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Lessons learned from a pediatric powered mobility lending program
Naomi Gefen1,2, Patrice L Weiss2,3, Amihai Rigbi4
1ALYN Hospital, Jerusalem, Israel.
Insights
A powered wheelchair lending program significantly improved quality of life for children with cerebral palsy (CP) and other neuromuscular diseases (NMD). Key predictors of powered mobility proficiency include communication and manual wheelchair skills.
Area of Science:
- Pediatric Rehabilitation
- Assistive Technology
- Mobility Research
Background:
- Powered mobility devices (PMDs) are crucial for enhancing independence in children with mobility impairments.
- Lending programs offer a valuable pathway for children to trial and adapt to PMDs before long-term commitment.
- Understanding factors influencing PMD proficiency is essential for optimizing rehabilitation outcomes.
Purpose of the Study:
- To assess the characteristics and impact of a powered wheelchair lending program for children.
- To compare outcomes between children with cerebral palsy (CP) and other neuromuscular diseases (NMD).
- To validate a predictive model for powered mobility proficiency.
Main Methods:
- Retrospective analysis of 172 children in a powered mobility lending program (2009-2022).
- Data collection via questionnaires on demographics and functional levels.
- Evaluation of driving proficiency and interviews with participants and parents.
Main Results:
- Children with NMD (73% proficiency) showed higher powered mobility proficiency than those with CP (57%).
- Significant predictors of proficiency included communication, manual wheelchair operation, access mode, and go-stop ability, predicting outcomes in ~80% of cases.
- The program notably improved participants' and families' quality of life.
Conclusions:
- Powered wheelchair lending programs effectively enhance children's mobility skills and quality of life.
- Specific skills like communication and manual wheelchair operation predict powered mobility success.
- Even children initially unable to perform certain tasks can achieve proficiency and benefit from PMDs.
Purpose:
To evaluate children's characteristics and impact of a powered wheelchair lending program including comparisons of diagnostic sub-groups, and validation of a predictive model of powered mobility proficiency.
Methods And Materials:
This retrospective study included 172 children who participated in the ALYN powered mobility lending program from 3/2009-7/2022. Demographics and functional levels were measured via questionnaires; driving proficiency was evaluated when the wheelchair was returned, and parents and children were interviewed following their participation in the program.
Results:
Two diagnostic groups were identified: cerebral palsy (CP) (n = 136, median = 9.75 yrs) and other neuromuscular diseases (NMD) (n = 30, median = 5.83 yrs). They differed significantly in the age they commenced PM training, the male/female ratio, walking ability and access mode. Fifty-seven percent of the participants with CP achieved powered mobility proficiency, a rate that was significantly lower than the 73% proficiency found for the NMD group. Four significant predictors were identified: communication, manual wheelchair operation, access mode and go-stop upon request. They predicted proficiency in approximately 80% of cases. Overall feedback from the parents and children indicated that their personal and family's quality of life improved as a result of their child's ability to use a powered wheelchair.
Conclusions:
A lending program provides children with opportunities to improve mobility skills in an appropriate powered wheelchair. Children who can communicate verbally, propel a manual wheelchair, use a joystick and go-stop upon request are significantly more likely to become proficient drivers; however, many who were unable to complete these tasks also improved and even became proficient drivers.
