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Goldberg M, Rushton P, Kirby RL, Muñera S, Kandavel K, Pearlman J, Tawashy A. Wheelchair service provision content in professional rehabilitation organisations' standards documents and contemporary initiatives: a rapid review. Disabil Rehabil Assist Technol 2024; 19:78-89. [PMID: 35446737 DOI: 10.1080/17483107.2022.2063421] [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: 09/13/2021] [Accepted: 04/02/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE We sought to identify opportunities, challenges, contemporary initiatives and strategies for preparing entry-level practitioners who are competent at the basic level of wheelchair service provision across four key international professional rehabilitation organisations as revealed by their educational standards, relevant guidelines and policy statements, and other publicly available information. METHOD A rapid review was conducted in 2021 from the International Society of Physical and Rehabilitation Medicine (ISPRM), the International Society for Prosthetics and Orthotics (ISPO), World Physiotherapy, and the World Federation of Occupational Therapists (WFOT). Additional grey-literature and grey-data searches were conducted to identify contemporary initiatives that may support competency development in wheelchair service provision. RESULTS A total of 17 standards, guidelines, and policy statement documents were selected for detailed review. Each of the four organisations published at least one document containing language relating to wheelchair service provision. Twelve contemporary initiatives relating to wheelchair service provision were identified from the grey literature across the four organisations. Six additional initiatives were identified from the organisations' social media accounts. Themes emerged in the areas of contemporary content, opportunities, and challenges. CONCLUSION Global standardisation could help harmonise professional societies' approach to training wheelchair service providers.IMPLICATIONS FOR REHABILITATIONThere is a need to provide more descriptive content on wheelchair service provision in education and service standards and related documents to influence what is taught in professional rehabilitation programs that are accredited or approved by professional rehabilitation organisations.The organisations' networks are vast and may also help to promote additional continuing education in this area.
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Affiliation(s)
- Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Paula Rushton
- International Society of Wheelchair Professionals, Medellin, Colombia
- Université de Montréal, Montreal, Canada
| | - R Lee Kirby
- International Society of Wheelchair Professionals, Medellin, Colombia
- Dalhousie University, Halifax, Canada
| | - Sara Muñera
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Krithika Kandavel
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Amira Tawashy
- International Society of Wheelchair Professionals, Medellin, Colombia
- Dalhousie University, Halifax, Canada
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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.
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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
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Garcia-Mendez Y, D'Innocenzo M, Pearlman J, Vásquez-Gabela S, Rosen P, Rodriguez-Funes MV, Kirby RL, Mhatre A. Effects of the WHO 8-step wheelchair-service-delivery process on wheelchair users in El Salvador: a cohort study. Disabil Rehabil Assist Technol 2023:1-12. [PMID: 37740696 DOI: 10.1080/17483107.2023.2256808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/05/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE To test the hypotheses that, after the delivery of manual wheelchairs following the WHO 8-step service-delivery process, wheelchair-related health and quality of life, wheelchair skills, wheelchair use, and poverty probability would improve; and that the number of wheelchair repairs required, adverse events, caregiver burden, and the level of assistance provided would decrease. METHODS This was a longitudinal, prospective within-subject study including 247 manual wheelchair users, and 119 caregivers, in El Salvador who received a wheelchair following the WHO 8-step process as well as maintenance reminders. Outcome measurements were performed via structured questionnaires and dataloggers at the initial assessment, at wheelchair delivery, and at 3- and 6-month follow-up. RESULTS Significant improvements in wheelchair-related health indicators (all with p < 0.004) and quality of life (p = 0.001), and a significant reduction in national and "extreme" poverty probability (p = 0.004 and p = 0.012) were observed by six months. Wheelchair use significantly decreased (p = 0.011 and p = 0.035) and wheelchair skills increased (p = 0.009). Caregiver burden did not change (p = 0.226) but the number of activities of daily living (ADLs) that required no assistance significantly increased (p = 0.001) by three months and those who required complete assistance decreased (p = 0.001). No changes were observed in wheelchair repairs (p = 0.967) and breakdowns over time with new wheelchairs. CONCLUSIONS Wheelchair service delivery using the WHO 8-step process on manual wheelchair users in El Salvador has positive effects on health and quality of life, wheelchair skills, caregiver assistance levels, and poverty. Further research is needed to determine the relative contributions of the intervention components.Implications for RehabilitationProviding manual wheelchairs using the 8-step process of the WHO has benefits on health and quality of life, wheelchair skills, caregiver assistance levels, and poverty.The WHO 8-steps service delivery process for manual wheelchairs can be used in less-resourced settings.
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Affiliation(s)
| | - Megan D'Innocenzo
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie Vásquez-Gabela
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Perth Rosen
- Momentum Wheels for Humanity, Chatsworth, CA, USA
| | | | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
| | - Anand Mhatre
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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Short N, Peters HS, Eckert J, Grady N, Kline E, Weber H. Impact of Seating and Mobility Services for Individuals With Disabilities in El Salvador. Am J Occup Ther 2023; 77:7704205140. [PMID: 37540763 DOI: 10.5014/ajot.2023.050150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Abstract
IMPORTANCE Outcomes research on the impact of seating and mobility services delivered using a short-term medical mission (STMM) model is limited. OBJECTIVE To evaluate the impact of seating and mobility services on the occupational performance of individuals with disabilities in El Salvador. DESIGN One-group retrospective pretest-posttest. SETTING Clinical (El Salvador). PARTICIPANTS Individuals with disabilities in El Salvador. OUTCOMES AND MEASURES Survey and the standardized Wheelchair Outcome Measure (WhOM) for those who received a wheelchair as their mobility device. METHOD Participants rated satisfaction with performance of preferred in-home and out-of-home occupations on the WhOM before and after receiving seating and mobility services. RESULTS For most survey questions assessing the impact on activities of daily living, more than 86% of the respondents selected agree or strongly agree. Nearly half of the respondents reported that questions regarding work and education were not applicable. Participants' WhOM scores (n = 86) demonstrated a statistically significant improvement in performance satisfaction for both in-home (p < .001; d > 1) and out-of-home (p < .001; d > 1) occupations after they received services, with a huge effect size (d > 2). CONCLUSIONS AND RELEVANCE The findings suggest that seating and mobility services provided by rehabilitation professionals in El Salvador improved occupational performance for people with disabilities. Compared with STMMs that solely provide equipment, the findings emphasize the importance of professional service provision with education and training as best practice. What This Article Adds: Seating and mobility services delivered through a STMM model may improve occupational performance for individuals with disabilities. However, STMMs should be carefully planned in collaboration with in-country partners, provide customized seating systems, and include education and training from licensed rehabilitation professionals.
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Affiliation(s)
- Nathan Short
- Nathan Short, PhD, OTD, OTR/L, CHT, is Associate Professor of Occupational Therapy, Huntington University, Fort Wayne, IN;
| | - Heather St Peters
- Heather St. Peters, PhD, is Associate Professor of Occupational Therapy, Huntington University, Fort Wayne, IN
| | - Jonah Eckert
- Jonah Eckert, BA, OTD, was Doctoral Student, Doctoral Program in Occupational Therapy, Fort Wayne, IN, at the time this research was conducted
| | - Natalie Grady
- Natalie Grady, BS, OTD, was Doctoral Student, Doctoral Program in Occupational Therapy, Fort Wayne, IN, at the time this research was conducted
| | - Erin Kline
- Erin Kline, BS, OTD, was Doctoral Student, Doctoral Program in Occupational Therapy, Fort Wayne, IN, at the time this research was conducted
| | - Holly Weber
- Holly Weber, BS, OTD, was Doctoral Student, Doctoral Program in Occupational Therapy, Fort Wayne, IN, at the time this research was conducted
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D’Innocenzo ME, Pearlman JL, Garcia-Mendez Y, Vasquez-Gabela S, Zigler C, Rosen P, Dewi EH, Praptoraharjo I, Mhatre A. Exploratory investigation of the outcomes of wheelchair provision through two service models in Indonesia. PLoS One 2021; 16:e0228428. [PMID: 34061868 PMCID: PMC8168880 DOI: 10.1371/journal.pone.0228428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/27/2021] [Indexed: 11/18/2022] Open
Abstract
The World Health Organization (WHO) estimates that only 17-37% of the approximately 77 million people who need a wheelchair have access to one. Many organizations are trying to address this need through varying service delivery approaches. For instance, some adhere to WHO's recommended 8-steps service approach while others provide wheelchairs with little to no service. There is limited and sometimes conflicting evidence of the impact of the WHO's recommendations on the outcomes of wheelchair provision. To help build this evidence, we \explored outcomes of two groups of users who received their wheelchairs through two service models over time. The 8-Steps group (n = 118) received a wheelchair selected from a range of models from service providers trained using the WHO process, and the standard of care (SOC) group (n = 24) received hospital-style wheelchairs and without clinical service. Interviews were conducted at baseline and at follow-up 3 to 6 months after provision, to collect data about wheelchair usage, satisfaction, skills, maintenance and repairs, and life satisfaction. Across-group statistical comparisons were not appropriate due to significant differences between groups. In general, participants used their wheelchairs every day but reported very low mobility levels (<500 meters for the 8-steps group, and <100 meters for the SOC group.) The 8-steps group used their wheelchair for either between 1-3 hours per day, or more than 8 hours per day. The SOC used it between 1 and 3 hours per day. Overall, wheelchair usage and wheelchair skills decreased over the 3- to 6-month data collection timeline. Wheelchair breakdowns were common in both groups emphasizing the need for maintenance, occurring more frequently in the 8-Steps (28.8%) compared to the SOC group (8%), and emphasizing the need for maintenance services. No significant differences were found when comparing device satisfaction across wheelchairs types. Our results emphasize the need for routine maintenance to address frequent wheelchair breakdowns. Our results also demonstrate a large disparity in several outcome variables across groups which motivates future studies where across-group comparisons are possible.
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Affiliation(s)
- Megan E. D’Innocenzo
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jonathan L. Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Yasmin Garcia-Mendez
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Stephanie Vasquez-Gabela
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Christina Zigler
- Department of Population Health Science, Duke University, Durham, North Carolina, United States of America
| | - Perth Rosen
- United Cerebral Palsy (UCP) Wheels for Humanity, Chatsworth, California, United States of American
| | - Eviana Hapsari Dewi
- Department of Health Policy and Management, Gadjah Mada University, Yogyakarta, Indonesia
| | - Ignatius Praptoraharjo
- Department of Health Policy and Management, Gadjah Mada University, Yogyakarta, Indonesia
| | - Anand Mhatre
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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Gowran RJ, Clifford A, Gallagher A, McKee J, O'Regan B, McKay EA. Wheelchair and seating assistive technology provision: a gateway to freedom. Disabil Rehabil 2020; 44:370-381. [PMID: 32510246 DOI: 10.1080/09638288.2020.1768303] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aim: The meaning of wheelchair and seating assistive technology and the impact inappropriate provision has on people's lives from a service user's perspective within an Irish context is highlighted. There is a dearth in evidence examining the process of wheelchair and seating provision and the interconnectedness between satisfaction, performance and participation from an equality and human rights perspective. The purpose if the study is to investigate wheelchair service users' perspectives of wheelchair and seating provision in Ireland.Method: This is a mixed-methods study with an exploratory sequential design that includes two phases. During phase one, wheelchair service users were invited to take part in qualitative in-depth semi-structured interviews, which were thematically analysed and formed part of a larger ethnographic study involving multiple stakeholders in sustainable wheelchair and seating provision strategy development. In phase two, an online Survey Monkey questionnaire was distributed to obtain a wider overview of wheelchair service provision from a wheelchair service users perspective. Data obtained from the closed questions and content analysis for open comments was analysed descriptively for this phase.Results: Eight wheelchair service users agreed to participate in the interviews and 273 responded to the online survey. Thematic analysis and questionnaire frequency and content analysis revealed the vital meaning of wheelchair and seating assistive technology provision. However, bottlenecks within the system affect daily living, with qualitative data highlighting the obstruction to experiences of independent living from initial appointment to wheelchair breakdowns during daily life.Conclusion: Appropriate wheelchair and seating assistive technology provision is a basic human right, supported by the essential and embodied nature of the wheelchair as demonstrated through the wheelchair service users' perspective throughout this study. These findings highlight the impact of ad-hoc services on individual freedoms and how the overall pace of the system affects a person's ability to organise their time as an equal member of the community across the lifespan. A national review of wheelchair and seating assistive technology provision services is called for, giving consideration to access to services, assessment and delivery, follow up and management, education and training.IMPLICATIONS FOR REHABILITATIONWheelchair and seating assistive technology provision as a basic human right is misunderstood.Appropriate wheelchair and seating assistive technology provision should be provided to meet this primary need as a pre-requisite for survival.Every aspect of the wheelchair and seating provision process impacts on occupational performance, equality of opportunity and community mobility. Wheelchair and seating assistive technology professionals and providers have a responsibility to review their practice and service provision systems.
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Affiliation(s)
- 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.,School of Health and Sports Science, University of the Sunshine Coast, Maroochydore, Australia.,Assisting Living and Learning (ALL), Institute Maynooth University, Maynooth, Ireland
| | - Amanda Clifford
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Ageing Research Centre, University of Limerick, Limerick, Ireland
| | - Andrea Gallagher
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Jennifer McKee
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Bernadette O'Regan
- Centre for Environmental Research, University of Limerick, Limerick, Ireland
| | - Elizabeth A McKay
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
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Kirby RL, Doucette SP. Relationships Between Wheelchair Services Received and Wheelchair User Outcomes in Less-Resourced Settings: A Cross-Sectional Survey in Kenya and the Philippines. Arch Phys Med Rehabil 2019; 100:1648-1654.e9. [DOI: 10.1016/j.apmr.2019.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 11/28/2022]
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Pearlman J, Cooper R. Editorial. Afr J Disabil 2017; 6:423. [PMID: 29134180 PMCID: PMC5675921 DOI: 10.4102/ajod.v6i0.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
No abstract available.
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Affiliation(s)
- Jonathan Pearlman
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, United States
- Department of Rehabilitation Sciences and Technology, University of Pittsburgh, United States
| | - Rory Cooper
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, United States
- School of Health and Rehab Sciences, University of Pittsburgh, United States
- Department of Rehabilitation Science and Technology, Uniformed Services University of Health Sciences, United States
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