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Powered wheelchairs and independence in young children with tetraplegia
M Bottos1, C Bolcati, L Sciuto
1Childhood Neuromotor Disabilities Centre, Azienda USL Città di Bologna, Italy. fa11090@iperbole.bologna.it
Insights
Early powered wheelchair (PWC) use significantly enhances independence and socialization in children with tetraplegia. Most children achieve driving competence, regardless of motor impairment or IQ, with parental acceptance increasing post-provision.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Assistive Technology
Background:
- Children with tetraplegia often experience severe motor impairments affecting independence.
- Early intervention with assistive devices is crucial for functional development.
Purpose of the Study:
- To evaluate the impact of early powered wheelchair (PWC) provision on children with tetraplegia.
- To assess outcomes across impairment, functional limitation, and participation levels.
Main Methods:
- Study included 29 children (aged 3-8 years) with spastic or dystonic tetraplegia and severe motor impairment.
- Outcomes measured included independence, motor impairment, IQ, quality of life, and driving competence.
- Parental and child reactions to PWC use were also recorded.
Main Results:
- Significant improvement in independence was observed post-PWC provision.
- Motor impairment, IQ, and quality of life showed no significant changes.
- Most children (21/27) achieved driving competence, correlating with time spent using the PWC.
- Parental acceptance of PWCs increased significantly after provision.
Conclusions:
- Powered wheelchairs (PWCs) can effectively enhance independence and socialization in children with tetraplegia.
- Good driving competence is achievable even with severe motor deficits or learning disabilities.
- Early PWC provision should be considered an efficient mobility solution, not a last resort.
Abstract:
The aim of this study was to assess the effect of early provision (< or = 8 years) of a powered wheelchair (PWC) in children with tetraplegia. Twenty-nine children (15 males, 14 females; mean age 6 years 3 months, age range 3 to 8 years) with spastic or dystonic tetraplegia were studied. All participants had severe motor impairment. Treatment outcomes were investigated in several dimensions of disablement: Impairment, Functional Limitation/Activity, Disability/Participation. It was found that the level of independence improved significantly after PWC provision, while motor impairment, IQ, and quality of life did not. The majority of children (21 of 27) reached a level of driving competence which allowed them to move around with or without minimal (i.e. verbal) adult support. Achievement of this competence was not statistically related to IQ or motor impairment but correlated to the time spent in the PWC. The majority of parents (21 of 25) were not in favour of the PWC when the study started but after PWC provision, 23 of 25 parents expressed positive feelings about it. Reactions of the majority of children (23 of 25) were positive from the beginning of the study and did not change over time. The authors concluded that PWCs can aid independence and socialization and the majority of children can achieve a good-enough driving competence, even those with severe learning disability or motor deficit. PWCs should not be viewed as a last resort but as a means of providing efficient self-locomotion in children with a severe motor deficit.