A Clinical Trial of a Rehabilitation Expert Clinician Versus Usual Care for Providing Manual Wheelchairs
Article first published online: 19 AUG 2005
Journal of the American Geriatrics Society
Volume 53, Issue 10, pages 1712–1720, October 2005
How to Cite
Hoenig, H., Landerman, L. R., Shipp, K. M., Pieper, C., Pieper, C., Richardson, M., Pahel, N. and George, L. (2005), A Clinical Trial of a Rehabilitation Expert Clinician Versus Usual Care for Providing Manual Wheelchairs. Journal of the American Geriatrics Society, 53: 1712–1720. doi: 10.1111/j.1532-5415.2005.53502.x
- Issue published online: 21 SEP 2005
- Article first published online: 19 AUG 2005
- durable medical equipment;
- outcome and process assessment;
- activities of daily living;
- physical therapy
Objectives: To determine the effect of differing methods of dispensing wheelchairs.
Design: Quasi-experimental by day of week.
Setting: Department of Veterans Affairs Medical Center.
Participants: Eighty-four community-dwelling, cognitively intact patients prescribed a standard manual wheelchair.
Intervention: A multifactorial intervention consisting of an expert physical/occupational therapist who used a scripted evaluation that included an evaluation based on medical record review and self-reported and physical performance measures; individualization of the wheelchair and initiation of orders for additional occupational/physical therapy, equipment, or home modifications as needed; multimodal patient education; and telephone follow-up at 3 and 6 weeks.
Measurements: The primary outcome was amount of wheelchair use. Secondary outcomes were shoulder pain, wheelchair comfort and confidence, and home modifications.
Results: The intervention group had significantly greater wheelchair use than usual care at 2 weeks, 3 months, and 6 months (P=.01). Wheelchair use declined monotonically over time for the entire study sample (P<.001). There were no significant differences between the two groups in shoulder pain, wheelchair comfort or confidence, or home modifications.
Conclusion: New wheelchair owners used the wheelchair more often if they received it from an expert therapist using a multifactorial intervention.