Abstract
BackgroundMobility is important for the cognitive and psychosocial development of children. Almost one third of children with cerebral palsy (CP) are non-ambulant. Wheelchairs can provide independent mobility, allowing them to explore their environment. Independent mobility is vital for activity and participation and reduces the dependence on caregivers. The purpose of this study was to describe the use of manual and powered wheelchair indoors and outdoors in relation to the degree of independent wheelchair mobility or need for assistance in a total population of children with CP.MethodsA cross-sectional study was performed including all children aged 3-18 years with CP living in southern Sweden during 2008. Data was extracted from a register and health care programme for children with CP (CPUP). There were a total of 562 children (326 boys, 236 girls) in the register. Information on the child's use of manual and powered wheelchair indoors and outdoors and the performance in self-propelling or need for assistance were analysed related to age, CP subtype and gross motor function.ResultsWheelchairs for mobility indoors were used by 165 (29%) of the 562 children; 61 used wheelchair for independent mobility (32 using manual only, 12 powered only, 17 both) and 104 were pushed by an adult. For outdoor mobility wheelchairs were used by 228 children (41%); 66 used a wheelchair for independent mobility (18 using manual only, 36 powered only, 12 both) and 162 were pushed. The use of wheelchair increased with age and was most frequent in the spastic bilateral and dyskinetic subtypes. Most powered wheelchairs were operated by children at GMFCS level IV.ConclusionIn this total population of children with CP, aged 3-18 years, 29% used a wheelchair indoors and 41% outdoors. A majority using manual wheelchairs needed adult assistance (86%) while powered wheelchairs provided independent mobility in most cases (86%). To achieve a high level of independent mobility, both manual and powered wheelchairs should be considered at an early age for children with impaired walking ability.
Highlights
Mobility is important for the cognitive and psychosocial development of children
The CPUP register includes all children with cerebral palsy (CP) born after 1 January 1990 living in the counties of Skåne and Blekinge in southern Sweden, which have a total population of about 1.3 million
The use of manual and powered wheelchair indoors increased with Gross Motor Function Classification System (GMFCS) level (p < 0.001) (Figure 1)
Summary
Almost one third of children with cerebral palsy (CP) are non-ambulant. Independent mobility is vital for activity and participation and reduces the dependence on caregivers. The purpose of this study was to describe the use of manual and powered wheelchair indoors and outdoors in relation to the degree of independent wheelchair mobility or need for assistance in a total population of children with CP. The severity of impairments varies greatly and the children’s mobility ranges from independent walking to totally dependent wheelchair mobility and almost one third is non-ambulant [2]. Independent mobility is vital for activity and participation, reducing dependence on caregivers and the environment [3,4,5]. The single most important factor for the experience of participation in adolescents with disabilities is the possibility to be “where it happens”, which is closely related to independent mobility [6]. Independent mobility is important for self-sufficiency [6]
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