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Flemmer CL, Flemmer RC. Reinventing the wheel for a manual wheelchair. Disabil Rehabil Assist Technol 2024; 19:2166-2177. [PMID: 37916314 DOI: 10.1080/17483107.2023.2272851] [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: 12/09/2022] [Revised: 08/22/2023] [Accepted: 10/13/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE Standard manual wheelchairs (MWCs) are inefficient and pushrim propulsion may cause progressive damage and pain to the user's arms. We describe a wheel for a MWC with a novel propulsion mechanism. METHODS The wheel has two modes of operation called "Standard" mode and "Run" mode. In Run mode, the wheelchair is propelled forward by pushing a compliant handle forward and then pulling it back, both strokes contributing to forward propulsion. We report the propulsive force and preliminary testing on a rough outdoor circuit by three able-bodied participants. RESULTS In Run mode, the peak applied force is reduced to 30% and the maximum force gradient is reduced to 10% of that for standard pushrim propulsion, for the same work output. The travel time for the 1.06 km outdoor circuit is about 60% of that for a brisk walk and about 40% of that for pushrim propulsion. At a propulsion speed of 1 m/s, the cardiovascular effort in Run mode is 56% of that for pushrim propulsion. Automatic hill-hold in Run mode improves safety when ascending slopes. The mechanism has three gears so that it can be used by people with widely varying strength and fitness. Folding the handle away converts the operation to Standard mode with the conventional pushrim propulsion, supplemented by three gears. CONCLUSIONS Despite the increased weight, width and friction, the bimodal geared wheels facilitate wheelchair travel on challenging paths. This may bring significant improvement to the quality of life of MWC users.
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Affiliation(s)
- Claire L Flemmer
- School of Built Environment, Massey University, Palmerston North, New Zealand
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Wołoszyn N, Wiśniowska-Szurlej A, Grzegorczyk J, Kwolek A. The impact of physical exercises with elements of dance movement therapy on the upper limb grip strength and functional performance of elderly wheelchair users living in nursing homes - a randomized control trial. BMC Geriatr 2021; 21:423. [PMID: 34247582 PMCID: PMC8274008 DOI: 10.1186/s12877-021-02368-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 06/30/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Over the last few decades, the quality of care and the quality of life of nursing home (NH) residents have significantly improved, but insufficient physical activity and social involvement still represent substantial challenges in modern nursing facilities. The main aim of this research was to assess the influence of physical exercises with dance movement therapy (DMT) elements on strength and other fitness components of the upper limbs and the overall functional performance of NH residents in wheelchairs compared to standard exercise programmes and usual care. METHOD The study participants were persons aged 68-85 who lived in NH and used manual wheelchairs as a primary means of mobility. Individuals meeting the inclusion criteria were assigned to one of the three groups: Group 1, basic exercise/BE group (n = 55); group 2, physical exercises with elements of dance movement therapy/PED group (n = 55); and group 3, control group, usual care/CO group (n = 55). The intervention for both exercising groups consisted of a 30-min session, two times a week, for 12 weeks in total. Outcome assessments were performed at baseline, 12 weeks after baseline (immediately after the intervention) and 24 weeks after baseline (12 weeks after the intervention). The main outcome was observed for hand grip strength (HGS), while secondary outcomes for box and block test (BBT), arm curl test (ACT), back scratch test (BS), chair sit-and-reach (CSR), peak expiratory flow (PEF), Barthel Index (BI), Berg Balance Scale (BBS) and the range of motion of the shoulder. RESULTS Prior to the start of the exercise programmes, all the tested groups were homogeneous. After 12 weeks the PED group presented higher statistically significant scores in HGSL, BBT, ACT, BS, CSR, BI, BBS: p < 0.001 and HGSR: p = 0.01, compared to the BE group. After 24 weeks from the beginning of the intervention the comparison between the PED group and the BE group showed statistically significant differences (p < 0.001) in favour of PED group in almost all areas: HGSR, HGSL, BBT: ACT, PEF, BS, CSR, BI. After 12 and 24 weeks both intervention groups performed better than the CO in all measures except for Katz ADL and shoulder extension. CONCLUSION Twelve weeks of physical exercises had beneficial effects on the strength and fitness of the upper limbs and overall functional performance in both exercise groups. This study demonstrated that group performing physical exercises with elements of DMT obtained statistically better scores in the majority of analysed domains than other groups. TRIAL REGISTRATION The study was registered in the Sri Lanka Clinical Trials Registry (Registration Number - SLCTR/2018/014 - Date of Registration 16/05/2018. Accessed on https://slctr.lk/trials/1045 ).
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Affiliation(s)
- Natalia Wołoszyn
- Institute of Health Sciences, Medical College of Rzeszow University, Warzywna 1A Street, 35-310 Rzeszów, Poland
| | | | - Joanna Grzegorczyk
- Institute of Medicine, Medical College of Rzeszow University, Warzywna 1A Street, 35-310 Rzeszów, Poland
| | - Andrzej Kwolek
- Institute of Health Sciences, Medical College of Rzeszow University, Warzywna 1A Street, 35-310 Rzeszów, Poland
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Bourassa S, Best KL, Racine M, Borisoff J, Leblond J, Routhier F. Use of actigraphy to measure real-world physical activities in manual wheelchair users. J Rehabil Assist Technol Eng 2020; 7:2055668320907814. [PMID: 32292592 PMCID: PMC7144670 DOI: 10.1177/2055668320907814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 01/14/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction The benefits of physical activity for manual wheelchair users are well-known. The purpose of this study was to validate actigraphy to objectively measure physical activity intensity among manual wheelchair users. Method An experimental design was used. Adult manual wheelchair users wore a GT3X actigraph on their non-dominant arm while completing eight physical activities of low (reading), moderate (propelling -- flat) and high (propelling -- steep ramp) intensity. Heart rate and rating of perceived exertion were collected at the end of each physical activity. Distribution of data were examined and used to determine the type of repeated measures (parametric vs. non-parametric). A categorical principal component analysis was performed to determine the amount of variability explained by actigraphy, heart rate and rating of perceived exertion. Activity count cut-points were estimated using bootstrapping methods. Results Twenty-eight manual wheelchair users completed the study. Actigraphy, heart rate and rating of perceived exertion co-varied as physical activity intensity changed. Activity counts for low-intensity and medium-intensity physical activities were estimated to be 0 to 45 and 45 to 100 activity counts per second, respectively. Activity counts' ranges for high-intensity physical activities were not clear. Conclusion Combining actigraphy and rating of perceived exertion could be an easy and reliable method to measure the intensity of real-world activities. Further research is needed confirm cut-points for physical activity intensity.
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Affiliation(s)
- Sophie Bourassa
- Department of Rehabilitation, Université Laval, Quebec City, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de réadaptation en déficience physique de Québec, Quebec City, Canada
| | - Krista L Best
- Department of Rehabilitation, Université Laval, Quebec City, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de réadaptation en déficience physique de Québec, Quebec City, Canada
| | - Maxence Racine
- Department of Rehabilitation, Université Laval, Quebec City, Canada.,Department of Mechanical Engineering, Université Laval, Quebec City, Canada
| | - Jaimie Borisoff
- International Collaboration on Repair Discoveries (ICORD), Vancouver, Canada.,Rehabilitation Engineering Design Laboratory, British Columbia Institute of Technology, Burnaby, Canada
| | - Jean Leblond
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de réadaptation en déficience physique de Québec, Quebec City, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec City, Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de réadaptation en déficience physique de Québec, Quebec City, Canada
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Best KL, Routhier F, Sweet SN, Arbour-Nicitopoulos KP, Borisoff JF, Noreau L, Martin Ginis KA. The Smartphone Peer Physical Activity Counseling (SPPAC) Program for Manual Wheelchair Users: Protocol of a Pilot Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e69. [PMID: 28446419 PMCID: PMC5425772 DOI: 10.2196/resprot.7280] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/17/2017] [Accepted: 03/17/2017] [Indexed: 01/08/2023] Open
Abstract
Background Physical activity (PA) must be performed regularly to accrue health benefits. However, the majority of manual wheelchair users do not meet PA recommendations. Existing community-based PA programs for manual wheelchair users appear to work, but effect sizes are small and retention is low. Existing PA programs may not fully implement some psychosocial factors that are strongly linked with PA (eg, autonomy). The use of peers and mobile phone technology in the Smartphone Peer PA Counseling (SPPAC) program represents a novel approach to cultivating a PA-supportive environment for manual wheelchair users. Objective The primary objective is to compare change in objective PA between the experimental (SPPAC) and control groups from baseline to postintervention (10 weeks) and follow-up (3 months). Changes in and relationships between subjective PA, wheelchair skills, motivation, self-efficacy (for overcoming barriers to PA for manual wheelchair use), satisfaction of psychological needs for PA, and satisfaction with PA participation will be explored (secondary outcome). Program implementation will be explored (tertiary objective). Methods A total of 38 community-living manual wheelchair users (≥18 years) will be recruited in a randomized controlled trial (RCT). Participants in both the control and experimental groups will receive existing PA guidelines. Participants in the experimental group will also receive the SPPAC program: 14 sessions (~30 min) over a 10-week period delivered by a peer trainer using a mobile phone. PA activities will be based on individuals’ preferences and goals. Implementation of important theoretical variables will be enforced through a peer-trainer checklist. Outcomes for objective PA (primary) and subjective PA, wheelchair skills, motivation, self-efficacy, satisfaction of psychological needs, and satisfaction with participation will be collected at three time points (baseline, postintervention, follow-up). Multiple imputations will be used to treat missing data. A mixed-model ANCOVA will be conducted, controlling for covariates (primary and secondary objectives). The strength and direction of the relationships between the primary and secondary outcomes will be explored (secondary objective). Descriptive and content analysis will be used to appraise program implementation (tertiary objective). Results Funding has been obtained from the Craig Neilsen Foundation and the Canadian Disability Participation Project, with additional funds being sought from the Canadian Institute for Health Research and Fonds de Recherche du Québec-Santé. Pilot evaluation of intervention implementation is currently underway, with enrollment anticipated to begin early 2018. Conclusions There may be substantial benefits for the SPPAC program including limited burden on health care professionals, decreased barriers (eg. accessibility, transportation), development of peer social supports, and potential cost savings related to physical inactivity. Before conducting a large and expensive multisite RCT within a small heterogeneous population of manual wheelchair users, a pilot study affords a prudent step to establishing an adequate study protocol and implementation strategies. Trial Registration ClinicalTrials.gov NCT02826707; https://clinicaltrials.gov/ct2/show/NCT02826707 (Archived by WebCite at http://www.webcitation.org/6pqIc14dU)
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Affiliation(s)
- Krista L Best
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada.,Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, QC, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada.,Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, QC, Canada
| | - Shane N Sweet
- Department of Kinesiology and Physical Education, McGill University, Montreal, QC, Canada.,Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR)., Montréal, QC, Canada
| | | | - Jaimie F Borisoff
- International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada.,Rehabilitation Engineering Design Laboratory, British Columbia Institute of Technology, Burnaby, BC, Canada
| | - Luc Noreau
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada.,Centre for interdisciplinary research in rehabilitation and social integration, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Institut de réadaptation en déficience physique de Québec, Quebec City, QC, Canada
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Pilot Study of a Peer-Led Wheelchair Training Program to Improve Self-Efficacy Using a Manual Wheelchair: A Randomized Controlled Trial. Arch Phys Med Rehabil 2016; 97:37-44. [DOI: 10.1016/j.apmr.2015.08.425] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 08/17/2015] [Accepted: 08/21/2015] [Indexed: 10/23/2022]
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Learmonth YC, Rice IM, Ostler T, Rice LA, Motl RW. Perspectives on Physical Activity Among People with Multiple Sclerosis Who Are Wheelchair Users: Informing the Design of Future Interventions. Int J MS Care 2015; 17:109-19. [PMID: 26052256 DOI: 10.7224/1537-2073.2014-018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND People with advanced multiple sclerosis (MS) are less physically active than those with milder forms of the disease, and wheelchair use has a negative association with physical activity participation. Thus, wheelchair users with MS are doubly disadvantaged for accruing the benefits of physical activity and exercise. Appropriate physical activity and exercise interventions are needed for this population. METHODS We undertook a qualitative study to explore the meanings, motivations, and outcomes of physical activity in wheelchair users with MS. We sought to understand daily opportunities to accumulate physical activity and exercise, and to identify perceived barriers, facilitators, and benefits that might inform the design of future interventions. RESULTS We interviewed 15 wheelchair users (mean age, 52 ± 8.8 years; n = 12 women). Data were transcribed and analyzed to identify and explore common themes. Our first theme was the reduced opportunity to participate in physical activity due to participants' dependence on mobility devices, environmental adaptations, and tangible support. Our second theme was the importance of incorporating physical activity and exercise into the everyday environment, highlighting the need for adaptive exercise and accessible environments. This indicated the need to incorporate behavior change modulators into physical activity and exercise interventions for those with advanced MS. Health-care professionals played an important role in promoting increased physical activity and exercise participation in those with advanced MS. CONCLUSIONS Our findings may inform future interventions to increase initiation and maintenance of physical activity and exercise among people with advanced MS.
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Affiliation(s)
- Yvonne C Learmonth
- Department of Kinesiology and Community Health (YCL, IMR, LAR, RWM) and the School of Social Work (TO), University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Ian M Rice
- Department of Kinesiology and Community Health (YCL, IMR, LAR, RWM) and the School of Social Work (TO), University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Teresa Ostler
- Department of Kinesiology and Community Health (YCL, IMR, LAR, RWM) and the School of Social Work (TO), University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Laura A Rice
- Department of Kinesiology and Community Health (YCL, IMR, LAR, RWM) and the School of Social Work (TO), University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
| | - Robert W Motl
- Department of Kinesiology and Community Health (YCL, IMR, LAR, RWM) and the School of Social Work (TO), University of Illinois at Urbana-Champaign, Urbana-Champaign, IL, USA
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Best KL, Miller WC, Eng JJ, Routhier F, Goldsmith C. Randomized controlled trial protocol feasibility: The Wheelchair Self-Efficacy Enhanced for Use (WheelSeeU). The Canadian Journal of Occupational Therapy 2015; 81:308-19. [PMID: 25702375 DOI: 10.1177/0008417414546743] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Manual wheelchairs (MWCs) can improve mobility and social participation for individuals who experience difficulty walking; however, older adults receive little training for wheelchair use. The Wheelchair Self-Efficacy Enhanced for Use (WheelSeeU) research program provides peer-led training that may positively influence wheelchair use while reducing clinician burden. PURPOSE The purpose of this study is to evaluate the feasibility and clinical outcomes of WheelSeeU. METHOD A randomized control trial (RCT) recruits and randomly assigns 40 MWC users (55+ years). Feasibility indicators assessing process, resource, management, and treatment issues are measured, and clinical outcomes (wheelchair skills, safety, confidence, mobility, social participation, quality of life, health utility) are collected at three time points. IMPLICATIONS WheelSeeU provides an innovative approach for teaching wheelchair skills to an aging population that may improve wheelchair use and decrease clinician burden. Since RCTs are expensive and challenging in rehabilitation, establishing feasibility prior to larger effectiveness trials is prudent.
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Smith EM, Sakakibara BM, Miller WC. A review of factors influencing participation in social and community activities for wheelchair users. Disabil Rehabil Assist Technol 2014; 11:361-74. [PMID: 25472004 PMCID: PMC4581875 DOI: 10.3109/17483107.2014.989420] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/15/2014] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To systematically identify factors associated with participation in social and community activities for adult wheelchair users (WCUs). DATA SOURCES PubMed/MEDLINE, CINAHL, PsycINFO and EMBASE. STUDY SELECTION Quantitative and qualitative peer-reviewed publications were included, which were written in English, reported original research and investigated factors associated with social and community participation in adult WCUs. DATA EXTRACTION The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Factors were organized using the International Classification of Functioning, Disability and Health (ICF). DATA SYNTHESIS Thirty-five studies were selected: two of power WCUs, 10 of manual WCUs and 23 of both. Six qualitative studies, ranging in quality from 8/10 to 9/10 and 29 quantitative studies were included, ranging in quality from 4/15 to 11/15. Fifteen body function, 4 activity, 5 participation, 15 environmental and 14 personal factors were found to be associated with social and community participation. CONCLUSIONS Social and community participation of WCUs is associated with factors from all ICF domains. Wheelchair factors, accessibility, skills with wheelchair use, pain, finances and education are modifiable factors frequently reported to be associated with participation. Experimental research focusing on modifiable factors is needed to further our understanding of factors influencing participation among WCUs. Implications for Rehabilitation Wheelchair factors, including comfort and durability, are associated with participation and may be targeted in clinical intervention. Wheelchair skills are clinically modifiable and have been shown to improve participation in manual wheelchair users. Body functions (e.g. confidence, depression and fatigue) and personal factors (e.g. finances and level of education) may be considered for clinical intervention.
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Affiliation(s)
- Emma M. Smith
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia
- GF Strong Rehabilitation Research Lab, Vancouver, BC, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute
| | - Brodie M. Sakakibara
- GF Strong Rehabilitation Research Lab, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute
| | - William C. Miller
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia
- GF Strong Rehabilitation Research Lab, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia
- Department of Occupational Sciences and Occupational Therapy, Faculty of Medicine, University of British Columbia
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute
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Escobar-Viera CG, Jones PD, Schumacher JR, Hall AG. Association between living alone and physical inactivity among people with and without disability, Florida Behavioral Risk Factor Surveillance System, 2009. Prev Chronic Dis 2014; 11:E173. [PMID: 25299979 PMCID: PMC4193062 DOI: 10.5888/pcd11.140182] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
People with disability may be at risk of developing diseases due to physical inactivity; social support from family and friends is positively related to engaging in regular physical activity. We compared the association between living alone and engagement in physical activity among people with and without disability in Florida. We used multivariate logistical regression to analyze 2009 Florida Behavioral Risk Factor Surveillance System data (n = 10,902) to assess differences in physical activity in disability levels for respondents who lived alone versus those who did not. Respondents with a disability were less likely to engage in physical activity than were people without a disability, regardless of disability type, and the lowest rates of engaging in physical activity were found for people with disability who lived alone. Public health efforts should consider the role of household composition when targeting physical activity interventions among people with disability.
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Affiliation(s)
- César G Escobar-Viera
- Department of Health Services, Research, Management and Policy, University of Florida, College of Public Health and Health Professions, PO Box 100195, Gainesville, FL 32610-0195. E-mail:
| | - Patrice D Jones
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida
| | - Jessica R Schumacher
- Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin
| | - Allyson G Hall
- Department of Health Services Research, Management and Policy, University of Florida, Gainesville, Florida
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Sakakibara BM, Miller WC, Routhier F, Backman CL, Eng JJ. Association between self-efficacy and participation in community-dwelling manual wheelchair users aged 50 years or older. Phys Ther 2014; 94:664-74. [PMID: 24415774 PMCID: PMC4016678 DOI: 10.2522/ptj.20130308] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 01/03/2014] [Indexed: 11/17/2022]
Abstract
BACKGROUND Self-efficacy with using a wheelchair is an emerging construct in the wheelchair-use literature that may have implications for the participation frequency in social and personal roles of wheelchair users. OBJECTIVES The aim of this study was to investigate the direct and mediated effects of self-efficacy on participation frequency in community-dwelling manual wheelchair users aged 50 years or older. DESIGN A cross-sectional study was conducted. METHODS Participants were community-dwelling wheelchair users (N=124), 50 years of age or older (mean=59.7 years), with at least 6 months of experience with wheelchair use. The Late-Life Disability Instrument, the Wheelchair Use Confidence Scale, the Life-Space Assessment, and the Wheelchair Skills Test-Questionnaire Version measured participation frequency, self-efficacy, life-space mobility, and wheelchair skills, respectively. Multiple regression analyses with bootstrapping were used to investigate the direct and mediated effects. The International Classification of Functioning, Disability and Health was used to guide the analyses. RESULTS Self-efficacy was a statistically significant determinant of participation frequency and accounted for 17.2% of the participation variance after controlling for age, number of comorbidities, and social support. The total mediating effect by life-space mobility, wheelchair skills, and perceived participation limitations was statistically significant (point estimate=0.14; bootstrapped 95% confidence interval=0.04, 0.24); however, the specific indirect effect by the wheelchair skills variable did not contribute to the total effect above and beyond the other 2 mediators. The mediated model accounted for 55.0% of the participation variance. LIMITATIONS Causality cannot be established due to the cross-sectional nature of the data, and the self-report nature of our data from a volunteer sample may be influenced by measurement bias or social desirability, or both. CONCLUSION Self-efficacy directly and indirectly influences the participation frequency in community-dwelling manual wheelchair users aged 50 years or older. Development of interventions to address low self-efficacy is warranted.
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Affiliation(s)
- Brodie M Sakakibara
- B.M. Sakakibara, PhD, Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, and Rehabilitation Research Program, G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada
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Sakakibara BM, Routhier F, Lavoie MP, Miller WC. Reliability and validity of the French-Canadian Late Life Function and Disability Instrument in community-living wheelchair-users. Scand J Occup Ther 2013; 20:365-73. [PMID: 23786550 PMCID: PMC4019580 DOI: 10.3109/11038128.2013.810304] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine the test-retest reliability, standard error of measurement, minimal detectable change, construct validity, and ceiling and floor effects in the French-Canadian Late Life Function and Disability Instrument (LLFDI-F). METHOD The LLFDI-F is a measure of activity (i.e. physical functioning of upper and lower extremities), and participation (i.e. frequency of and limitations with). The measure was administered over the telephone to a sample of community-living wheelchair-users, who were 50 years of age and older, in this 10-day retest methodological study. The sample (n = 40) was mostly male (70%), had a mean age of 62.2 years, and mean experience with using a wheelchair of 20.2 years. Sixty-five percent used a manual wheelchair. RESULTS The test-retest intraclass correlation coefficients (ICC2,1) for the participation component ranged from 0.68 to 0.90 and from 0.74 to 0.97 for the activity component. Minimal detectable changes ranged from 7.18 to 22.56 in the participation component and from 4.71 to 16.19 in the activity component. Mann-Whitney U-tests revealed significant differences between manual and power wheelchair-users in the personal and instrumental role domains, and all areas in the activity component. CONCLUSION There is support for the test-retest reliability and construct validity of the LLFDI-F in community-living wheelchair-users, 50 years of age and older. However, because the majority of items in the lower-extremity domains of the activity component do not account for assistive device use, they are not recommended for use with individuals who have little or no use of their lower-extremities.
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Affiliation(s)
- Brodie M. Sakakibara
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, BC, Canada
| | - François Routhier
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de réadaptation en déficience physique de Québec, Québec City, QC, Canada
| | - Marie-Pier Lavoie
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Institut de réadaptation en déficience physique de Québec, Québec City, QC, Canada
| | - William C. Miller
- Graduate Program in Rehabilitation Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- GF Strong Rehabilitation Research Lab, Vancouver Coastal Research Institute, Vancouver, BC, Canada
- Department of Occupational Sciences and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Tredal I, Soares JJF, Sundin Ö, Viitasara E, Melchiorre MG, Torres-Gonzales F, Stankunas M, Lindert J, Ioannidi-Kapolou E, Barros H. Alcohol use among abused and non-abused older persons aged 60–84 years: An European study. DRUGS-EDUCATION PREVENTION AND POLICY 2013. [DOI: 10.3109/09687637.2012.751087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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