Abstract: The variability of symptoms in persons with multiple sclerosis (MS) leads to dilemmas in clinical decision-making related to mobility device prescription. When is a good time to consider a switch to wheeled mobility? What is the best type of wheeled mobility? What are the changes one can expect as they transition? Three studies addressed these questions. First, we investigated the characteristics of individuals with MS who are about to transition to wheeled mobility. Seven ambulatory individuals with MS performed the timed 25-foot walk test (T25FW), and completed questionnaires measuring quality of life (QoL), self-reported fatigue, and participation. These individuals were not able to ambulate at functional speeds and had sedentary activity levels. They also had QoL below that of the general population. Next, we investigated changes that accompany a transition in primary means of mobility. Eleven individuals with MS or other chronic conditions leading to a decline in mobility function participated. We collected strength, fatigue, participation and QoL data at baseline, and after mobility intervention. Substantive results revealed that individuals may not experience the expected declines in strength and endurance as they transition. Furthermore, they experienced improvements in QoL concomitant with amount of daily device use. Methodological results revealed difficulties in conducting longitudinal mobility studies, and addressed research design barriers. Finally, we investigated whether a difference exists in the type of wheeled mobility issued to veterans with MS when compared to veterans with a spinal cord injury (SCI). Using the National Prosthetic Patient Database, we isolated all veterans with MS or an SCI who received a wheelchair or scooter in 2000 and 2001. We found that the quality of wheeled mobility devices issued to individuals with MS was inferior to those issued to individuals with SCI.
These studies provide preliminary evidence that individuals with MS may be waiting too long to transition to the use of wheeled mobility. When they do receive a wheelchair, veterans with MS tend to receive a lower quality of wheelchair. Finally, we made suggestions for conducting longitudinal mobility research in this population, and emphasized the need for future studies.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-08152005-135950 |
| Date | 28 August 2005 |
| Creators | Woollard, Fabrisia Ambrosio |
| Contributors | Betty Liu, MD, Michael L. Boninger, MD, Steven Schwid, MD, Shirley G. Fitzgerald, PhD, Rory A. Cooper, PhD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-08152005-135950/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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