Wheelchair repairs, breakdown, and adverse consequences for people with traumatic spinal cord injury.

UNLABELLED McClure LA, Boninger ML, Oyster ML, Williams S, Houlihan B, Lieberman JA, Cooper RA. Wheelchair repairs, breakdown, and adverse consequences for people with traumatic spinal cord injury. OBJECTIVES To investigate the frequency of repairs that occurred in a 6-month period and the consequences of breakdowns on wheelchair users living with spinal cord injuries (SCIs), and to determine whether certain wheelchair and subject characteristics are associated with an increased number of repairs and adverse consequences. DESIGN Convenience sample survey. SETTING Sixteen Model Spinal Cord Injury Systems Centers that are part of the national database funded through the Department of Education, National Institute on Disability and Rehabilitation Research. PARTICIPANTS People with SCI who use a wheelchair for more than 40h/wk (N=2213). INTERVENTION Not applicable. MAIN OUTCOME MEASURES The frequency of wheelchair repairs and occurrence of adverse consequences caused by a wheelchair breakdown in a 6-month period. RESULTS Within a 6-month period, 44.8% of full-time wheelchair users completed a repair, and 8.7% had an adverse consequence occur. People who use power wheelchairs required significantly more repairs (P<.001), and adverse consequences occurred more frequently (P<.001) compared with manual wheelchair users. The presence of power seat functions, and a person's occupational status or sex did not influence the number of repairs or adverse consequences. CONCLUSIONS Frequent repairs and breakdown can negatively impact a person's life by decreasing community participation and threatening health and safety. Mandatory compliance with the American National Standards Institute and the Rehabilitation Engineering and Assistive Technology Society of North America standards, changes in insurance reimbursement policy, and patient and clinician education are necessary to reduce the number of repairs and adverse consequences that occur.

[1]  M. Boninger,et al.  Driving characteristics of electric-powered wheelchair users: how far, fast, and often do people drive? , 2002, Archives of physical medicine and rehabilitation.

[2]  Richard C. Simpson,et al.  Using the Speed-Accuracy Operating Characteristic to Visualize Performance with Pointing Devices , 2009 .

[3]  M. Boninger,et al.  Comparison of fatigue life for 3 types of manual wheelchairs. , 2001, Archives of physical medicine and rehabilitation.

[4]  Julianna Arva,et al.  RESNA Position on the Application of Wheelchair Standing Devices , 2009, Assistive technology : the official journal of RESNA.

[5]  A. Jackson,et al.  Research from the Model Spinal Cord Injury Systems: findings from the current 5-year grant cycle. , 2004, Archives of physical medicine and rehabilitation.

[6]  Shirley G Fitzgerald,et al.  Durability, value, and reliability of selected electric powered wheelchairs. , 2004, Archives of physical medicine and rehabilitation.

[7]  R P Gaal,et al.  Wheelchair rider injuries: causes and consequences for wheelchair design and selection. , 1997, Journal of rehabilitation research and development.

[8]  Rory A Cooper,et al.  Wheelchair Standards: It's All About Quality Assurance and Evidence-based Practice , 2006, The journal of spinal cord medicine.

[9]  R A Cooper,et al.  Performance of selected lightweight wheelchairs on ANSI/RESNA tests. American National Standards Institute-Rehabilitation Engineering and Assistive Technology Society of North America. , 1997, Archives of physical medicine and rehabilitation.

[10]  Hongwu Wang,et al.  Real-time model based electrical powered wheelchair control. , 2009, Medical engineering & physics.

[11]  R. Gunnarsson,et al.  Fewer accidents and better maintenance with active wheelchair check-ups: a randomized controlled clinical trial , 2004, Clinical rehabilitation.

[12]  R L Kirby,et al.  WHEELCHAIR-RELATED ACCIDENTS CAUSED BY TIPS AND FALLS AMONG NONINSTITUTIONALIZED USERS OF MANUALLY PROPELLED WHEELCHAIRS IN NOVA SCOTIA , 1994, American journal of physical medicine & rehabilitation.

[13]  G. A. Smith,et al.  Wheelchair related injuries treated in US emergency departments , 2006, Injury Prevention.

[14]  A. Jackson,et al.  Overview Of The National Spinal Cord Injury Statistical Center Database , 2002, The journal of spinal cord medicine.

[15]  R. L. Kirby,et al.  WHEELCHAIR SAFETY—ADVERSE REPORTS TO THE UNITED STATES FOOD AND DRUG ADMINISTRATION , 1994, American journal of physical medicine & rehabilitation.

[16]  J. Unsworth,et al.  Patient satisfaction: an indicator of quality in disablement services centres. , 1995, Quality in health care : QHC.

[17]  Shirley G Fitzgerald,et al.  Evaluation of selected electric-powered wheelchairs using the ANSI/RESNA standards. , 2004, Archives of physical medicine and rehabilitation.

[18]  Rory A Cooper,et al.  Evaluation of the safety and durability of low-cost nonprogrammable electric powered wheelchairs. , 2005, Archives of physical medicine and rehabilitation.

[19]  Alicia M Koontz,et al.  Biomechanics of Sitting Pivot Transfers Among Individuals with a Spinal Cord Injury: A Review of the Current Knowledge , 2009 .

[20]  Gale G. Whiteneck,et al.  Spinal cord injury : clinical outcomes from the model systems , 1995 .

[21]  Shirley G Fitzgerald,et al.  Issues in maintenance and repairs of wheelchairs: A pilot study. , 2005, Journal of rehabilitation research and development.

[22]  R A Cooper,et al.  Evaluation of selected ultralight manual wheelchairs using ANSI/RESNA standards. , 1999, Archives of physical medicine and rehabilitation.

[23]  Alicia M Koontz,et al.  Manual wheelchair propulsion patterns on natural surfaces during start-up propulsion. , 2009, Archives of physical medicine and rehabilitation.