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Wheelchair prescription in spinal cord injury:

Wheelchair prescription is a highly complex clinical practice. Evidence exists that long term success of wheelchair prescription is not always achieved and that rehabilitation professionals are experiencing increasing pressure to demonstrate accountability and cost containment in this area of service delivery. Occupational therapists within a spinal injury unit in South Australia conducted a quality activity to evaluate their wheelchair prescription practice. The quality activity involved consecutive sampling techniques to collect data on 128 wheelchair users who had a wheelchair prescribed between November 1993 and January 1996. / Demographic data related to the wheelchair user, the technology and the environment were collected at the time of the wheelchair prescription. Outcome measures were used at the time of wheelchair prescription and repeated at 3 months and again at 12 months post prescription. Outcome measures included 5 point self-rating scales for satisfaction with the wheelchair and sitting comfort. Rating scales were also used to measure postural symmetry, wheelchair skills and wheelchair maintenance knowledge. / In 1999, a 5 year follow-up was commenced to investigate what factors influence wheelchair prescription outcome after five years. Wheelchair users involved in the quality activity were invited to participate in this 5 year follow-up. Of these, 94 people agreed to participate in the 5 year follow-up. A repeated-measures study design was employed with outcome measures used during the quality activity repeated in an identical fashion. Additional measures were used to gain information regarding wheelchair abandonment. / Analysis involved Multiple Regression techniques for the prediction of outcomes where rating scales were used and Logistic Regression techniques where dichotomous variables were used. The possibility of early predictors of a successful long-term outcome was explored. / This study found wheelchair prescription outcomes changed significantly over 5 years with all outcomes except for wheelchair skills demonstrating a significant decrease over time. Significant positive associations were found between wheelchair user's satisfaction and comfort and between postural symmetry and wheelchair maintenance knowledge. / Reported level of comfort at 3 months post wheelchair prescription was found to be an early predictor of a successful long-term outcome. Abandonment rates were found to be lower than general assistive technology rates reported elsewhere. / Findings from this research support the importance of the direct relationship or 'fit' between the wheelchair user and the technology as a key factor in the achievement of successful short and long-term wheelchair prescription outcomes. Wheelchair prescription outcomes changed over time as a result of a change in this relationship. That is, as the condition of the wheelchair deteriorated or the person's needs changed, the 'fit' between the person and the wheelchair changed affecting important outcomes such as wheelchair user satisfaction comfort and posture. / Findings from this study provide valuable information an a little researched area. In this way, these findings may be useful in informing prescription practices which promote the provision of wheelchairs that meet the unique needs of the wheelchair user at the time of prescription and into the future. / Thesis (MApSc(OccupationalTherapy))--University of South Australia, 2004
CreatorsDi Marco, Allie.
Source SetsAustraliasian Digital Theses Program
Detected LanguageEnglish
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