6
|
McSweeney E, Gowran RJ. Wheelchair service provision education and training in low and lower middle income countries: a scoping review. Disabil Rehabil Assist Technol 2017; 14:33-45. [PMID: 29092684 DOI: 10.1080/17483107.2017.1392621] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE Improving access to education and training for those providing wheelchair and seating assistive technology to meet personal posture and mobility requirements, as a basic human right, is a priority. This review considers education and training available to personnel within low and lower middle income countries (LLMIC), to ascertain where gaps in knowledge exist and identify human resource education priorities. METHOD A scoping review, mapping out existing scientific and grey literature within the field between 1993 and 2017 was conducted. The search strategy included use of online databases, manual analogue searches and key stakeholder informant advice. A content analysis process was applied to organize the literature retrieved and extract key themes. RESULTS Education and training in LLMIC appears ad hoc and limited, however, there is growing recognition as to its importance, notably by the World Health Organization and nongovernmental organizations, delivering education initiatives to a number of countries, along with the development of a credentialing test. Inconsistency exists regarding personnel responsible for wheelchair provision, with no specific professional clearly recognized to oversee the system within many LLMIC. CONCLUSIONS Education and training is required for all stakeholders involved in wheelchair provision. Advocating for programme development to enhance personnel skills, build capacity and ensure best practice is a priority. Pilot sites, delivering and credentialing appropriate wheelchair provision education and training within context should be considered. Measuring outcomes and transferable skills should be part of education programme delivery structures. Considering a new discipline responsible for oversight of wheelchair provision should be investigated. Implications for rehabilitation Education and training is an essential step in the wheelchair provision process in the bid to obtain an appropriate wheelchair via appropriate provision services. However, it is more than education and training; its a human rights issue. Mandatory education and training needs to be a requirement for all stakeholders involved in wheelchair provision. Key wheelchair personnel need to establish their central role in this arena. The study raises awareness as to the importance of working with governments to commit to building sustainable wheelchair provision infrastructures.
Collapse
Affiliation(s)
- Elizabeth McSweeney
- a Department of Clinical Therapies , Faculty of Education and Health Sciences, University of Limerick , Ireland
| | - Rosemary Joan Gowran
- a Department of Clinical Therapies , Faculty of Education and Health Sciences, University of Limerick , Ireland.,b School of Health & Sport Sciences , Faculty of Science, Health, Education & Engineering, University of the Sunshine Coast , Australia
| |
Collapse
|
7
|
Shore S. The long-term impact of wheelchair delivery on the lives of people with disabilities in three countries of the world. Afr J Disabil 2017; 6:344. [PMID: 28936417 PMCID: PMC5594261 DOI: 10.4102/ajod.v6i0.344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 05/20/2017] [Indexed: 11/25/2022] Open
Abstract
Background Lack of access to mobility for people with disabilities, particularly in less- resourced settings, continues to be widespread. Despite challenges to wheelchair delivery, the benefits to health, employment, social integration and life satisfaction are apparent. Objectives Previous studies have explored the impact of receiving a wheelchair on the lives of the users through cross-sectional or short-term longitudinal analysis. The current study was undertaken to evaluate whether previously reported changes were sustained after 30 months of use, and whether results varied between two differing models of a wheelchair. Method One hundred and ninety-one subjects from Peru, Uganda and Vietnam received one of two models of wheelchair provided by the Free Wheelchair Mission. Using interviews to record survey results, data were collected at the time the wheelchair was received and following 12 and 30 months of use. Variables of overall health, employment, income and travel were explored through non-parametric analysis. Results There was a significant improvement in overall health and distance travelled after 12 months, but these changes were no longer significant by 30 months (Friedman test for overall change, p = 0.000). Employment status showed a small but significant increase at 12 and 30 months (Cochran’s Q, p = 0.000). Reported income increased slowly, becoming significantly different at 30 months (Friedman test, p = 0.033). There was no association between the model of wheelchair received and the incidence of pressure ulcers, pain or maintenance required. There was higher satisfaction with the GEN_2 wheelchair at 12 months (p = 0.004), but this difference was not apparent by 30 months. Overall wheelchair satisfaction and maintenance levels were favourable. Conclusion While overall health status, and distance travelled into the community fluctuated over time, receipt of one of two models of a wheelchair in less-resourced settings of the world appears to have a positive sustained impact on employment and income. Further investigations should be carried out to confirm these results and explore the factors responsible for fluctuating variables. This study affirms the importance of long-term follow-up of outcomes associated with wheelchair distribution in less-resourced environments.
Collapse
Affiliation(s)
- Susan Shore
- Department of Physical Therapy, Azusa Pacific University, United States
| |
Collapse
|
8
|
Williams E, Hurwitz E, Obaga I, Onguti B, Rivera A, Sy TRL, Kirby RL, Noon J, Tanuku D, Gichangi A, Bazant E. Perspectives of basic wheelchair users on improving their access to wheelchair services in Kenya and Philippines: a qualitative study. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2017; 17:22. [PMID: 28818075 PMCID: PMC5561585 DOI: 10.1186/s12914-017-0130-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 07/27/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND The United Nations has called for countries to improve access to mobility devices when needed. The World Health Organization has published guidelines on the provision of manual wheelchairs in less-resourced settings. Yet little is known about the extent to which appropriate wheelchairs are available and provided according to international guidelines. This study's purpose was to describe wheelchair users' experiences receiving services and acquiring wheelchair skills in urban and peri-urban areas of Kenya and the Philippines. METHODS Local researchers in Nairobi and Manila interviewed 48 adult basic wheelchair users, with even distribution of those who had and had not received wheelchair services along with their wheelchair. Recordings were transcribed in the local language and translated into English. The study team coded transcripts for predetermined and emergent themes, using Atlas-ti software. A qualitative content analysis approach was taken with the WHO service delivery process as an organizing framework. RESULTS Wheelchair users frequently described past experiences with ill-fitting wheelchairs and little formal training to use wheelchairs effectively. Through exposure to multiple wheelchairs and self-advocacy, they learned to select wheelchairs suitable for their needs. Maintenance and repair services were often in short supply. Participants attributed shorter duration of wheelchair use to lack of repair. Peer support networks emerged as an important source of knowledge, resources and emotional support. Most participants acknowledged that they received wheelchairs that would have been difficult or impossible for them to pay for, and despite challenges, they were grateful to have some means of mobility. Four themes emerged as critical for understanding the implementation of wheelchair services: barriers in the physical environment, the need for having multiple chairs to improve access, perceived social stigma, and the importance of peer support. CONCLUSIONS Interventions are needed to provide wheelchairs services efficiently, at scale, in an environment facilitating physical access and peer support, and reduced social stigma. TRIAL REGISTRATION Not applicable since this was a descriptive study.
Collapse
Affiliation(s)
- Emma Williams
- Jhpiego, 1615 Thames St, Baltimore, MD 21231-3492 USA
| | | | - Immaculate Obaga
- Jhpiego, 14 Riverside (Off Riverside Drive) Arlington Block, 2nd Floor, P.O Box 66119-00800, Nairobi, Kenya
| | - Brenda Onguti
- Jhpiego, 14 Riverside (Off Riverside Drive) Arlington Block, 2nd Floor, P.O Box 66119-00800, Nairobi, Kenya
| | - Adovich Rivera
- Institute of Health Policy and Development Studies, University of Philippines, Room 105, National Institutes of Health Building, 623 Pedro Gil St., Ermita, 1000 Manila, Philippines
| | - Tyrone Reden L. Sy
- Institute of Health Policy and Development Studies, University of Philippines, Room 105, National Institutes of Health Building, 623 Pedro Gil St., Ermita, 1000 Manila, Philippines
| | - R. Lee Kirby
- Dalhousie University, c/o Room 206, Nova Scotia Rehabilitation Centre Site, 1341 Summer Street, Halifax, NS B3H 4K4 Canada
| | - Jamie Noon
- Noon Design, Box 208, Cerrillos, NM 87010 USA
| | - Deepti Tanuku
- Jhpiego, 1615 Thames St, Baltimore, MD 21231-3492 USA
| | - Anthony Gichangi
- Jhpiego, 14 Riverside (Off Riverside Drive) Arlington Block, 2nd Floor, P.O Box 66119-00800, Nairobi, Kenya
| | - Eva Bazant
- Jhpiego, 1615 Thames St, Baltimore, MD 21231-3492 USA
| |
Collapse
|
9
|
Toro ML, Eke C, Pearlman J. The impact of the World Health Organization 8-steps in wheelchair service provision in wheelchair users in a less resourced setting: a cohort study in Indonesia. BMC Health Serv Res 2016; 16:26. [PMID: 26801984 PMCID: PMC4722611 DOI: 10.1186/s12913-016-1268-y] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/12/2016] [Indexed: 11/28/2022] Open
Abstract
Background For people who have a mobility impairment, access to an appropriate wheelchair is an important step towards social inclusion and participation. The World Health Organization Guidelines for the Provision of Manual Wheelchairs in Less Resourced Settings emphasize the eight critical steps for appropriate wheelchair services, which include: referral, assessment, prescription, funding and ordering, product preparation,fitting and adjusting, user training, and follow-up and maintenance/repairs. The purpose of this study was to investigate how the provision of wheelchairs according to the World Health Organization’s service provision process by United Cerebral Palsy Wheels for Humanity in Indonesia affects wheelchair recipients compared to wait-listed controls. Methods This study used a convenience sample (N = 344) of Children, Children with proxies, Adults, and Adults with proxies who were on a waiting list to receive a wheelchair as well as those who received one. Interviews were conducted at baseline and a 6 month follow-up to collect the following data: Demographics and wheelchair use questions, the World Health Organization Quality of Life-BREF, Functional Mobility Assessment, Craig Handicap Assessment Recording Technique Short Form. The Wheelchair Assessment Checklist and Wheelchair Skills Test Questionnaire were administered at follow up only. Results 167 participants were on the waiting list and 142 received a wheelchair. Physical health domain in the World Health Organization Quality of Life-BREF improved significantly for women who received a wheelchair (p = 0.044) and environmental health improved significantly for women and men who received a wheelchair as compared to those on the waiting list (p < 0.017). Satisfaction with the mobility device improved significantly for Adults with proxies and Children with proxies as compared to the waiting list (p < 0.022). Only 11 % of Adults who received a wheelchair reported being able to perform a “wheelie”. The condition of Roughrider wheelchairs was significantly better than the condition of kids wheelchairs for Children with proxies as measured by the Wheelchair Assessment Checklist (p = 0.019). Conclusions Wheelchair provision according to World Health Organization’s 8-Steps in a less-resourced setting has a range of positive outcomes including increased satisfaction with the mobility device and better quality of life. Wheelchair provision service could be improved by providing more hours of wheelchair skills training. There is a need for outcome measures that are validated across cultures and languages.
Collapse
Affiliation(s)
- Maria L Toro
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.,Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.,Programa de Ingenieria Biomedica, Escuela de Ingeniería de Antioquia y Universidad CES, Envigado, Antioquia, Colombia
| | - Chika Eke
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jonathan Pearlman
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA. .,Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
10
|
Marasinghe KM, Lapitan JM, Ross A. Assistive technologies for ageing populations in six low-income and middle-income countries: a systematic review. BMJ INNOVATIONS 2015; 1:182-195. [PMID: 26688747 PMCID: PMC4680721 DOI: 10.1136/bmjinnov-2015-000065] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 07/25/2015] [Accepted: 08/03/2015] [Indexed: 12/02/2022]
Abstract
Despite the benefits derived from the use of assistive technologies (AT), some parts of the world have minimal or no access to AT. In many low-income and middle-income countries (LMIC), only 5-15% of people who require AT have access to them. Rapid demographic changes will exacerbate this situation as populations over 60 years of age, as well as functional limitations among older populations, in LMIC are expected to be higher than in high-income countries in the coming years. Given both these trends, AT are likely to be in high demand and provide many benefits to respond to challenges related to healthy and productive ageing. Multiple databases were searched for English literature. Three groups of keywords were combined: those relating to AT, ageing population and LMIC selected for this study, namely Brazil, Cambodia, Egypt, India, Turkey and Zimbabwe. These countries are expected to see the most rapid growth in the 65 and above population in the coming years. Results indicate that all countries had AT designed for older adults with existing impairment and disability, but had limited AT that are designed to prevent impairment and disability among older adults who do not currently have any disabilities. All countries have ratified the UN Convention on the Rights of Persons with Disabilities. The findings conclude that AT for ageing populations have received some attention in LMIC as attested by the limited literature results. Analysis of review findings indicate the need for a comprehensive, integrated health and social system approach to increase the current availability of AT for ageing populations in LMIC. These would entail, yet not be limited to, work on: (1) promoting initiatives for low-cost AT; (2) awareness raising and capacity building on AT; (3) bridging the gap between AT policy and practice; and (4) fostering targeted research on AT.
Collapse
Affiliation(s)
| | - Jostacio Moreno Lapitan
- Innovation for Healthy Ageing, World Health Organization Centre for Health Development (WHO Kobe Centre), Kobe, Japan
| | - Alex Ross
- Innovation for Healthy Ageing, World Health Organization Centre for Health Development (WHO Kobe Centre), Kobe, Japan
| |
Collapse
|
11
|
Rispin K, Wee J. Comparison between performances of three types of manual wheelchairs often distributed in low-resource settings. Disabil Rehabil Assist Technol 2015; 10:316-22. [PMID: 25585812 DOI: 10.3109/17483107.2014.1002541] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study was conducted to compare the performance of three types of chairs in a low-resource setting. The larger goal was to provide information which will enable more effective use of limited funds by wheelchair manufacturers and suppliers in low-resource settings. METHODS The Motivation Rough Terrain and Whirlwind Rough Rider were compared in six skills tests which participants completed in one wheelchair type and then a day later in the other. A hospital-style folding transport wheelchair was also included in one test. For all skills, participants rated the ease or difficulty on a visual analogue scale. For all tracks, distance traveled and the physiological cost index were recorded. Data were analyzed using repeated measures analysis of variance. RESULTS The Motivation wheelchair outperformed Whirlwind wheelchair on rough and smooth tracks, and in some metrics on the tight spaces track. Motivation and Whirlwind wheelchairs significantly outperformed the hospital transport wheelchair in all metrics on the rough track skills test. CONCLUSION This comparative study provides data that are valuable for manufacturers and for those who provide wheelchairs to users. The comparison with the hospital-style transport chair confirms the cost to users of inappropriate wheelchair provision. Implications for Rehabilitation For those with compromised lower limb function, wheelchairs are essential to enable full participation and improved quality of life. Therefore, provision of wheelchairs which effectively enable mobility in the cultures and environments in which people with disabilities live is crucial. This includes low-resource settings where the need for appropriate seating is especially urgent. A repeated measures study to measure wheelchair performances in everyday skills in the setting where wheelchairs are used gives information on the quality of mobility provided by those wheelchairs. This study highlights differences in the performance of three types of wheelchairs often distributed in low-resource settings. This information can improve mobility for wheelchair users in those settings by enabling wheelchair manufacturers to optimize wheelchair design and providers to optimize the use of limited funds.
Collapse
Affiliation(s)
- Karen Rispin
- Department of Biology, LeTourneau University , Longview, TX , USA and
| | | |
Collapse
|
12
|
Rios A, Miguel Cruz A, Guarín MR, Caycedo Villarraga PS. What factors are associated with the provision of assistive technologies: the Bogotá D.C. case. Disabil Rehabil Assist Technol 2014; 9:432-44. [PMID: 25007129 DOI: 10.3109/17483107.2014.936053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To examine what demographics and clinical factors are associated with the provision of assistive technology (AT) devices in a low-income country. METHOD Retrospective cross-sectional exploratory study design including 15 of the 20 localities across Bogotá D.C., Colombia, a city with 6,776,009 inhabitants. RESULTS The type of AT device provided was significantly dependent (p < 0.001) on the client's diagnosis, impairment, age, and socio-economic strata, whether the client has a care giver, the geographical zone in which the client lives, the year of the AT provision, and the total number of AT delivered. In contrast, the client's gender (p > 0.05) and the client's affiliated type of healthcare service had no effect. In addition to that, the client's age, the client's socio-economic strata, the number of AT devices provided to the client, and the diagnostic type were the factors with the strongest level of association with the type of AT device provided. CONCLUSIONS Our research showed that the provision of AT in Bogotá D.C. prioritizes both people who are at the highest levels of vulnerability, and as many people as possible with the budget. That is, the low socio-economic strata, younger and older people, and the provision of at least one AT device. IMPLICATIONS FOR REHABILITATION Provision of AT is intended for equal opportunities for the social participation of people with a disability. Also, people with disabilities have the right to access AT regardless of the type of limitation, gender, race, age or region where they live. Research regarding AT in developing countries is scarce; thus, there is a need to conduct studies in such contexts. This study provides scientific evidence to support the development of models, approaches and strategies of AT provision in low-income countries where resources for rehabilitation are scarce.
Collapse
Affiliation(s)
- Adriana Rios
- School of Medicine and Health Sciences, Universidad del Rosario , Bogotá D.C , Colombia
| | | | | | | |
Collapse
|
13
|
Rispin K, Wee J. A Paired Outcomes Study Comparing Two Pediatric Wheelchairs for Low-Resource Settings: The Regency Pediatric Wheelchair and a Similarly Sized Wheelchair Made in Kenya. Assist Technol 2014; 26:88-95. [DOI: 10.1080/10400435.2013.837847] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
14
|
Rushton PW, Kirby RL, Miller WC. Manual wheelchair skills: objective testing versus subjective questionnaire. Arch Phys Med Rehabil 2012; 93:2313-8. [PMID: 22728701 DOI: 10.1016/j.apmr.2012.06.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Revised: 05/07/2012] [Accepted: 06/04/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To test the hypothesis that the total scores of the Wheelchair Skills Test (WST) version 4.1, an observer-rated scale of wheelchair performance, and the Wheelchair Skills Test Questionnaire (WST-Q) version 4.1, a self-report of wheelchair skills, are highly correlated. We also anticipate that the WST-Q scores will be slightly higher, indicating an overestimation of capacity to perform wheelchair skills as compared with actual capacity. DESIGN A cross-sectional, within-subjects comparison design. SETTING Three Canadian cities. PARTICIPANTS Convenience sample of community-dwelling, experienced manual wheelchair users (N=89) ranging in age from 21 to 94 years. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Participants completed the subjective WST-Q version 4.1 followed by the objective WST version 4.1 in 1 testing session. RESULTS The mean ± SD total percentage scores for WST and WST-Q were 79.5%±14.4% and 83.0%±12.1% for capacity and 99.4%±1.5% and 98.9%±2.5% for safety, respectively. The correlations between the WST and WST-Q scores were ρ=.89 (P=.000) for capacity and ρ=.12 (P=.251) for safety. WST-Q total score mean differences were an average of 3.5%±6.5% higher than WST scores for capacity (P=.000) and .52%±2.8% lower for safety (P=.343). For the 32 individual skills, the percentage agreement between the WST and WST-Q scores ranged from 82% to 100% for capacity and from 90% to 100% for safety. CONCLUSION WST and WST-Q version 4.1 capacity scores are highly correlated although the WST-Q scores are slightly higher. Decisions on which of these assessments to use can safely be based on the circumstances and objectives of the evaluation.
Collapse
Affiliation(s)
- Paula W Rushton
- Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada.
| | | | | |
Collapse
|
15
|
Beyene NM, Steinfeld A, Pearlman J, Cooper RA. Exploration of health perceptions and assistive technology use by driving status as related to transportation independence in New Delhi, India. Disabil Rehabil Assist Technol 2012; 7:314-22. [DOI: 10.3109/17483107.2011.635328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|