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Dupitier E, Voisin M, Stalens C, Laforêt P, Pouplin S. Identification of wheelchair seating criteria in adults with neuromuscular diseases: A Delphi study. PLoS One 2023; 18:e0290627. [PMID: 37682819 PMCID: PMC10490879 DOI: 10.1371/journal.pone.0290627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/13/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Adults with neuromuscular diseases like spinal muscular atrophy or Duchenne muscular dystrophy require full-time use of a wheelchair (WC) and perform all activities of daily living in a sitting position. Optimal configuration of the WC and seating system is essential to maintain the health and quality of life of users. However, few recommendations for configuration exist. The aim of this study was to identify and select 10 WC seating criteria that ensure an optimal sitting posture for health and quality of life. METHODS A four round Delphi method was used to collect the opinions of WC users and health professionals (HP), separately. First, the HP were asked if they believed that different criteria would apply to each disease. Then the HP and SMA II and DMD WC user experts responded to electronic surveys in 4 rounds. RESULTS Overall, 74 experts took part: 31 HP, 21 WC users with SMA II and 22 WC users with DMD. In total, 52% of HP believed that different criteria would apply to each disease. Ten criteria were identified by the HP for SMA II and 10 for DMD. Of the 40 criteria selected, 30 (75%) were common to each panel. Six topics were similar across panels: comfort, access to the joystick, prevention of pain, stability, pressure management and power seat functions. However, power seat functions did not reach consensus between HP and WC users (30-33% of agreement for HP and 93-100% for the WC user panels, p < 0.001). CONCLUSION Adults with SMA II and DMD had similar WC seating needs. Therefore, the same recommendations can be applied to these groups. Further research is necessary to understand the impact of cost on the prescription of power seat functions by health professionals.
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Affiliation(s)
- Elise Dupitier
- UR2020 ERPHAN, Paramedical Research Team in Neuromuscular Disability, Paris—Saclay University, University Hospital Site of Raymond Poincaré, Garches, France
- UFR Simone Veil-Santé, UMR 1179 End-iCap, Paris—Saclay University, University Hospital Site of Raymond Poincaré, Garches, France
- Medical Department, AFM-Téléthon, Evry, France
| | | | | | - Pascal Laforêt
- UFR Simone Veil-Santé, UMR 1179 End-iCap, Paris—Saclay University, University Hospital Site of Raymond Poincaré, Garches, France
| | - Samuel Pouplin
- UR2020 ERPHAN, Paramedical Research Team in Neuromuscular Disability, Paris—Saclay University, University Hospital Site of Raymond Poincaré, Garches, France
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Vance D, Blanchard M, Pendleton S, Richardson S, Moran J, Baker J, Benton H. Creating a consumer-friendly resource to assist persons with Amyotrophic Lateral Sclerosis (ALS) in navigating the power wheelchair selection process. Assist Technol 2023; 35:35-40. [PMID: 33909545 DOI: 10.1080/10400435.2021.1915899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Persons living with Amyotrophic Lateral Sclerosis (ALS), a fatal neurodegenerative disease, are often asked to make important decisions regarding power wheelchair (PWC) selection soon after receiving a diagnosis. There is currently a paucity of consumer-friendly information to aid clients living with ALS in better understanding the long-term functional implications of decisions made during the PWC selection process. The purpose of this action research project was to identify the specific considerations and choices required during the PWC selection process to use as the basis for creating a concise, educational video tool that emphasizes functional independence and self-advocacy for clients living with ALS. Semi-structured interviews of a panel of expert stakeholders were conducted to isolate important considerations for PWC selection in clients living with ALS. Qualitative data were collected through coded interviews and used to prioritize themes that were incorporated into an educational video. Once the draft video was created, the expert panel was provided time to review and critique the video prior to the creation of a professional quality video. Major themes identified and analyzed included environmental considerations, PWC component options, self-advocacy, and transportation. The video resource aims to be a resource for beginning a conversation about PWC options to make the PWC evaluation and selection process less daunting for clients and their caregivers.
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Affiliation(s)
- Daniel Vance
- Louisiana State University Health Sciences Center, School of Occupational Therapy, New Orleans, Louisiana, USA
| | - Mark Blanchard
- Louisiana State University Health Sciences Center, School of Occupational Therapy, New Orleans, Louisiana, USA
| | - Sara Pendleton
- Louisiana State University Health Sciences Center, School of Occupational Therapy, New Orleans, Louisiana, USA
| | - Sally Richardson
- Louisiana State University Health Sciences Center, School of Occupational Therapy, New Orleans, Louisiana, USA
| | - Jessica Moran
- Louisiana State University Health Sciences Center, School of Occupational Therapy, New Orleans, Louisiana, USA
| | - Jessica Baker
- Louisiana State University Health Sciences Center, School of Occupational Therapy, New Orleans, Louisiana, USA
| | - Hillary Benton
- Louisiana State University Health Sciences Center, School of Occupational Therapy, New Orleans, Louisiana, USA
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Geers AM, Prinsen EC, van der Pijl DJ, Bergsma A, Rietman JS, Koopman BFJM. Head support in wheelchairs (scoping review): state-of-the-art and beyond. Disabil Rehabil Assist Technol 2021:1-24. [PMID: 34000206 DOI: 10.1080/17483107.2021.1892840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Many wheelchair users experience disabilities in stabilising and positioning of the head. For these users, adequate head support is required. Although several types of head supports are available, further development of these systems is needed to improve functionality and quality of life, especially for the group of severely challenged users. For this group, user needs have not been clearly established. In this article, we provide an overview of the state-of-the-art in wheelchair mounted head supports and associated scientific evidence in order to identify requirements for the next generation of head support systems. MATERIALS AND METHODS A scoping review was performed including scientific literature (PubMed/Scopus), patents (Espacenet/Google Scholar) and commercial information. Types of head support and important system characteristics for future head support systems were proposed from consultations with wheelchair users (n = 3), occupational therapists (n = 3) and an expert panel. RESULTS Forty scientific papers, 90 patents and 80 descriptions of commercial devices were included in the scoping review. The identified head support systems were categorised per head support type. Only limited scientific clinical evidence with respect to the effectiveness of existing head support systems was found. From the user and expert consultations, a need was identified for personalised head support systems that intuitively combine changes in sitting and head position with continuous optimal support of the head to accommodate severely challenged users. CONCLUSIONS This study presents the state-of-the-art in head support systems. Additionally, several important system characteristics are introduced that provide guidance for the development and improvement of head supports.Implications for rehabilitationEspecially for the group of severely challenged wheelchair users, current head support systems require further development to improve their users' quality of life.The desired system characteristics which are discussed in this review are an important step in the definition of requirements for the next generation of head supports.
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Affiliation(s)
- Anoek M Geers
- Department of Biomechanical Engineering, TechMed Centre, University of Twente, Enschede, The Netherlands.,Focal Meditech B.V, Tilburg, The Netherlands
| | - Erik C Prinsen
- Department of Biomechanical Engineering, TechMed Centre, University of Twente, Enschede, The Netherlands.,Roessingh Research and Development, Enschede, The Netherlands
| | | | - Arjen Bergsma
- Department of Biomechanical Engineering, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Johan S Rietman
- Department of Biomechanical Engineering, TechMed Centre, University of Twente, Enschede, The Netherlands.,Roessingh Research and Development, Enschede, The Netherlands.,Roessingh Centre of Rehabilitation, Enschede, The Netherlands
| | - Bart F J M Koopman
- Department of Biomechanical Engineering, TechMed Centre, University of Twente, Enschede, The Netherlands
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Geronimo AM. Taking the eye road: A new access method for powered mobility in amyotrophic lateral sclerosis. Muscle Nerve 2019; 60:493-495. [PMID: 31495915 DOI: 10.1002/mus.26696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/01/2019] [Accepted: 09/03/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Andrew M Geronimo
- Department of Neurosurgery, Penn State College of Medicine, Hershey, Pennsylvania
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5
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Jerath NU, Simoens K, Mann D, Kollasch S, Grosland N, Malik KA, Reddy CG. Survey of the functional priorities in patients with disability due to neuromuscular disorders. Disabil Rehabil Assist Technol 2017; 14:133-137. [PMID: 29216771 DOI: 10.1080/17483107.2017.1413143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
TITLE Survey of the functional priorities in patients with disability due to neuromuscular disorders. OBJECTIVE This study attempts to determine the functional priorities for patients with neuromuscular disorders. METHODS A survey asking about functional priorities with respect to activities of daily living, ankle foot orthotic design, and assistive device design, was distributed to patients with neuromuscular disorders to assess the needs of patients from their perspectives. Descriptive statistics were used to analyse answers. RESULTS A total of 171 subjects with neuromuscular disorders responded to the questionnaire. Of the respondents with weakness in both the upper and lower extremities, 45% stated that if they had to choose between correction of one or the other, they would prefer that of their lower extremities. Activities that patients most frequently wanted to gain independence with were mobility and transfers (46%), followed by toilet use and hygiene (32%). The most popular control mechanism of an assistive device was voice activation (35%). CONCLUSION This study assessed the functional priorities of those with neuromuscular disorders. Although such individuals can experience a range of weakness in the upper and/or lower extremities, common functional priorities were reported: independence with mobility, transfers, toilet use and hygiene. Knowledge of these priorities will help guide development of assistive devices that will restore function in the future. Implications for Rehabilitation Neuromuscular Disorders • Neuromuscular disorders result in disabling weakness; there are few cures and many are unable to carry out activities of daily living. • Information that would be helpful in determining functional priorities is limited. • In a survey of 171 patients with neuromuscular disorders, functional priorities included mobility and transfers (46%), followed by toilet use and hygiene (32%). • Of the respondents with weakness in both the upper and lower extremities, 45% stated that if they had to choose between correction of one or the other, they would prefer that of their lower extremities. • If an assistive device were to be created to help those with neuromuscular disorders, the most popular control mechanism would be voice activation (35%).
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Affiliation(s)
- Nivedita U Jerath
- a Carver College of Medicine, Department of Neurology , The University of Iowa , Iowa City , IA , USA.,b Department of Neurology , The University of Florida , Gainesville , FL , USA
| | - Kevin Simoens
- c Department of Biomedical Engineering , The University of Iowa , Iowa City , IA , USA
| | - Dylan Mann
- c Department of Biomedical Engineering , The University of Iowa , Iowa City , IA , USA
| | - Steph Kollasch
- d Muscular Dystrophy Association , Cedar Rapids , IA , USA
| | - Nicole Grosland
- c Department of Biomedical Engineering , The University of Iowa , Iowa City , IA , USA
| | - Karim A Malik
- c Department of Biomedical Engineering , The University of Iowa , Iowa City , IA , USA
| | - Chandan G Reddy
- e Department of Neurosurgery , The University of Florida , Gainesville , FL , USA
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Landfeldt E, Edström J, Lindgren P, Lochmüller H. Patient Preferences for Treatments of Neuromuscular Diseases: A Systematic Literature Review. J Neuromuscul Dis 2017; 4:285-292. [DOI: 10.3233/jnd-170271] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Erik Landfeldt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Mapi Group, Stockholm, Sweden
| | | | - Peter Lindgren
- Department of Learning, Informatics, Managementand Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Hanns Lochmüller
- MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
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Ward AL, Hammond S, Holsten S, Bravver E, Brooks BR. Power Wheelchair Use in Persons With Amyotrophic Lateral Sclerosis: Changes Over Time. Assist Technol 2016; 27:238-45. [PMID: 26691564 DOI: 10.1080/10400435.2015.1040896] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The objectives of this study were to survey persons with Amyotrophic Lateral Sclerosis (ALS) at 1 and 6 months after receiving power wheelchairs to determine long-term use, comfort, and function as well as the power wheelchair's impact on daily tasks and quality of life. A 33-question survey and Psychosocial Impact of Assistive Devices Scale (PIADS) were sent 1 month after getting a new power wheelchair; a follow-up survey was sent at 6 months. Based on satisfaction and feature use survey results, at 1 month, 81% of users found the power wheelchair overall comfort to be high, 88% found their overall mobility to be improved, and 95% found it easy to use. Their quality of life increased and pain decreased at 1 and 6 months. According to the PIADS, the power wheelchair gave users increased ability to participate and sense of competence. This study has important results for the ALS community, as it is the first to assess power wheelchair users at 1 and 6 months after power wheelchair procurement. The results demonstrate the impact the power wheelchair has on mobility, psychosocial issues, functional abilities, and quality of life for a person with ALS.
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Affiliation(s)
- Amber Lea Ward
- a Neurology Department , Carolinas Medical Center , Charlotte , North Carolina , USA
| | - Sara Hammond
- b Occupational Therapy Department , University of North Carolina Chapel Hill , Chapel Hill , North Carolina , USA
| | - Scott Holsten
- a Neurology Department , Carolinas Medical Center , Charlotte , North Carolina , USA
| | - Elena Bravver
- a Neurology Department , Carolinas Medical Center , Charlotte , North Carolina , USA
| | - Benjamin Rix Brooks
- a Neurology Department , Carolinas Medical Center , Charlotte , North Carolina , USA
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Ribeiro S. Iyengar Yoga Therapy Intervention for Ischial Pressure Ulcers in a Patient with Amyotrophic Lateral Sclerosis: A Case Study. J Altern Complement Med 2015. [PMID: 26222670 DOI: 10.1089/acm.2014.0163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although some research suggests that the formation of pressure ulcers is rare in patients with amyotrophic lateral sclerosis (ALS), several patients have nonetheless developed this problem. To date, however, no case reports in the literature have described patients with ALS who develop ischial pressure ulcers. Outside of the ALS literature, evidence suggests that ischial pressure ulcers frequently develop in wheelchair users and also in patients treated in various health care settings. CASE DESCRIPTION A patient diagnosed with ALS reported the development of ischial pressure ulcers after consistent immobility for 1 year (32 months after her ALS diagnosis). This patient, who was sitting on the wounds, was treated with ointment and morphine; the latter was ineffective in controlling the pain. Moving the patient from sitting to supine, lateral, or semilateral positions, either on the bed or wheelchair, to separate the ulcers from the surface of the chair or bed was deemed impossible because of exaggeration of other symptoms, including shortness of breath and pain in other parts of the body. A new method of postural alignment was developed to alleviate the pain associated with the pressure ulcer. This method, Iyengar yoga therapy, which uses props to reposition a patient, alleviated pain and healing of two pressure ulcers of the patient after 3 weeks of starting this intervention. CONCLUSION Although the ischial pressure ulcers were successfully treated in a patient with ALS, further study is necessary to investigate the effectiveness of this postural alignment intervention in ALS and other patient populations for the management of ischial pressure ulcers.
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Affiliation(s)
- Subbappa Ribeiro
- B.K.S. Iyengar Yoga Center of the Willamette Valley , Corvallis, OR
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Arbesman M, Sheard K. Systematic review of the effectiveness of occupational therapy-related interventions for people with amyotrophic lateral sclerosis. Am J Occup Ther 2014; 68:20-6. [PMID: 24367951 DOI: 10.5014/ajot.2014.008649] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We describe the results of a systematic review of the literature on occupational therapy-related interventions for people with amyotrophic lateral sclerosis (ALS). The review included 14 studies. We found limited to moderate evidence that people involved in multidisciplinary programs have longer survival than those in general care and limited evidence that those in multidisciplinary programs have a higher percentage of appropriate assistive devices and higher quality of life in social functioning and mental health. Limited evidence indicates that people with ALS are satisfied with the comfort and ease of use of their power wheelchairs (PWCs). In addition, limited evidence is available that PWCs allow people to have increased interaction in the community. Evidence also is limited that some assistive devices are more helpful than others. Moderate evidence indicates that a home exercise program of daily stretching and resistance exercise results in improved function. The implications for practice, education, and research are discussed.
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Affiliation(s)
- Marian Arbesman
- Marian Arbesman, PhD, OTR/L, is Consultant, Evidence-Based Practice Project, American Occupational Therapy Association, Bethesda, MD; President, ArbesIdeas, Inc., 19 Hopkins Road, Williamsville, NY 14221; and Adjunct Assistant Professor, Department of Rehabilitation Science, University at Buffalo, State University of New York;
| | - Kendra Sheard
- Kendra Sheard, OTR/L, is Occupational Therapist, University of Virginia Transitional Care Hospital and Richard R. Dart ALS Clinic, Charlottesville, VA
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11
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Abstract
Amyotrophic lateral sclerosis (ALS), the most common adult motor neuron disease, is an acquired disorder that results in loss of function in multiple domains. Although there is no treatment that can halt or reverse this progressive condition, there are many opportunities for interventions that can lead to improved quality of life for the patient and caregiver. Physical and occupational therapy can assist with mobility and activities of daily living. Interventions by speech pathology can optimize nutrition and communication. Respiratory function can be managed noninvasively or invasively. Depression, hopelessness, anxiety, and other mental health issues can and should be aggressively addressed and treated. Many symptoms such as pseudobulbar affect, sialorrhea, constipation, spasticity, and cramps can be treated effectively with medications. Spirituality and religion are important issues to address, as are end-of-life concerns, including advance directives, hospice, and the dying process. In contrast to the discouraging view that "there is nothing we can do," a broad approach to management, through collaboration with a multidisciplinary team, will permit the ALS physician to make a meaningful difference in the lives of individuals living with ALS.
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Affiliation(s)
- Zachary Simmons
- Department of Neurology, Pennsylvania State University College of Medicine, Hershey, PA, USA.
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Karmarkar AM, Dicianno BE, Graham JE, Cooper R, Kelleher A, Cooper RA. Factors Associated with Provision of Wheelchairs in Older Adults. Assist Technol 2012; 24:155-67. [DOI: 10.1080/10400435.2012.659795] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Foley G, Timonen V, Hardiman O. Experience of services as a key outcome in amyotrophic lateral sclerosis (ALS) care: the case for a better understanding of patient experiences. Am J Hosp Palliat Care 2011; 29:362-7. [PMID: 21998444 DOI: 10.1177/1049909111423774] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
People with amyotrophic lateral sclerosis (ALS) frequently express dissatisfaction with services. Patient satisfaction with services in ALS care is not always measured and service user perspectives are not usually included when evaluating the outcomes of care. There is a lack of consensus on what constitutes satisfaction for patients in ALS care. To date, health care professionals' conceptualization of outcomes in ALS care has excluded measures of patient satisfaction with services. Exploring the context of the ALS service user experience of care will identify a conceptual framework that will include the domains of satisfaction with care for patients with ALS. An instrument that draws on the ALS patient perspective of services, developed on the basis of qualitative investigation, should be used to measure satisfaction with services.
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Affiliation(s)
- Geraldine Foley
- School of Social Work & Social Policy, Trinity College Dublin, Dublin 2, Ireland.
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Foley G, Timonen V, Hardiman O. Patients’ perceptions of services and preferences for care in amyotrophic lateral sclerosis: A review. ACTA ACUST UNITED AC 2011; 13:11-24. [DOI: 10.3109/17482968.2011.607500] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Gruis KL, Wren PA, Huggins JE. Amyotrophic lateral sclerosis patients' self-reported satisfaction with assistive technology. Muscle Nerve 2011; 43:643-7. [PMID: 21462207 PMCID: PMC3114042 DOI: 10.1002/mus.21951] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2010] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Assistive devices are prescribed for amyotrophic lateral sclerosis (ALS) patients with motor deficits, but little is known about their perceived benefit. Therefore, we assessed ALS patients' satisfaction with commonly prescribed devices. METHODS A telephone survey of 63 ALS patients from a single multidisciplinary clinic was conducted to assess the frequency of use, perceived usefulness, and satisfaction with 33 assistive devices. RESULTS Of those assistive technologies used "often or always" by ≥ 20% of respondents, arm rails by the toilet, elevated toilet seat, shower seat, shower bars, and slip-on shoes were ranked very highly for both usefulness and satisfaction. The ankle brace for ambulation, transfer board, speaker phone, and electronic seating controls were also ranked highly. The button hook, dressing stick, and long-handled reaching tool received low ratings for both usefulness and satisfaction. CONCLUSIONS ALS patients reported high usefulness and satisfaction levels with all bathroom adaptive devices and certain low-technology devices.
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Affiliation(s)
- Kirsten L Gruis
- Department of Neurology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA, , Ph:734-936-8586, Fax:734-936-5185
| | - Patricia A Wren
- School of Health Sciences, Oakland University, 2200 North Squirrel Road, Rochester, MI 48309, USA,
| | - Jane E Huggins
- Department of Physical Medicine and Rehabilitation, University of Michigan, 325 East Eisenhower Boulevard, Ann Arbor, MI 48108, USA,
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Crane B, Hobson D, Stadelmeier S. Development and Testing of an Innovative User-Adjustable Support Surface for Wheelchair Seating Discomfort. Assist Technol 2010; 22:152-62. [DOI: 10.1080/10400430903519936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ward AL, Sanjak M, Duffy K, Bravver E, Williams N, Nichols M, Brooks BR. Power wheelchair prescription, utilization, satisfaction, and cost for patients with amyotrophic lateral sclerosis: preliminary data for evidence-based guidelines. Arch Phys Med Rehabil 2010; 91:268-72. [PMID: 20159132 DOI: 10.1016/j.apmr.2009.10.023] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 10/12/2009] [Accepted: 10/20/2009] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To determine the features most frequently selected in a power wheelchair (PWC), level of satisfaction with the selections, and how often the PWC features are used by patients diagnosed with amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND). DESIGN Internally generated questionnaire. SETTING An ALS/Muscular Dystrophy Association center. PARTICIPANTS Convenience sample of current patients (N=45) of our clinic with ALS/MND who are PWC users (men, n=27; women, n=18; age range, 27-85 y). INTERVENTION Self-administered survey. MAIN OUTCOME MEASURE Thirty-two patients completed a 31-question survey investigating patients' patterns of selection, satisfaction, and frequency of PWC use; technical and psychometric influences; and other aspects of decision-making processes that patients experience before, during, and after acquiring a PWC. RESULTS Ninety percent of respondents received their evaluations at a multidisciplinary ALS clinic, 1 via the Department of Veterans Affairs, and 1 was unknown. Sixty-six percent of patients thought the chair evaluation was timed correctly, and 19% wished they had started sooner. Forty-five percent of people were able to walk a few steps, and 55% were able to stand when their chairs arrived. When they first received the chair, 79% were satisfied with the overall comfort of the chair, and 86% were satisfied with the ease of use; currently, 69% are satisfied with the overall comfort, and 72% are satisfied with ease of use. There was a statistically significant difference in how patients used their wheelchair features initially and currently in terms of seat elevate and attendant control, but not tilt, recline, and elevating leg rests. The average cost for the power chairs was $26,404 (range, $19,376-$34,311), and the average cost a month is $917. Overall, 88% of respondents said they would get the same type of chair with the same features again, and 81% felt that the chair was a good value for the cost. CONCLUSIONS We obtained first-hand knowledge from 32 patients with ALS/MND who are current PWC users on their use and satisfaction with their PWCs from initial to current use. Based on this survey, patients with ALS/MND seen for their wheelchair evaluation with experienced clinicians exhibit high use and satisfaction with their PWCs.
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Affiliation(s)
- Amber L Ward
- Department of Neurology, Carolinas Medical Center, Charlotte, NC, USA.
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Abstract
Patients with amyotrophic lateral sclerosis (ALS) rely on a variety of support services during the course of their illness. Patients with primary lateral sclerosis (PLS) have a slower progression of disease and different clinical spectrum. Their needs for allied health services and social support have not been well characterized. To investigate these needs, 25 patients with PLS and caregivers were surveyed on the use of assistive devices and support services. Needs for assistance changed as the disease progressed. Their greatest need was for gait-assistive devices and home help for activities requiring mobility. As in other chronic diseases, there was a striking use of the internet to gather information and for patient support groups.
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Affiliation(s)
- Tracy L Peters
- Human Spinal Physiology Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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Belcher MJH, Frank AO. Survey of the use of transport by recipients of a regional Electric Indoor/Outdoor Powered (EPIOC) wheelchair service. Disabil Rehabil 2009; 26:563-75. [PMID: 15204510 DOI: 10.1080/09638280410001684055] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To determine the extent to which Electric Indoor/Outdoor Powered wheelchair (EPIOC) users travel in vehicles, their concerns about safety, any accidents occurring during transportation and difficulties with their equipment. METHOD All 268 EPIOC users on the departmental database were sent a purpose-designed postal questionnaire asking whether the respondent:--used the chair during transportation and in what type of vehicle; understood clamping processes; had a 'mishap' or an 'accident'; felt safe during transportation and wished to comment. Replies from two mailings resulted in 203 usable replies (76%). Responses and comments were entered into an Excel database. RESULTS Thirty-seven (18%) users did not use any transport. Of the 170 (82%) who did: 51% used Dial-a-Ride, 44% taxis, 41% ambulances, 37% local authority transport, 34% cars and others 17%. Twenty-one (12%) experienced 'mishaps'--8 toppled out of their chairs and 6 reported clamping-related accidents. Headrests were only used by 69 (41%). Thirty-four (19%) of 182 expressing a view about 'feeling safe' felt unsafe sometimes. Wheelchair users often feel vulnerable when being transported by public providers. DISCUSSION Risks of vehicular travel by wheelchair users could be reduced with appropriate equipment and regular review of NHS prescriptions, education of users, wheelchair services and transport providers.
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Affiliation(s)
- M J H Belcher
- Stanmore Specialist Wheelchair Service, Brockley Hill, UK
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Dicianno BE, Arva J, Lieberman JM, Schmeler MR, Souza A, Phillips K, Lange M, Cooper R, Davis K, Betz KL. RESNA Position on the Application of Tilt, Recline, and Elevating Legrests for Wheelchairs. Assist Technol 2009; 21:13-22; quiz 24. [DOI: 10.1080/10400430902945769] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Mayadev AS, Weiss MD, Jane Distad B, Krivickas LS, Carter GT. The Amyotrophic Lateral Sclerosis Center: A Model of Multidisciplinary Management. Phys Med Rehabil Clin N Am 2008; 19:619-31, xi. [DOI: 10.1016/j.pmr.2008.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gordon PH, Mitsumoto H. Chapter 20 Symptomatic therapy and palliative aspects of clinical care. HANDBOOK OF CLINICAL NEUROLOGY 2007; 82:389-424. [PMID: 18808905 DOI: 10.1016/s0072-9752(07)80023-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Morris ME, Perry A, Bilney B, Curran A, Dodd K, Wittwer JE, Dalton GW. Outcomes of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease: a systematic review. Neurorehabil Neural Repair 2006; 20:424-34. [PMID: 16885429 DOI: 10.1177/1545968305285092] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This article describes a systematic review and critical evaluation of the international literature on the effects of physical therapy, speech pathology, and occupational therapy for people with motor neuron disease (PwMND). The results were interpreted using the framework of the International Classification of Functioning, Disability and Health. This enabled us to summarize therapy outcomes at the level of body structure and function, activity limitations, participation restrictions, and quality of life. Databases searched included MEDLINE, PUBMED, CINAHL, PSYCInfo, Data base of Abstracts of Reviews of Effectiveness (DARE), The Physiotherapy Evidence data base (PEDro), Evidence Based Medicine Reviews (EMBASE), the Cochrane database of systematic reviews, and the Cochrane Controlled Trials Register. Evidence was graded according to the Harbour and Miller classification. Most of the evidence was found to be at the level of "clinical opinion" rather than of controlled clinical trials. Several nonrandomized small group and "observational studies" provided low-level evidence to support physical therapy for improving muscle strength and pulmonary function. There was also some evidence to support the effectiveness of speech pathology interventions for dysarthria. The search identified a small number of studies on occupational therapy for PwMND, which were small, noncontrolled pre-post-designs or clinical reports.
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Affiliation(s)
- Meg E Morris
- School of Physiotherapy, The University of Melbourne, Victoria, Australia.
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Comment dit-on le diagnostic de Sclérose Latérale Amyotrophique (SLA) ? Rev Neurol (Paris) 2006. [DOI: 10.1016/s0035-3787(06)75173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Collins F. The Ibis XP tilt-in-space powered wheelchair: A review. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2005. [DOI: 10.12968/ijtr.2005.12.11.20062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Fiona Collins
- Tissue Viability Consultancy Services Ltd, Masters Building, Dental Practice Board, Eastbourne BN20 8AD, UK
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Nelson ND, Trail M, Van JN, Appel SH, Lai EC. Quality of Life in Patients with Amyotrophic Lateral Sclerosis: Perceptions, Coping Resources, and Illness Characteristics. J Palliat Med 2003; 6:417-24. [PMID: 14509487 DOI: 10.1089/109662103322144736] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess and compare quality of life (QOL) for two groups of patients with amyotrophic lateral sclerosis (ALS): (1) those reporting a more positive quality of life and (2) those reporting a more negative quality of life. METHODS One hundred patients with ALS participated in this cross-sectional, descriptive study conducted in an ALS clinic. Quality of life was graded in two ways: (1) a global question about present QOL, giving four choices (life could not be better, usually good, sometimes good, and not good) which the researchers divided into two groups: the more positive QOL and the more negative QOL and (2) patients' responses to a 25-item internally generated open-ended survey. The Appel ALS Rating Scale measured objective data for physical strength and functioning. RESULTS One hundred patients (68 men and 32 women) with a mean age of 58.2 (range, 29-82) years participated in the study. The average disease duration was 1.9 (range, 0.08-15) years. Patients who reported the more positive QOL were younger, had a shorter disease duration, and experienced less disease severity (p < 0.05). Those endorsing the more positive QOL reported more adequate finances and less stress over disease characteristics (p < 0.05). CONCLUSIONS Illness characteristics do influence QOL for patients with ALS, but they are not the only concerns. When measuring QOL in patients with ALS, the unique features of the psychosocial factors, personality traits, and spiritual factors, in addition to disease symptoms, need to be identified and discussed with patients and families throughout the illness.
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Affiliation(s)
- N D Nelson
- Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA
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