RESUMEN
OBJECTIVE: The purpose of this study was to examine factors associated with variability in satisfaction with functional mobility (as measured by the Functional Mobility Assessment [FMA]) in users of mobility devices. Our primary hypothesis was that device type and Assistive Technology Professional (ATP) involvement will be the most significant predictors of FMA score. Our secondary hypothesis was that ATP involvement is associated with use of more custom-fitted manual wheelchairs and group 3 and 4 power wheelchairs. DESIGN: Retrospective cohort study. SETTING: Data were collected from equipment suppliers who collaborate with clinicians to administer the FMA and associated Uniform Data Set within various settings (ie, rehabilitation clinic, school, supplier place of business). PARTICIPANTS: A data set of 4743 cases was included in the analysis (N=4743). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: FMA questionnaire collected at baseline, client age, gender, primary diagnosis, years since disability onset, device type, device age, living situation, ATP involvement, and geographic area. RESULTS: Ordinal logistic regression modeling showed that geographic area, device type, ATP involvement, primary diagnosis, gender, age, device age, and years since onset of disability significantly predicted the variance in FMA scores at P<.05. Device type was the most significant predictor of variance in FMA score. Involvement of an ATP had a significant effect on the type of device that participants used (χ220=1739.18, P<.001; odds ratio, 0.589; 95% confidence interval, 0.49-0.708). If an ATP was involved, there were significantly higher proportions (all P<.05) of individuals using custom-fitted manual wheelchair and high-end groups 3 and 4 power wheelchairs prescribed compared with when no ATP was involved or when involvement was uncertain. CONCLUSIONS: The relationship between ATP involvement and functional outcome supports the concept that ATP certification recognizes demonstrated competence in analyzing the needs of consumers with disabilities and selection of appropriate mobility assistive equipment with improved functional outcomes.
Asunto(s)
Técnicos Medios en Salud , Personas con Discapacidad/rehabilitación , Diseño de Equipo , Limitación de la Movilidad , Satisfacción del Paciente , Dispositivos de Autoayuda , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Suministros de Energía Eléctrica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVE: To describe the development of a wheelchair repair registry from large datasets to attain an understanding of wheelchair failures and service repairs. DESIGN: Guidelines for registry development were applied and anchored around Labor-Tracker, a web-based information management system for wheelchair suppliers to manage and track wheelchair repairs. The registry was designed using online analytical processing, allowing for rapid data queries from multiple dimensions that enable complex data analysis and discovery. SETTING: The Wheelchair Repair Registry (WRR) was developed through an industry and academic collaboration whereby repair data were collected in the field, entered into the Labor-Tracker system, deidentified, and then transferred to the registry and made available for analyses. PARTICIPANTS: Wheelchair supplier service technicians reported data from repair services provided to individuals who use power wheelchairs, manual wheelchairs, and scooters. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Wheelchair failure and repair data, including variables related to scheduling, equipment information (eg, manufacturer, model, serial number, purchase date), labor, parts, and reasons for repairs. RESULTS: The WRR was developed to analyze wheelchair repairs and failures from the Labor-Tracker system. Currently, the registry has more than 60,000 repairs conducted on more than 5000 wheelchair devices from 25 manufacturers. The devices include 60% power wheelchairs, 35% manual wheelchairs, and 5% scooters. CONCLUSIONS: The WWR creates opportunities to apply large-data analytical methodologies that will serve to inform quality standards, practice, equipment selection, preventative maintenance routines, product design, and policy.
Asunto(s)
Diseño de Equipo , Falla de Equipo , Sistema de Registros , Silla de Ruedas , Personas con Discapacidad/rehabilitación , HumanosRESUMEN
As the smartphone becomes ubiquitous, mobile health is becoming a viable technology to empower individuals to engage in preventive self-care. An innovative mobile health system called iMHere (Internet Mobile Health and Rehabilitation) has been developed at the University of Pittsburgh to support self-care and adherence to self-care regimens for individuals with spina bifida and other complex conditions who are vulnerable to secondary complications. The goal of this study was to explore the accessibility of iMHere apps for individuals with spina bifida. Six participants were asked to perform tasks in a lab environment. Though all of the participants were satisfied with the iMHere apps and would use them again in the future, their needs and preferences to access and use iMHere apps differed. Personalization that provides the ability for a participant to modify the appearance of content, such as the size of the icons and the color of text, could be an ideal solution to address potential issues and barriers to accessibility. The importance of personalization--and potential strategies--for accessibility are discussed.