Wheelchair Mobility Research Articles

Broken elevators, temporalities of breakdown, and open data: how wheelchair mobility, social media activism and situated knowledge negotiate public transport systems

This paper analyzes the significance of disability for urban mobility assemblages by focusing on the uneven encounters of public transport infrastructures, wheelchairs and their users by connecting media studies, STS, and Dis/Ability Studies. The particular focus of this article is how knowledge and lived experiences concerning wheelchair mobility are related to dysfunctional media infrastructure spaces and their translation to social media activism as well as open data practices. In my analysis, I particularly focus on access work by initiatives in Berlin, Germany, towards inclusive mobile technologies and platforms (Elevate Project) and their potential impact on the field of dis/abling mobilities. The analysis suggests that wheelchair mobility is implemented in urban infrastructures of public transportation, where temporalities of broken elevators might emerge as a challenging effect and trigger responses that affect the lived experiences of the drivers. Some of the effects include social media activism and initiatives to build novel forms of knowledge, digital mapping or data processing.

Prevention of hip fractures in older adults residing in long-term care facilities with a hip airbag: a retrospective pilot study

BackgroundHip and pelvic fractures do commonly occur among older adults. This pilot study aimed to evaluate the effect of introduction of the WOLK hip airbag on the incidence of hip fractures.MethodsA retrospective study was performed among 969 participants residing within 11 long-term care facilities for older patients, belonging to one large healthcare organization in The Netherlands. The intervention concerned application of 45 WOLK hip-airbags, distributed among selected residents of the long-term care facilities. Inclusion criteria; physically active participants with a pelvic circumference between 90-125 cm able to wear the hip airbag. Exclusion criteria; participants who continuously removed the hip airbag themselves or participants who depended on a wheelchair for mobility. Main outcome measures were the occurrence of falls and hip, pelvic and other fractures.ResultsThe incidence of hip and pelvic fractures declined from 3.3/100 person years to 1.8/100 person years during the study for an Incidence Rate Ratio (IRR) of 0.55 (95% confidence interval (95%CI) 0.34–0.87) in the entire study population. The incidence of other fractures did not decline during the study period (IRR 0.72;95%CI 0.37–1.40). The incidence of falls declined to some extent during the study (IRR 0.88; 95%CI 0.83–0.93).ConclusionsAfter introduction of the WOLK hip airbag a reduction of the incidence of hip and pelvic fractures by almost half was observed in older patients residing in long-term care facilities, even though only 45 hip airbags were distributed among the 969 residents. As selection bias cannot be ruled out in this study, the results of this pilot study warrant replication by a future clinical trial to determine true effectiveness of this intervention.

Effect of Manual Wheelchair Type on Mobility Performance, Cardiorespiratory Responses, and Perceived Exertion.

This study is aimed at comparing the design and configuration of the most commonly used manual wheelchair models through cardiorespiratory responses, perceived exertion, and mobility performance using two different manual wheelchairs, during mobility tasks. A within-group 2 × 3 × 2 controlled experiment was designed with three independent and four dependent variables. The independent variables included wheelchairs, with the levels active wheelchair with a rigid frame and passive wheelchair with foldable frame; conditions with the levels straight line, slalom, and agility; and speed with levels comfortable and fast. Dependent variables included oxygen uptake (VO2), distance travelled, speed, and perceived exertion. Results show that the active wheelchair yielded more beneficial characteristics although only the effect of wheelchair type on VO2 efficiency (oxygen uptake per meter travelled) was statistically significant with a large effect size (F(1, 14) = 118.298, p < 0.001, η2 = 0.541). The better VO2 efficiency was achieved with the active wheelchair under all tested conditions. The effect of wheelchair type on Borg scores was also statistically significant, although with a small effect size (F(1, 14) = 10.340, p = 0.006, η2 = 0.119); thus, active wheelchair use had lower Borg scores under all trials and was considered less exhausting than the passive wheelchair. In summary, use of the active wheelchair resulted in the users expending less energy per meter travelled and at the same time experiencing less fatigue. This may benefit overall wheelchair mobility and possibly reduce health complications.

Beware: adult-onset and fast-progressing Charcot-Marie-Tooth disease chameleons

Differentiating between an acquired and genetic aetiology of peripheral neuropathy poses a challenge to the neurologist. Contributing factors to this include a lack of family history of neuropathy, a rapid progres- sion of the clinical syndrome and/or the presence of features that are considered atypical for inherited neuropathies such as non-length dependent weakness and denervation.We present 6 patients with genetically confirmed CMT (2 NEFH, 3 MME and 1 TFG), who presented in adulthood with a rapid course of disease progression. The mean age of symptom onset was 37.8yrs (range 33–49) and despite an average disease duration of only 12.8yrs (range 7–16), 50% of patients (3/6) required a wheelchair or stick for mobility. All patients developed significant proximal involvement early on in the course of their disease with half of them having persistent evidence of non-length dependent weakness and denervation. All sporadic cases had CSF examinations and investigations for inflammatory causes of neuropathy, 1 patient had 2 courses of IVIG and another was considered for a nerve biopsy prior to achieving a genetic diagnosis.Certain adult onset CMT subtypes may mimic acquired neuropathies and in order to avoid missing treatable causes, the pursuit of both diagnostic avenues is often necessary.m.pipis@ucl.ac.uk

Cognitive status is associated with performance of manual wheelchair skills in hospitalized older adults

Purpose To examine the relationship between manual wheelchair skills and cognitive function in hospitalized older adults. Methods The observational study included older adults who used a manual wheelchair following hip/knee surgery. Participants underwent a series of tests to evaluate manual wheelchair skills and cognitive performance. Four items appearing on the Wheelchair Skills Test: brake handling (locking/unlocking), a 10-metre forward roll, a 2-metre backward roll and rotating in place, were used to evaluate manual wheelchair skills. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA), Trail Making Test (TMT), the Clock Drawing Test, and the Loewenstein Occupational Therapy Cognitive Assessment. The relationship between wheelchair skills and cognitive scores was assessed by a series of univariate linear regression analyses. Results Fifty older adults, aged 65–85, participated in the study. The MoCA-7 (orientation) explained 19.3% of the variance related to the turn in place wheelchair skill, 18.8% of the variance related to the two-metre backwards roll and 31.9% of the variance related to the 10-metre forward roll. The addition of gender (to the MoCA-7) increased the explained variance related to the 10-metre forward roll and turn in place skills to 38.5% and 28.5%, respectively. As for the brakes handling skill test, gender explained 18.3% of the variance. The addition of the CDT (to gender) increased the explained variance for the brakes handling skill to 31.4%. Conclusions Because cognitive impairments negatively affect the performance of wheelchair skills, rehabilitation therapists may need to adjust wheelchair mobility training methods for cognitively impaired older adults. Implication for rehabilitation Given the prevalence of older adults with cognitive impairments who use manual wheelchairs, it is critical to better understand the relationship between cognition and wheelchair skills. Poor results reported on the cognitive tests, specifically, visual attention and orientation, were found to be associated with poor performance of four manual wheelchair skills. Rehabilitation therapists should consider the cognitive status of older adults when teaching manual wheelchair skills, specifically in new users. Future studies should examine whether a customized preparation program, enhancing visuospatial orientation, can benefit manual wheelchair control in older adults.

Daytime predictors of nocturnal hypercapnic hypoventilation in children with neuromuscular disorders.

To examine objective daytime predictors of nocturnal hypercapnic hypoventilation (NHH) and identify a forced vital capacity (FVC) z-score cut off that predicts NHH using the 2012 Global Lung Function Initiative (GLI) reference equations in pediatric neuromuscular patients. Single-centre retrospective medical record review. Tertiary pediatric hospital in Australia. Children (<18 years old) with a neuromuscular disorder (NMD) who had a diagnostic sleep study over a 5-year period. Fifty children were included, median age 11.9 years (interquartile range [IQR]: 4.5-14.3). The majority of children had a diagnosis of Duchenne Muscular Dystrophy (32%). NHH was diagnosed in 18 children (36%). Multivariate logistic regression analysis performed for the entire cohort confirmed a statistically significant association between NHH and scoliosis (odds ratio [OR]: 3.3, p = 0.03), but not age (OR: 1.01, p = 0.26), body mass index z-score (OR: 0.86, p = 0.26) or use of a wheelchair for mobility (OR: 1.25, p = 0.72). For the subset of 29 children who had spirometry testing (median age 12.9 years [IQR: 10.2-14.3]), FVC z-score was the only statistically significant predictor of NHH (OR: 0.45, p = 0.02). NHH was predicted by an FVC z-score <-3.24 (sensitivity 78%, specificity 73%), or FVC <60% predicted (sensitivity 78%, specificity 73%). There was a strong positive correlation between FVC and forced expiratory volume in 1 s z-scores (rp = 0.98, p = 0.00) and FVC and peak expiratory flow z-scores (rp = 0.72, p = 0.00). Children with a NMD and scoliosis or a lower FVC z-score have increased odds of having NHH.

Investigation of Vibration and User Comfort for Powered Wheelchairs

Disabled users who use powered wheelchairs for mobility may suffer back and neck pain. Prolonged exposition to whole-body vibration due to different terrain surfaces may negatively impact the user’s health and comfort. This study investigates the impact of whole-body vibration on powered wheelchair users following the ISO-2631 standard. The ISO-2631 standard defines the whole-body vibration limits and quantifies its impact on the user’s health and comfort. Four users with a range of different weights drive an electrical powered wheelchair (EPW) on five different terrain surfaces. Results indicate that users’ weights can impact vibration perception. Additionally, outdoor surfaces generally produce high vertical accelerations, which can negatively impact the user’s health and comfort when the EPW is driven for a long period.

Shoulder Pain, Function, and Ultrasound-Determined Structure in Elite Wheelchair-Using Para Athletes: An Observational Study.

This study aimed to determine the relationship between shoulder pain, physical examination, and tissue pathology in manual wheelchair users competing in elite sport. Eighty elite para athletes who used a manual wheelchair for daily mobility were recruited from international track (n = 40), field (n = 19), and powerlifting (n = 21) competitions. Athletes were surveyed regarding shoulder pain history and symptoms (Wheelchair User's Shoulder Pain Index (WUSPI)), whereas independent blind observers measured signs (Physical Examination of the Shoulder Scale (PESS)) and tissue pathology (Ultrasound Shoulder Pathology Rating Scale (USPRS)). Relationships between measures for the total cohort and for subgroups defined by sporting discipline were calculated. A large proportion of athletes reported a history of upper limb pain (39% dominant and 35% nondominant). For the total cohort, WUSPI score was 22.3 ± 26.9, PESS score was 7.4 ± 6.7, and USPRS score was 5.2 ± 4.0. There were no USPRS score differences between athlete subgroups; however, track athletes had lower WUSPI and PESS scores, especially compared with field athletes. The first principal component explained most of the variance in the WUSPI and PESS, which were strongly correlated (r = 0.71), and the second orthogonal component explained the USPRS, which did not correlate with either the PESS (r = 0.21) or WUSPI (r = 0.20). Subgroup analysis showed that track athletes had lower symptom scores for a given physical examination score. Elite para athletes who use manual wheelchairs for daily mobility have a high prevalence of shoulder symptoms, positive signs on physical examination, and ultrasound-determined tissue pathology. Ultrasound-determined tissue pathology does not correlate with symptoms or signs. This information can help to guide clinicians in managing shoulder problems in this athlete population at high risk of injury.

Estimating whole-body vibration limits of manual wheelchair mobility over common surfaces.

Whole-body vibration (WBV) experienced during manual wheelchair use was quantified across several types of terrain (tile, sidewalk, decorative bricks, expanded metal grates). Over-ground travel was controlled using a robotic propulsion system. Vibrations along the vertical axis were measured with a triaxial accelerometer mounted to the seat of the wheelchair. Root-mean-square acceleration values were compared to the health guidance exposure limits established by the European Council using the WBV calculator tool published by the Health and Safety Executive (HSE). Vibrations along the vertical axis were well below the exposure values associated with health risks. Even the most aggressive tactile surface (grates) tested in this study would require more than 14 h of daily travel to reach the “exposure action value,” and more than 24 h would be required to reach the “exposure limit value”. Considering the average cumulative duration of active self-propulsion among manual wheelchair users is around an hour or less, none of the tested conditions were deemed unsafe or damaging.

A Comparative Study of Assistive Technologies for Physically challenged peoples for usability of Powered Wheelchair Mobility Aid

A Comparative Study of Assistive Technologies for Physically challenged peoples for usability of Powered Wheelchair Mobility Aid

Femoral Neck Osteotomy: A Salvage Procedure for Unstable and Locked Acetabulum Fractures in Selected Frail Patients

IntroductionPurpose of the study is to present and discuss the femoral neck osteotomy as a salvage procedure for unstable, locked geriatric acetabular fractures in selected frail patients. When disadvantages and possible risks of other treatments exceed the benefits, this method may relieve pain and allow for early wheelchair mobilization in frail patients with limited mobility.Materials and MethodsWe report nine patients from 2008 to 2020, which were treated with an osteotomy of the femoral neck for an unstable acetabular fracture. Indications, ASA-Score, Frailty Index, operative procedure, length of hospital stay, complications and outcomes will be discussed.ResultsPatient’s age averaged 86 years (range 81–92). Acetabular fractures were classified as six both column fractures, two anterior column posterior hemitransversal fractures and one destruction of the acetabulum by multiple metastases. Fracture dislocation with medialization plus locking of the femoral head and a superomedial dome impaction were present in all patients. All patients were classified as ASA III/ IV and the average value on the CSHA Frailty index was 7 (range 6–7). The operation time averaged 52 min (range 34–62). Immediate wheelchair mobilization in seven out of nine patients was started postoperatively.ConclusionThe osteotomy of the femoral neck may be discussed as a salvage procedure in low functional demanding, multimorbid, frail geriatric patients with unstable acetabular fractures and impairment of mobilisation due to a locked femoral head. The procedure has the advantages of a short operation time and immediate mobilization of the patients. However, this procedure only applies as a salvage solution in selected individual cases.

Development and Validation of a Robotic System Combining Mobile Wheelchair and Lower Extremity Exoskeleton

Development and Validation of a Robotic System Combining Mobile Wheelchair and Lower Extremity Exoskeleton

Developing a community-engaged wheelchair exercise program for persons with MS: community advisory board formation and feedback

Purpose Exercise is a safe, evidence-based approach for improving symptoms such as mobility impairment, cognitive dysfunction, and fatigue; however, persons with multiple sclerosis (MS) who use wheelchairs for mobility have been excluded from most research. This paper describes our approach for recruiting ten community advisor board (CAB) members and partnering with them on developing a novel home-based exercise training program for wheelchair users with MS. Materials and Methods The exercise training program, which was developed based on initial qualitative research, includes a progressive exercise prescription, equipment, and one-on-one behavioural coaching based on Social Cognitive Theory. The CAB members convened in groups of five people for five meetings online, using virtual conference software. The CAB meetings each lasted approximately 1-hour and notes were transcribed into digital format for data analyses. Results Content analysis identified elements that aligned with meeting foci (i.e., prescription, equipment, coaching, and outcomes). Feedback was divided into categories to refine the program, specifically modifying, adding, or retaining content and/or activities. CAB member feedback was very positive and emphasised potential additions to the materials presented. The research team proposed implementing modifications based on the CAB member feedback such as adding wrist weights to the equipment options for completing resistance training exercises. Conclusions The overall CAB feedback was invaluable for assessing the appropriateness of the proposed exercise training program before initiating feasibility testing. This report provides a model and guidance for researchers who seek community-engaged research approaches in creating products and interventions. Implication for Rehabilitation Community advisory board participation was invaluable in creating and modifying a novel exercise training programmes for wheelchair users with multiple sclerosis (MS). The current study provides a framework for the creation of exercise interventions for subpopulations of persons with MS that may provide substantial rehabilitation benefits such as improved symptoms and quality of life. Health behaviour interventists targeting individuals with disabilities may consider the benefits of recruiting stakeholders from the community in creation of novel programmes.

Obtaining wheelchair kinematics with one sensor only? The trade-off between number of inertial sensors and accuracy for measuring wheelchair mobility performance in sports

In wheelchair sports, the use of Inertial Measurement Units (IMUs) has proven to be one of the most accessible ways for ambulatory measurement of wheelchair kinematics. A three-IMU configuration, with one IMU attached to the wheelchair frame and two IMUs on each wheel axle, has previously shown accurate results and is considered optimal for accuracy. Configurations with fewer sensors reduce costs and could enhance usability, but may be less accurate. The aim of this study was to quantify the decline in accuracy for measuring wheelchair kinematics with a stepwise sensor reduction. Ten differently skilled participants performed a series of wheelchair sport specific tests while their performance was simultaneously measured with IMUs and an optical motion capture system which served as reference. Subsequently, both a one-IMU and a two-IMU configuration were validated and the accuracy of the two approaches was compared for linear and angular wheelchair velocity. Results revealed that the one-IMU approach show a mean absolute error (MAE) of 0.10 m/s for absolute linear velocity and a MAE of 8.1°/s for wheelchair angular velocity when compared with the reference system. The two-IMU approach showed similar differences for absolute linear wheelchair velocity (MAE 0.10 m/s), and smaller differences for angular velocity (MAE 3.0°/s). Overall, a lower number of IMUs used in the configuration resulted in a lower accuracy of wheelchair kinematics. Based on the results of this study, choices regarding the number of IMUs can be made depending on the aim, required accuracy and resources available.

Evaluation of two power assist systems for manual wheelchairs for usability, performance and mobility: a pilot study

Background Power-assist devices for manual wheelchairs offer benefits, including increased community participation. Several power-assist devices are commercially available, but research on benefits and limitations of devices is limited. Objective To compare the usability, performance, and mobility of two power-assist device systems for manual wheelchairs in indoor and outdoor environments. Methods This mixed methods pilot study included 11 volunteers with limited wheelchair experience. Participants tested two different power-assist device configurations: (1) the Batec® and (2) the SmartDrive® + Freewheel®. Indoor & outdoor obstacle courses contained relevant skills from the Wheelchair Skills Test, Power Mobility Community Driving Assessment, and Power Mobility Indoor Driving Assessment. The NASA Task Load Index and System Usability Scale assessed participants’ perceptions of cognitive demand and usability. A semi-structured interview was conducted to explore participants’ experiences. Results Substantial differences were found in the NASA Task Load Index, and System Usability Scale scores. Participant interviews and researcher observations revealed each device performed better on some obstacle course elements. Qualitative findings showed a general preference for using the Batec® for long trips outside and off-road terrains, primarily due to the Batec’s® perceived better speed control, maximum speed, and simpler braking system. Conversely, the SmartDrive® + Freewheel® was deemed most useful indoors and in tight spaces; due to a smaller wheelchair footprint, better turning radius, and increased device portability. Conclusion Further studies are required to understand the usability, performance, and mobility of power-assist devices. Moving forward, these findings will inform end users and occupational therapists when procuring manual wheelchair power-assist devices. Implications for rehabilitation Power-assist devices (PADs) for manual wheelchairs increase the potential for community participation. Qualitative findings showed a general preference for using the Batec® for long trips outside and for off-road terrains, primarily due to the Batec’s® perceived better speed control, maximum speed, and simpler braking system. The SmartDrive® + Freewheel® was deemed most useful indoors and in tight spaces; due to a smaller wheelchair footprint, better turning radius, and increased device portability. Increasing knowledge and research about PADs will support development of alternative options for manual or power wheelchairs users. PADs may allow manual wheelchair users (MWC) to delay moving to a power wheelchair (PWC), potentially reducing the perceived stigma associated with transitioning to a power wheelchair and impacting health outcomes.

Wheel-chair mobilization

Wheel-chair mobilization

Psychometric properties of the PEDI-CAT for children and youth with spinal muscular atrophy.

The purpose of this study was to examine the psychometric properties of the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) in children and youth with Spinal Muscular Atrophy (SMA). In this prospective cross-sectional study, caregivers of children and youth with SMA completed the PEDI-CAT Daily Activities and Mobility domains. A subset of caregivers completed a questionnaire about the measure. Mean ranks of scaled scores for Daily Activities (n = 96) and Mobility (n = 95) domains were significantly different across the three SMA types and across the three motor classifications. Normative scores indicated that 85 participants (89.5%) had limitations in Mobility and 51 in Daily Activities (53.1%). Floor effects were observed in≤10.4% of the sample for Daily Activities and Mobility. On average, caregivers completed the Mobility domain in 5.4 minutes and the Daily Activities domain in 3.3 minutes. Most caregivers reported that they provided meaningful information (92.1%), were willing to use the PEDI-CAT format again (79%), and suggested adding content including power wheelchair mobility items. Convergent validity was demonstrated for the Daily Activities and Mobility domains. Normative scores detected limitations in Mobility and Daily Activity performance for most participants with SMA. The PEDI-CATwas feasible to administer and caregivers expressed willingness to complete the PEDI-CAT in the future.

Finger/Chin Joystick Control for Robotic Arms and Power Wheelchair Systems

<h3>Research Objectives</h3> To provide a reliable and easy to Joystick controlled transportation/manipulation system for individuals with restricted mobility for their daily tasks. <h3>Design</h3> Experimental study. <h3>Setting</h3> In UWM BioRobotics Lab. <h3>Participants</h3> Healthy and young participants. <h3>Interventions</h3> Collaborative Robotic Arm for Activities of Daily Living assistance (picking objects from a desk, the floor, opening doors, drawers and eating), finger/Chin Joystick Control. <h3>Main Outcome Measures</h3> * Control robotics arm with finger and chin while keeping control of the wheelchair's mobility. * A lightweight software capable of controlling a robotic arm with generic/commercial joysticks. * Intuitive and easy to learn operability of the robotic arm with its multiple control modes. <h3>Results</h3> The system is composed by a power wheelchair (in this case a Permobil M3 Corpus), a robotic arm (a 6 Degree of Freedom arm with its control box) and the two user joysticks (finger and chin). Some circuitry was developed in order to communicate with the wheelchair electrical system. The experiments were performed by healthy personal in order to measure the operability and ease to use of this controller. The experiment's mean time as well as its difficulty seen by the participants were some of the variables to compare. A 3D trajectory of the robot arm end effector was recorded for the 4 different Activities in the Daily Living using the two different control devices. Each experiment had a fixed position for the wheelchair and the same initial position for the robotic arm. <h3>Conclusions</h3> The finger/chin joystick control is meant for individuals with restricted mobility, to allow them to perform their activities of daily living that were previously impossible to. This method will allow the to integrate a robotic arm in their power wheelchair system and expand its capabilities. <h3>Author(s) Disclosures</h3> No conflict.

Survey of Functional Deficits in Pediatric Patients with Osteogenesis Imperfecta to Determine Rehabilitation Needs: A Retrospective Analysis

<h3>Research Objectives</h3> To investigate components of self-described functional deficits in pediatric patients with osteogenesis imperfecta to understand areas of need for rehabilitation in this population. <h3>Design</h3> A cohort of pediatric patients receiving ongoing OI care in outpatient settings or parents were surveyed using pediatric PROMIS scales across multiple domains. Children too young or unable had parents complete a proxy form. Surveys were repeated within one year to assess for consistency. Data were analyzed retrospectively. <h3>Setting</h3> Patients and families were surveyed during in Shriners Hospitals for Children ambulatory settings. This sample was of the Shriners Chicago patients who completed the PROMIS measures. <h3>Participants</h3> Patients with OI of varied phenotypes seeking care at Shriners Chicago able to complete a form in English or Spanish utilizing a provided tablet were surveyed. Initial results for 102 patients were obtained. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> PROMIS pediatric scales for mobility, upper extremity function, pain interference and peer relations. Repeat surveys were conducted within one year. <h3>Results</h3> Mobility was moderate to severely impaired in 16/60 children, 18/30 parent proxy. Twelve children didn't have a mobility score, as they use a wheelchair for primary mobility. Pain interference was not severe in any patients, but moderate in 25/65 (38%) children and 6/32 (19%) parent proxy. Half of children self-reported mild or no pain interference. Peer relations were mildly or not affected in over 88% (90/102). Upper extremity impairment was moderately to severely affected in about half of the respondents (53/102) with higher impairment by parent proxy than child self-report. <h3>Conclusions</h3> OI is typically characterized by bone fragility, however muscle weakness is a common presenting symptom and muscle abnormalities in this population have been widely described. As 45% of children have reported issues in our cohort with gait/mobility issues or primarily use a wheelchair, anticipatory guided approach to rehabilitation and planning in conjunction with bone-modifying treatment, may improve strength and mobility outcomes. Further study across other Shriners centers is planned. This data may serve as a baseline to assess outcomes of developed programs. <h3>Author(s) Disclosures</h3> N/A.

Update on the Evidence: RESNA Ultralight Manual Wheelchair Position Paper

<h3>Research Objectives</h3> To identify optimal manual wheelchair configuration for people who self-propel for full-time wheeled mobility. To identify new evidence on how prescribing an ultralight weight manual wheelchair can minimize secondary complications in the body functions, promote functional independence with mobility related activities of daily living, and provide opportunities to participate in life roles <h3>Design</h3> This position paper was written following a scoping literature review process, open review period through RESNA and peer-review process. <h3>Setting</h3> This position paper is relevant to any prescribers or clinicians recommending manual wheelchairs. The results of the scoping review is applicable to treatment settings where people use a manual wheelchair for primary mobility, from pediatrics to long term care. <h3>Participants</h3> N/A. <h3>Interventions</h3> The RESNA Paper on the Application of Ultralight Manual Wheelchairs was published in 2012 and sought to provide evidence to support the application of fully customizable manual ultralight weight wheelchairs. Since that time, new developments in clinical research in our understanding of manual wheelchair considerations have prompted a revision of this foundational document. <h3>Main Outcome Measures</h3> The presentation will describe the intention of the revision and review new evidence based topics incorporated into the new position paper including: Manual wheelchair configuration, wheelchair training and wheelchair skills relating to function, rolling resistance and propulsion effort, various propulsion styles and considerations for overuse injuries in all extremities. <h3>Results</h3> The results of the scoping literature review and position paper will provide supportive evidence for the need for ultralight weight manual wheelchair configuration and the impact on body functions and structures, activities of daily living, and participation. <h3>Conclusions</h3> This scoping review and position paper will allow the clinician and practitioner to have supportive evidence for equipment recommendation for their patients who use a manual wheelchair full-time for mobility. <h3>Author(s) Disclosures</h3> Jennith Bernstein is a full-time employee of Permobil, Inc.; however, this work is presented on behalf of an entire work group of clinicians, engineers, and professors.