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Retrospective Analysis of Predictors of Proficient Power Mobility in Young Children With Severe Motor Impairments
Shelley R Mockler1, Irene R McEwen2, Maria A Jones2
1Center for Disabilities and Development, University of Iowa Stead Family Children's Hospital, Iowa City, IA.
Insights
Cognition, wheelchair control, and diagnosis are key factors for power mobility skills in young children with severe motor impairments. These findings aid in assessing proficiency and comparing outcomes across studies using different measurement tools.
Area of Science:
- Pediatric rehabilitation
- Assistive technology
- Motor development
Background:
- Early power mobility is crucial for children with severe motor impairments.
- Understanding factors influencing proficient power mobility skills is essential for intervention development.
Purpose of the Study:
- To identify child characteristics, intervention parameters, and wheelchair control types associated with proficient power mobility skills in young children (14-30 months).
- To assess the agreement between the Wheelchair Skills Checklist (WSC) and the Powered Mobility Program (PMP) for measuring proficiency.
Main Methods:
- Secondary data analysis of two randomized controlled trials (RCTs) involving 31 children.
- Children received 12 months of training with customized power wheelchairs in natural environments.
- Proficiency was measured using the WSC and PMP; baseline cognition, motor skills, and mobility were also assessed.
Main Results:
- Cognition, fine motor skills, and wheelchair control mechanism were significantly associated with proficient power mobility skills.
- Multiple regression analysis indicated that cognition, wheelchair control type, and diagnosis predicted proficiency.
- High agreement (94.7%) was found between the WSC and PMP.
Conclusions:
- Cognition, wheelchair control type, and diagnosis may predict power mobility proficiency in young children with severe motor impairments.
- These predictive factors should not exclude children from participating in training programs.
- The strong agreement between WSC and PMP facilitates consistent outcome measurement across research and clinical settings.
Objectives:
To determine if child characteristics, maternal education, intervention parameters, type of wheelchair control mechanism, or a combination of these variables were associated with proficient power mobility skills in children with severe motor impairments aged 14 to 30 months; and to determine if performance on the Wheelchair Skills Checklist (WSC) was associated with performance on the Powered Mobility Program (PMP).
Design:
Secondary data analyses on data collected from 2 previously completed randomized controlled trials (RCTs).
Setting:
Intervention and outcomes measurements took place in natural environments.
Participants:
Participants included children who were assigned to the intervention groups in 2 RCTs (N=31).
Intervention:
Children practiced maneuvering individually customized power wheelchairs for 12 months in natural environments.
Main Outcome Measures:
Proficiency was assessed using the WSC and the PMP. The Battelle Developmental Inventory and Merrill-Palmer-Revised were used to assess baseline cognition and motor skills. Baseline mobility was assessed using the Pediatric Evaluation of Disability Inventory.
Results:
Cognition, fine motor skills, and wheelchair control mechanism were associated with proficiency. Cognition, type of wheelchair control, and diagnosis all predicted proficiency while controlling for other covariates using multiple regression analysis. Agreement between the WSC and PMP was 94.7%.
Conclusions:
Cognition, type of wheelchair control, and diagnosis might predict power mobility proficiency in young children with severe motor impairments. These factors however should not be used to determine whether a child has the opportunity to participate in a training program. Agreement between the WSC and PMP could help researchers and clinicians compare results across studies that use only one of these outcome measures.
