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McKenney CM, McKenney EE. Wheeled repair alliance: Rolling out wheelchair repair and maintenance in community bicycle shops. Assist Technol 2024:1-6. [PMID: 38771976 DOI: 10.1080/10400435.2024.2348163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 05/23/2024] Open
Abstract
The increasing population of wheelchair users in the United States highlights the importance of access to reliable and affordable wheelchair maintenance and repair. Having a well-maintained mobility device is essential to living a safe, healthy, and social life as a wheelchair user. Unfortunately, access to these services is limited. This study aims to address this need by developing and evaluating a workshop program designed to teach basic wheelchair maintenance skills to bike shop employees, allied health professionals, and wheelchair users themselves. The workshops covered key wheelchair maintenance tasks. Pre and post workshop surveys assessed participants' confidence in basic maintenance and repair skills and overall satisfaction with the workshop. Workshop participants reported increased confidence in all maintenance skills following the workshops and bike shop employees expressed increased confidence in their ability to work with and provide resources for wheelchair users. This study highlights that community-based workshops may help to enhance confidence in wheelchair maintenance skills, potentially aiding in bridging the gap in affordable and accessible repair services. The Wheeled Repair Alliance has the potential to empower wheelchair users and improve their quality of life. Further research should consider increasing the precision of measurements and assessing long-term outcomes related to wheelchair maintenance and repair.
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Affiliation(s)
- Caitlin M McKenney
- Institute on Disabilities, Temple University, Philadelphia, Pennsylvania, USA
| | - Erin E McKenney
- Psychology Department, Rowan University, Glassboro, New Jersey, USA
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2
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Mhatre A, Loew C, Yurtsever E, Mair C. Power wheelchair usage and repair are associated: a retrospective analysis. Disabil Rehabil Assist Technol 2024:1-8. [PMID: 38754034 DOI: 10.1080/17483107.2024.2353861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
Purpose: This study evaluates the effect of power wheelchair telemonitoring and battery charging training on user charging behavior and repair measures and assesses the relationship between wheelchair usage and repair measures to support technician-led servicing.Methods: This is a retrospective analysis of two matched cohorts with a total of n=237 users from the NHS service dataset. In the training cohort, a wheelchair usage telemonitoring device monitored the battery usage of n=119 power wheelchair users for 12 months. Users whose battery charging behavior was not optimal were instructed on appropriate charging practices. Wheelchair usage parameters of wheelchair drive and power time every month were used to predict repairs and associated costs.Results: Fifty-four out of 119 users in the training cohort did not charge batteries regularly and were instructed on appropriate charging. Twenty-six of them changed their behavior and charged their batteries every night. This cohort experienced reduced battery repairs by 18%, wheelchair repairs by 11%, and repair costs by £3,092 compared to a matched standard care cohort (n=118). User age and drive time were associated with repair measures. Drive time predicted time-to-failure for wheelchair parts and classified failure risk with the area under the receiver operating characteristic curve as 0.71 (95% CI 0.61 to 0.82; p<.001). Conclusions: By leveraging the significant relationships between wheelchair usage and repairs, wheelchair users at risk of part failures can be identified, and technician-led servicing tools for proactive interventions can be developed. Wheelchair battery health telemonitoring and instructing users on appropriate battery charging reduced repairs and associated costs.
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Affiliation(s)
- Anand Mhatre
- The Ohio State University, Division of Occupational Therapy, College of Medicine, Columbus, OH, USA
| | - Cassandra Loew
- The Ohio State University, Division of Occupational Therapy, College of Medicine, Columbus, OH, USA
| | - Ekim Yurtsever
- The Ohio State University College of Engineering, Columbus, OH, USA
| | - Colin Mair
- National Health Service West of Scotland Mobility and Rehabilitation Centre (WestMARC), Glasgow, UK
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3
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Ruffing JJ, Schmeler MR, Schein RM, Mhatre A. A cross-sectional descriptive analysis of complex rehabilitation technology (CRT) supplier opinions on the current state of wheelchair repair services. Disabil Rehabil Assist Technol 2024; 19:739-744. [PMID: 36094416 DOI: 10.1080/17483107.2022.2121007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/01/2022] [Accepted: 08/31/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE It is documented that wheelchair failures occur frequently, repair times are lengthy, and users often experience adverse consequences. This study aims to gather evidence on efficiency of current wheelchair repair processes from the perspective of complex rehabilitation technology (CRT) suppliers who perform repairs within the United States. MATERIALS AND METHODS A 20 statement survey was developed to identify barriers and facilitators related to wheelchair repairs across the domains of administrative and operational factors as well as to identify future opportunities for improvement. Key statements in these areas included time to perform a repair, documentation requirements, tracking repair progress, reimbursement, technician competency, emerging strategies and preventative maintenance. The online survey was broadly disseminated to a nationwide network of CRT suppliers for data collection. RESULTS A total of 127 responses were received. Results showed that administrative statements received the lowest scores while those statements dealing with future opportunities received the highest scores. Areas of the industry that suppliers were in most disagreement with included wait time for insurance approval, reimbursement for parts, reimbursement for technician travel time and lack of coverage for preventative maintenance. Telehealth system usage, preventative maintenance coverage, tracking repairs and repair scheduling were future opportunities that suppliers were in most agreement with. CONCLUSIONS Administrative issues exist in the CRT industry due to restrictive insurance policies associated with repairs and maintenance. Future opportunities to improve the process exist including payment models and the application of telehealth, device monitoring and service-based performance incentives to reduce adverse consequences to the user. Implications for rehabilitationHighlights the direct importance and barriers faced within the wheelchair repair industry by CRT suppliers.In a sample of CRT suppliers, there is agreement there exists many administrative and operational issues related to wheelchair repairs.There is agreement among survey respondents of opportunities to investigate further telehealth and remote strategies, preventative maintenance coverage and online tracking for wheelchair repairs.
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Affiliation(s)
- Jeffrey J Ruffing
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark R Schmeler
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Richard M Schein
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anand Mhatre
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH, USA
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Goldberg M, Rushton P, Kirby RL, Muñera S, Kandavel K, Pearlman J, Tawashy A. Wheelchair service provision content in professional rehabilitation organisations' standards documents and contemporary initiatives: a rapid review. Disabil Rehabil Assist Technol 2024; 19:78-89. [PMID: 35446737 DOI: 10.1080/17483107.2022.2063421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 04/02/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE We sought to identify opportunities, challenges, contemporary initiatives and strategies for preparing entry-level practitioners who are competent at the basic level of wheelchair service provision across four key international professional rehabilitation organisations as revealed by their educational standards, relevant guidelines and policy statements, and other publicly available information. METHOD A rapid review was conducted in 2021 from the International Society of Physical and Rehabilitation Medicine (ISPRM), the International Society for Prosthetics and Orthotics (ISPO), World Physiotherapy, and the World Federation of Occupational Therapists (WFOT). Additional grey-literature and grey-data searches were conducted to identify contemporary initiatives that may support competency development in wheelchair service provision. RESULTS A total of 17 standards, guidelines, and policy statement documents were selected for detailed review. Each of the four organisations published at least one document containing language relating to wheelchair service provision. Twelve contemporary initiatives relating to wheelchair service provision were identified from the grey literature across the four organisations. Six additional initiatives were identified from the organisations' social media accounts. Themes emerged in the areas of contemporary content, opportunities, and challenges. CONCLUSION Global standardisation could help harmonise professional societies' approach to training wheelchair service providers.IMPLICATIONS FOR REHABILITATIONThere is a need to provide more descriptive content on wheelchair service provision in education and service standards and related documents to influence what is taught in professional rehabilitation programs that are accredited or approved by professional rehabilitation organisations.The organisations' networks are vast and may also help to promote additional continuing education in this area.
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Affiliation(s)
- Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Paula Rushton
- International Society of Wheelchair Professionals, Medellin, Colombia
- Université de Montréal, Montreal, Canada
| | - R Lee Kirby
- International Society of Wheelchair Professionals, Medellin, Colombia
- Dalhousie University, Halifax, Canada
| | - Sara Muñera
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Krithika Kandavel
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
- International Society of Wheelchair Professionals, Medellin, Colombia
| | - Amira Tawashy
- International Society of Wheelchair Professionals, Medellin, Colombia
- Dalhousie University, Halifax, Canada
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Garcia-Mendez Y, D'Innocenzo M, Pearlman J, Vásquez-Gabela S, Rosen P, Rodriguez-Funes MV, Kirby RL, Mhatre A. Effects of the WHO 8-step wheelchair-service-delivery process on wheelchair users in El Salvador: a cohort study. Disabil Rehabil Assist Technol 2023:1-12. [PMID: 37740696 DOI: 10.1080/17483107.2023.2256808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/05/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE To test the hypotheses that, after the delivery of manual wheelchairs following the WHO 8-step service-delivery process, wheelchair-related health and quality of life, wheelchair skills, wheelchair use, and poverty probability would improve; and that the number of wheelchair repairs required, adverse events, caregiver burden, and the level of assistance provided would decrease. METHODS This was a longitudinal, prospective within-subject study including 247 manual wheelchair users, and 119 caregivers, in El Salvador who received a wheelchair following the WHO 8-step process as well as maintenance reminders. Outcome measurements were performed via structured questionnaires and dataloggers at the initial assessment, at wheelchair delivery, and at 3- and 6-month follow-up. RESULTS Significant improvements in wheelchair-related health indicators (all with p < 0.004) and quality of life (p = 0.001), and a significant reduction in national and "extreme" poverty probability (p = 0.004 and p = 0.012) were observed by six months. Wheelchair use significantly decreased (p = 0.011 and p = 0.035) and wheelchair skills increased (p = 0.009). Caregiver burden did not change (p = 0.226) but the number of activities of daily living (ADLs) that required no assistance significantly increased (p = 0.001) by three months and those who required complete assistance decreased (p = 0.001). No changes were observed in wheelchair repairs (p = 0.967) and breakdowns over time with new wheelchairs. CONCLUSIONS Wheelchair service delivery using the WHO 8-step process on manual wheelchair users in El Salvador has positive effects on health and quality of life, wheelchair skills, caregiver assistance levels, and poverty. Further research is needed to determine the relative contributions of the intervention components.Implications for RehabilitationProviding manual wheelchairs using the 8-step process of the WHO has benefits on health and quality of life, wheelchair skills, caregiver assistance levels, and poverty.The WHO 8-steps service delivery process for manual wheelchairs can be used in less-resourced settings.
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Affiliation(s)
| | - Megan D'Innocenzo
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephanie Vásquez-Gabela
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Perth Rosen
- Momentum Wheels for Humanity, Chatsworth, CA, USA
| | | | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
| | - Anand Mhatre
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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Ardianuari S, Pasaribu E, Amannullah G, Prana A, Widiyanta E. Assistive technology unmet need in Indonesia: challenges and opportunities for enhancing equitable access. Disabil Rehabil Assist Technol 2023:1-12. [PMID: 37610101 DOI: 10.1080/17483107.2023.2244996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE To analyze the rapid Assistive Technology Assessment (rATA) data and identify challenges and opportunities for improving access to assistive technology products (AP) in Indonesia. MATERIALS AND METHODS An explanatory sequential mixed-methods design consisting of a quantitative survey and a qualitative interview study was used. The rATA survey was administered to households in two randomly sampled provinces to collect data on AP met and unmet need. Descriptive statistics was used to analyze the survey data. Qualitative data were collected from unstructured videorecorded interviews with rATA policymakers. Interview transcripts were coded and analyzed using thematic analysis. RESULTS On average, data from rATA respondents (n = 11,300) revealed 60% of AP unmet need. A high proportion of funding sources came from the private sector, and contributions from the government remained low. Affordability and funding were the main barriers to access. From the policymaker interviews (n = 5), four essential themes emerged, i.e., "resources and workforce", "funding", "laws and policies", and "guidelines and standards". From each theme, key challenges and opportunities were identified. CONCLUSIONS Affordability remained a major challenge, in part because government-sponsored funding was still inadequate, forcing people with low financial status to self-produce AP. One potential opportunity would be to localize AP production and improve local workforce training. Integrated national funding schemes and intersectoral coordination could accelerate improvement in meeting AP unmet need. This study may provide evidence of current challenges and opportunities to help improve the field of rehabilitation through enhanced access to AP services in Indonesia.
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Affiliation(s)
- Satria Ardianuari
- Department of Mechanical Engineering, University of Washington, Seattle, WA, USA
| | - Ester Pasaribu
- Public Health and Health Promotion, Griffith University, Gold Coast, Australia
| | | | - Adhi Prana
- Ministry of National Development Planning (BAPPENAS), Jakarta, Indonesia
| | - Eka Widiyanta
- Association of Health Services (ADINKES), Jakarta, Indonesia
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Oldfrey B, Holloway C, Walker J, McCormack S, Deere B, Kenney L, Ssekitoleko R, Ackers H, Miodownik M. Repair strategies for assistive technology in low resource settings. Disabil Rehabil Assist Technol 2023:1-11. [PMID: 37466362 DOI: 10.1080/17483107.2023.2236142] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 06/19/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To investigate the practices of repair that exist for users of mobility assistive products in low resource settings, as well as the psychosocial impact that the repair, or non-repair, of these devices has on users' lives. MATERIALS AND METHODS This article collates data on repair practices and the responses from participants on the topic of repair from studies conducted by the authors across four different low resource settings in Kenya, Uganda, Sierra Leone, and Indonesia. This data was then analyzed to identify the common themes found across geographies. RESULTS Three major models of repair practice emerged from the data: "Individual or Informal Repair in the Community"; "Local Initiatives"; and "Specialist AT Workshop Repair". Additionally, the wider impact on the participants' lives of "Problems & Concerns with Repair"; "Experiences of Breakages & Frequencies of Repair" and the "Impact of Broken Devices" are explored. CONCLUSIONS The results of this analysis demonstrate the paramount importance of community-based repair of devices, and how despite this importance, repair is often overlooked in the planning and design of assistive products and services. There is a need to further incorporate and support these informal contributions as part of the formal provision systems of assistive device.IMPLICATIONS FOR REHABILITATIONA lack of available specialist repair services in low resource settings hinders the potential impact of assistive technology provision systems.Community-based repair is the major route by which assistive devices are repaired in low resource settings.Appropriate community-based repair strategies should be incorporated into and supported by the formal assistive technology provision models in order to optimise outcomes.A lack of data on outcomes across the lifecycle of assistive products hinders progress on improving focus on follow-up services - in particular repair & maintenance.By supporting community-based repair, repairs that are inappropriate for that approach could be better directed to specialist repair services.
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Affiliation(s)
- Ben Oldfrey
- Global Disability Innovation Hub (GDI Hub), London, UK
- Institute of Making, University College London, London, UK
- Interaction Centre (UCLIC), University College London, London, UK
| | - Cathy Holloway
- Global Disability Innovation Hub (GDI Hub), London, UK
- Interaction Centre (UCLIC), University College London, London, UK
| | - Julian Walker
- The Bartlett Development Planning Unit, University College, London, UK
| | - Steven McCormack
- Orthopaedic Department, Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Bernadette Deere
- Division of Imaging Sciences and Biomedical Engineering, Department of Medical Engineering and Physics, King's College London, London, UK
| | - Laurence Kenney
- Centre for Health Sciences Research, University of Salford, Salford, UK
| | - Robert Ssekitoleko
- Biomedical Engineering, Department of Physiology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Helen Ackers
- School of Health and Society, University of Salford, Manchester, UK
| | - Mark Miodownik
- Institute of Making, University College London, London, UK
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Sarsak HI, von Zweck C, Ledgerd R. Wheeled and Seated Mobility Devices Provision: Quantitative Findings and SWOT Thematic Analysis of a Global Occupational Therapist Survey. Healthcare (Basel) 2023; 11:healthcare11081075. [PMID: 37107909 PMCID: PMC10137666 DOI: 10.3390/healthcare11081075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
PURPOSE To better understand the global role of occupational therapists and explore facilitators and barriers impacting user access to high quality, affordable wheeled and seated mobility device (WSMD) provision worldwide. METHODS Mixed-method approach utilizing quantitative findings and qualitative strengths, weaknesses, opportunities, and threats (SWOT) analysis of a global online survey. RESULTS A total of 696 occupational therapists from 61 countries completed the survey. Almost 49% had 10 or more years of experience with the provision of WSMDs. WSMD provision had positive, significant associations with attainment of certification (0.000), higher service funding (0.000), higher country income (0.001), standardized training (0.003), continuous professional development (0.004), higher experience (0.004), higher user satisfaction (0.032), custom-made device provision (0.038), higher staff capacity (0.040), and more time working with users (0.050); negative, significant associations were identified with high cost of WSMDs (0.006) and pre-made device provision (0.019). SWOT analysis identified high country income, funding, experience, training, certification from global partners, variety of roles and practice settings, and interdisciplinary teamwork as strengths and opportunities for professional growth, while low country income, lack of time/staff capacity/standardization/support services, and poor access to proper devices were indicated as weaknesses and threats. CONCLUSION Occupational therapists are skilled healthcare professionals and provide a variety of WSMD services. Efforts to build collaborative partnerships, enhance access to occupational therapists and funding options, improve service and standards for WMSD service delivery, and promote professional development will help to overcome challenges and facilitate WSMD provision globally. Promoting practices based on best available evidence for WSMD provision worldwide should be prioritized.
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Affiliation(s)
| | - Claudia von Zweck
- World Federation of Occupational Therapists, 1211 Geneva, Switzerland
| | - Ritchard Ledgerd
- World Federation of Occupational Therapists, 1211 Geneva, Switzerland
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Rushton PW, Kawish-Arbelaez D, Levac-Marquis A, Fung K, Daoust G, Ishack M, Goldberg M, Pearlman J. French-Canadian translation, cultural adaptation, and preliminary evaluation of the wheelchair service provision - basic test validity among occupational therapy students. Disabil Rehabil Assist Technol 2023; 18:59-66. [PMID: 35867645 DOI: 10.1080/17483107.2022.2103188] [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: 02/08/2023]
Abstract
PURPOSE The objectives were: (1) to translate and adapt the International Society of Wheelchair Professional (ISWP) basic Wheelchair Service Provision Test (bWSPT) into French-Canadian and (2) to conduct a preliminary evaluation of the French-Canadian version of the ISWP bWSPT internal consistency and relations with other variables among French-Canadian occupational therapy students. METHODS For Phase 1, based on the International Test Commission Guidelines for Translating and Adapting Tests, a forward translation and adaptation from English to French-Canadian was conducted by a translation team. For Phase 2, the validity evidence of the French-Canadian bWSPT was evaluated through internal consistency and comparison of bWSPT scores and final grades of a wheelchair-specific course with a sample of occupational therapy students (positive, moderate correlation hypothesized). Internal consistency was measured with Cronbach's α. The correlation was calculated using the Spearman's Rank Correlation Coefficient. RESULTS For phase 1, 61 of 167 items of the forward adaptation were revised and modified. All revisions were a consensus by the translation team. For phase 2, we found a Cronbach's α of 0.50 and a correlation of ⍴ = 0.27 (p = 0.43) between the bWSPT French-Canadian version and the wheelchair-specific course final grade. The low variability of the data may explain the lower-than-expected correlation. Other possible data-driven reasons have been explored using post-hoc analysis. CONCLUSION The ISWP bWSPT, French-Canadian version, is not internally consistent and demonstrates a non-statistically significant, positive, weak correlation with the final grade of a wheelchair service provision-specific course among a cohort of 35 occupational therapy students.IMPLICATIONS FOR REHABILITATIONThe lack of adequately educated wheelchair service providers is a contributing factor to inappropriate wheelchair provision worldwide.The ISWP Wheelchair Service Provision Basic Test (ISWP bWSPT) has been created to evaluate competency among wheelchair service providers and provides a standardized test recognized internationally.A French-Canadian version of the ISWP bWSPT allows competency testing of French-speaking wheelchair service providers across Canada.This study shows that the French-Canadian version of the test is not internally consistent and has a low correlation with a wheelchair provision-specific course among a cohort of 35 occupational therapy students at a French-Canadian university suggesting further refinement is required to improve its measurement properties in this population of test-takers.
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Affiliation(s)
- Paula W Rushton
- School of Rehabilitation, University of Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada
| | | | | | - Karen Fung
- School of Rehabilitation, University of Montréal, Montréal, Canada
| | - Geneviève Daoust
- School of Rehabilitation, University of Montréal, Montréal, Canada.,CHU Sainte-Justine Research Centre, Montréal, Canada
| | | | - Mary Goldberg
- Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jon Pearlman
- Rehabilitation Science & Technology, University of Pittsburgh, Pittsburgh, PA, USA
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Worobey LA, Kirby RL, Cowan RE, Dyson-Hudson TA, Shea M, Heinemann AW, Pedersen JP, Hibbs R, Boninger ML. Using remote learning to teach clinicians manual wheelchair skills: a cohort study with pre- vs post-training comparisons. Disabil Rehabil Assist Technol 2022; 17:752-759. [PMID: 32809896 PMCID: PMC8204376 DOI: 10.1080/17483107.2020.1804633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To test the hypothesis that remote learning to teach clinicians manual wheelchair skills is efficacious. MATERIALS AND METHODS A convenience sample of therapists (physical and occupational) and students were enrolled in pairs in a cohort study with pre- versus post-training comparisons. The intervention was a hybrid of self-study and hands-on practice paired with remote feedback for ten intermediate and advanced manual wheelchair skills. Participants practiced with self-selected frequency and duration, uploading a session log and video(s) to an online platform. A remote trainer provided asynchronous feedback prior to the next practice session. Capacity and confidence in completing the ten skills were evaluated using the Wheelchair Skills Test Questionnaire (WST-Q). Knowledge of wheelchair skills training and motor learning was assessed using a 62-item Knowledge Test. Secondary outcome measures included skill achievement, as confirmed by submitted video recordings, and participant feedback about the training. RESULTS Across 41participants, scores were higher at follow-up compared to baseline for WST-Q capacity (73.9 ± 19.1 vs 16.8 ± 15.6, p < 0.001), WST-Q confidence (80.1 ± 12.2 vs 47.6 ± 18.2, p = 0.003) and knowledge (70.8 ± 7.5 vs 67.0 ± 5.4, p = 0.004). CONCLUSIONS Remote learning can increase wheelchair skills capacity and confidence as well as knowledge about such training and assessment. This model should be further investigated as a delivery method for training rehabilitation professionals. CLINICAL TRIAL REGISTRATION NUMBER NCT01807728.Implications for rehabilitationWheelchair skills training is one of the 8 steps of wheelchair provision as outlined by the World Health Organization.Wheelchair skills are not a core part of most clinical curriculums and many clinicians cite a lack of resources and uncertainty on how to implement wheelchair skills training into practice as major barriers to providing such training.Remote learning offers the benefits of structured wheelchair skills training with expert feedback on an individual's own schedule that is not afforded by one-day "bootcamp"-type courses or on-the-job training, which are how many clinicians currently learn wheelchair skills.In a sample of physical and occupational therapists and students, remote learning was effective at increasing capacity and confidence to perform manual wheelchair skills as well as knowledge of wheelchair training.
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Affiliation(s)
- Lynn A Worobey
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA, USA
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
| | - Rachel E Cowan
- Department of Physical Medicine & Rehabilitation, University of Alabama, Birmingham, AB, USA
| | - Trevor A Dyson-Hudson
- Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Mary Shea
- Kessler Institute for Rehabilitation, West Orange, NJ, USA
| | - Allen W Heinemann
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Shirley Ryan Ability Lab, Chicago, IL, USA
| | | | - Rachel Hibbs
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael L Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA, USA
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11
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Boccardi A, Wu F, Pearlman J, Mhatre A. Elderly wheelchair users recommend age-friendly design improvements to a mHealth wheelchair maintenance application in a mixed-methods study (Preprint). JMIR Aging 2022; 5:e39301. [PMID: 36256830 PMCID: PMC9627462 DOI: 10.2196/39301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/27/2022] [Accepted: 08/29/2022] [Indexed: 11/22/2022] Open
Abstract
Background Wheelchair part failures have doubled over the past decade. Preventative wheelchair maintenance reduces wheelchair failures and prevents user consequences. We are developing a smartphone app called WheelTrak, which alerts users when maintenance is required, to encourage maintenance practices and compliance. Objective This mixed methods study aimed to develop a wheelchair maintenance app using broad stakeholder advice and investigate older adults’ interaction experience with the app and their perceived barriers to and facilitators of maintenance. Methods Interviews were conducted with stakeholders, including mobility device users, to generate needs statements and app specifications. The app was designed in 2 stages. Stage 1 involved the development of the app according to the specifications and evaluation of the app interface by lead users. Stage 2 included the revision of the app screens and manual functionality testing. Usability testing and semistructured interviews were conducted with older wheelchair and scooter users. The System Usability Scale was used to measure app usability. Results Interviews with power and manual wheelchair users (37/57, 65%), wheelchair service providers (15/57, 26%), manufacturers (2/57, 4%), seating and mobility researchers (1/57, 2%), and insurance plan providers (2/57, 4%) informed the needs and specifications of the app technology. The 2-stage development process delivered a fully functional app that met the design specifications. In total, 12 older adults (mean age 74.2, SD 9.1 years; n=10, 83% women; and n=2, 17% men) participated in the usability testing study. Of the 12 participants, 9 (75%) agreed to use WheelTrak for preventative maintenance. WheelTrak scored an average System Usability Scale score of 60.25 (SD 16). Four overarching themes were identified: WheelTrak app improvements, barriers to maintenance, consequences related to mobility device failure, and smart technology use and acceptance. Older adults preferred the simplicity, readability, personalization, and availability of educational resources in the app. Barriers to maintenance pertained to health issues and lack of maintenance knowledge among older adults. Facilitators of maintenance included notification for maintenance, app connectivity with the service provider, reporting of device failure, and the presence of a caregiver for maintenance. Conclusions This study highlighted age-friendly design improvements to the app, making it easy to be used and adopted by older wheelchair users. The WheelTrak app has close to average system usability. Additional usability testing will be conducted following app revision in the future.
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Affiliation(s)
- Alyssa Boccardi
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Fangzheng Wu
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anand Mhatre
- Occupational Therapy Division, Ohio State University Wexner Medical Center, Columbus, OH, United States
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Burrola-Mendez Y, Kamalakannan S, Rushton PW, Bouziane SA, Giesbrecht E, Kirby RL, Gowran RJ, Rusaw DF, Tasiemski T, Goldberg M, Tofani M, Pedersen JP, Pearlman J. Wheelchair service provision education for healthcare professional students, healthcare personnel and educators across low- to high-resourced settings: a scoping review. Disabil Rehabil Assist Technol 2022; 18:67-88. [PMID: 35436160 PMCID: PMC7614122 DOI: 10.1080/17483107.2022.2037757] [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: 02/08/2023]
Abstract
PURPOSE This review aimed to collate and summarize available research literature about wheelchair service provision education available to healthcare professional students, healthcare personnel and educators across low- to high-resourced settings. METHODS The Joanna Briggs Institute methodological steps for scoping reviews were followed. Included studies were mainly sourced from Medline, Embase, CINAHL, Scopus, Academic Search Complete and ProQuest. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. All screening and extraction were performed independently by two authors. A thematic approach was used to synthesize results. Data extracted from included studies were charted according to a template that we created. The study quality was also appraised. RESULTS A total of 25 articles were included (11, 36% from high-income settings) with 12 (48%) observational studies and 13 (52%) experimental studies. The literature addressed three main topics: (1) assessing wheelchair service provision knowledge, (2) implementing training interventions using in-person, online and/or hybrid learning approaches and (3) describing current wheelchair service provision education globally. The most frequently reported training programs used were the Wheelchair Skills Program and the World Health Organization Wheelchair Service Training Package - Basic Level. CONCLUSION Limited information has been published about the integration of wheelchair content into the curricula of professional rehabilitation programs. Efforts to build international partnerships, improve the quality and currency of training programs and build resources that can assist educators in the integration of wheelchair-related content into professional rehabilitation programs should be prioritized.Implications for RehabilitationThis is the first review that examined and synthesized the current state of wheelchair service provision education for rehabilitation students and personnel across low- to high-income countries.Findings from this review indicate that there is limited information about the integration of wheelchair-related content into professional rehabilitation programs.Efforts to build international partnerships, standardize wheelchair service provision content and evaluation and integrate training into professional rehabilitation programs worldwide should be prioritized.
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Affiliation(s)
- Yohali Burrola-Mendez
- School of Rehabilitation, Université de Montréal, Montréal, Canada,CHU Sainte-Justine Research Centre, Montréal, Canada
| | - Sureshkumar Kamalakannan
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK,Public Health Foundation of India, Indian Institute of Public Health, Hyderabad, India
| | - Paula W. Rushton
- School of Rehabilitation, Université de Montréal, Montréal, Canada,CHU Sainte-Justine Research Centre, Montréal, Canada
| | | | - Ed Giesbrecht
- Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Manitoba, Canada
| | - R. Lee Kirby
- Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Canada
| | - Rosemary J. Gowran
- School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, Health Implementation Science and Technology, University of Limerick, Limerick, Ireland,Assisting Living and Learning (ALL) Institute Maynooth University, Maynooth, Ireland
| | - David F. Rusaw
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Tomasz Tasiemski
- Department of Adapted Physical Activity, Poznan University of Physical Education, Poznan, Poland
| | - Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marco Tofani
- Department of Intensive Neurorehabilitation and Robotics, Bambino Gesú Children’s Hospital IRCCS, Rome, Italy
| | | | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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13
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Mhatre A, Pearlman J, Schmeler M, Krider B, Fried J. Community-based wheelchair caster failures call for improvements in quality and increased frequency of preventative maintenance. Spinal Cord 2022; 60:58-62. [PMID: 34413486 PMCID: PMC8737191 DOI: 10.1038/s41393-021-00689-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 11/24/2022]
Abstract
STUDY DESIGN Secondary data analysis of wheelchair failures and service repair logs from a network of wheelchair suppliers. OBJECTIVE To determine the frequency of wheelchair caster failures and service repairs across wheelchair manufacturers and models and investigate the relationships between them. SETTING Wheelchair caster failures and service repairs occurred in the community. METHODS Reported caster failure types were classified based on the risk they pose for user injuries and wheelchair damage. Caster failures experienced by users of tilt-in-space and ultralightweight manual wheelchair models and Group 2, 3 and 4 power wheelchair models between January 2017 and October 2019 were analyzed using Chi-Square tests for independence. Correlational analysis of failures and service repairs was performed. RESULTS A total of 6470 failures and 151 service repairs reported across four manufacturers and five models were analyzed. Failure types were significantly associated with manufacturers and models, respectively. Users of tilt-in-space wheelchairs, who require greater seating support, experienced twice the proportion of high-risk caster failures than the ultralightweight manual wheelchair users. Similarly, Group 3 and 4 power wheelchair users, who have complex rehabilitation needs, experienced 15-36% more high-risk failures than Group 2 users. Service repairs negatively correlated with high-risk manual wheelchair caster failures. CONCLUSIONS Wheelchair users who have greater seating and complex rehabilitation needs are at a higher risk for sustaining injuries and secondary health complications due to frequent caster failures. The study findings call for significant reforms in product quality and preventative maintenance practices that can reduce wheelchair failures and user consequences.
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Affiliation(s)
- Anand Mhatre
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark Schmeler
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Benjamin Krider
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - John Fried
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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14
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Goldberg M, Alharbi M, Kandavel K, Burrola-Mendez Y, Augustine N, Toro-Hernández ML, Pearlman J. An exploratory analysis of global trends in wheelchair service provision knowledge across different demographic variables: 2017-2020. Assist Technol 2021; 35:142-152. [PMID: 34705605 DOI: 10.1080/10400435.2021.1992541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To explore global trends in manual wheelchair service provision knowledge across geographic, professional, and socioeconomic domains. DESIGN A secondary analysis of a dataset from the International Society of Wheelchair Professionals' Wheelchair Service Provision Basic Knowledge Test was conducted. SETTING The dataset included test takers from around the world and was extracted from Test.com and International Society of Wheelchair Professionals' Wheelchair International Network. PARTICIPANTS 2,467 unique test takers from 86 countries. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES International Society of Wheelchair Professionals' Wheelchair Service Provision Basic Knowledge Test. RESULTS We identified significant inverse associations between pass rate and the following variables: education (high school and some college), test taker motivation (required by academic program or employer), and country income setting (low and middle). There were significant positive associations between pass rate and the following variables: training received (offered by Mobility India or 'other NGO'), and age group served (early childhood). CONCLUSION Global wheelchair knowledge trends related to key variables such as training, occupation, and income setting have been preliminarily explored. Future work includes further validation of the primary outcome measure and recruitment of a larger sample size to further explore significant associations between additional test taker variables.
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Affiliation(s)
- Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, USA.,Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, USA.,International Society of Wheelchair Professionals, Pittsburgh, USA
| | - Mohammed Alharbi
- Geoinformatics Laboratory, School of Computing and Information, University of Pittsburgh, Pittsburgh, USA.,College of Computer Science and Engineering, Taibah University, Medina, Saudi Arabia
| | - Krithika Kandavel
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, USA.,International Society of Wheelchair Professionals, Pittsburgh, USA
| | - Yohali Burrola-Mendez
- International Society of Wheelchair Professionals, Pittsburgh, USA.,Université de Montréal, Montreal, Quebec, Canada
| | - Nancy Augustine
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, USA.,International Society of Wheelchair Professionals, Pittsburgh, USA
| | | | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, USA.,International Society of Wheelchair Professionals, Pittsburgh, USA
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15
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Wilson-Jene H, Mhatre A, Ott J, Krider B, Smith C, Terhorst L, Pearlman J. Rolling resistance of casters increases significantly after two years of simulated use. J Rehabil Assist Technol Eng 2021; 8:20556683211025149. [PMID: 34408905 PMCID: PMC8365014 DOI: 10.1177/20556683211025149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/27/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction Manual wheelchair propulsion is associated with upper limb pain and injury, and clinical guidelines recommend minimizing propulsive force to lower health risks. One of the strategies to reduce propulsive force is by minimizing rolling resistance (RR). Product testing studies suggest that RR of casters is affected by wear and tear which could have implications on the health risk of wheelchair users. The study will investigate the relationship between caster RR and environmental exposure using standard testing protocols. Methods RR of ten casters representing a range of diameters for different models of wheelchairs were measured before and after environmental exposure that includes corrosion, shock and abrasion simulating two years of community use. Results Four casters exhibited failures during durability testing, one catastrophically. Increases to RR after corrosion, shock and abrasion exposure were statistically significant using mixed-effects modeling, and four casters had increased RR greater than 20%. Conclusions Many of the casters evaluated exhibited increased RR forces and failure after environmental exposure. Improved caster design and use of corrosion resistant materials may reduce these failures. In addition, modification of the provision process could include replacement casters to reduce failures and avoid breakdowns that leave manual wheelchair users stranded or injured.
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Affiliation(s)
- Holly Wilson-Jene
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA.,International Society of Wheelchair Professionals, Pittsburgh, PA USA
| | - Anand Mhatre
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA.,International Society of Wheelchair Professionals, Pittsburgh, PA USA
| | - Joseph Ott
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA.,International Society of Wheelchair Professionals, Pittsburgh, PA USA
| | - Benjamin Krider
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA.,International Society of Wheelchair Professionals, Pittsburgh, PA USA
| | - Clair Smith
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA
| | - Lauren Terhorst
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, PA, USA.,International Society of Wheelchair Professionals, Pittsburgh, PA USA
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16
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D’Innocenzo ME, Pearlman JL, Garcia-Mendez Y, Vasquez-Gabela S, Zigler C, Rosen P, Dewi EH, Praptoraharjo I, Mhatre A. Exploratory investigation of the outcomes of wheelchair provision through two service models in Indonesia. PLoS One 2021; 16:e0228428. [PMID: 34061868 PMCID: PMC8168880 DOI: 10.1371/journal.pone.0228428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/27/2021] [Indexed: 11/18/2022] Open
Abstract
The World Health Organization (WHO) estimates that only 17-37% of the approximately 77 million people who need a wheelchair have access to one. Many organizations are trying to address this need through varying service delivery approaches. For instance, some adhere to WHO's recommended 8-steps service approach while others provide wheelchairs with little to no service. There is limited and sometimes conflicting evidence of the impact of the WHO's recommendations on the outcomes of wheelchair provision. To help build this evidence, we \explored outcomes of two groups of users who received their wheelchairs through two service models over time. The 8-Steps group (n = 118) received a wheelchair selected from a range of models from service providers trained using the WHO process, and the standard of care (SOC) group (n = 24) received hospital-style wheelchairs and without clinical service. Interviews were conducted at baseline and at follow-up 3 to 6 months after provision, to collect data about wheelchair usage, satisfaction, skills, maintenance and repairs, and life satisfaction. Across-group statistical comparisons were not appropriate due to significant differences between groups. In general, participants used their wheelchairs every day but reported very low mobility levels (<500 meters for the 8-steps group, and <100 meters for the SOC group.) The 8-steps group used their wheelchair for either between 1-3 hours per day, or more than 8 hours per day. The SOC used it between 1 and 3 hours per day. Overall, wheelchair usage and wheelchair skills decreased over the 3- to 6-month data collection timeline. Wheelchair breakdowns were common in both groups emphasizing the need for maintenance, occurring more frequently in the 8-Steps (28.8%) compared to the SOC group (8%), and emphasizing the need for maintenance services. No significant differences were found when comparing device satisfaction across wheelchairs types. Our results emphasize the need for routine maintenance to address frequent wheelchair breakdowns. Our results also demonstrate a large disparity in several outcome variables across groups which motivates future studies where across-group comparisons are possible.
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Affiliation(s)
- Megan E. D’Innocenzo
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jonathan L. Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Yasmin Garcia-Mendez
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Stephanie Vasquez-Gabela
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Christina Zigler
- Department of Population Health Science, Duke University, Durham, North Carolina, United States of America
| | - Perth Rosen
- United Cerebral Palsy (UCP) Wheels for Humanity, Chatsworth, California, United States of American
| | - Eviana Hapsari Dewi
- Department of Health Policy and Management, Gadjah Mada University, Yogyakarta, Indonesia
| | - Ignatius Praptoraharjo
- Department of Health Policy and Management, Gadjah Mada University, Yogyakarta, Indonesia
| | - Anand Mhatre
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
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17
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Gilbert C, Hsieh S, Donovan J, Dyson-Hudson T, Cabarle M, Granger S, Kirshblum S. Effect of an interventional educational wheelchair program on medical students' understanding of manual wheelchair use. PM R 2021; 13:1350-1356. [PMID: 33956395 DOI: 10.1002/pmrj.12628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/02/2020] [Accepted: 04/05/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND There is limited literature exploring the benefits of interactive wheelchair educational programs in medical student curricula. OBJECTIVE To identify the effect of an educational interactive wheelchair program on medical students' understanding of wheelchair use. Researchers hypothesized that the program would increase understanding. DESIGN Repeated-measures survey study with postintervention comparison. SETTING Inpatient acute rehabilitation center. PARTICIPANTS Out of 123 eligible fourth-year medical students on a mandatory physical medicine and rehabilitation clerkship, 79 students participated. INTERVENTION All participants underwent a 2-hour educational wheelchair program consisting of (1) a disability lecture; (2) a video on the importance of proper wheelchair type and fit, wheelchair prescription, as well as recreational wheelchair use; and (3) an interactive wheelchair experience. MAIN OUTCOME MEASURES Pre- and postsurvey Likert scale questions measured medical students' understanding of four main areas: (1) impact of manual wheelchair use, (2) challenges of manual wheelchair use, (3) manual wheelchair skills, and (4) wheelchair etiquette. RESULTS A two-tailed sign test demonstrated a highly significant increase from pre- to postsurvey scores in each survey section (P < .001). Presurvey and postsurvey mean scores for impact of manual wheelchair use, challenges of manual wheelchair use, manual wheelchair skills, and wheelchair etiquette survey sections were 3.9 and 4.4, 3.1 and 4.4, 2.4 and 4.4, and 2.5 and 4.0, respectively. CONCLUSIONS This study demonstrates that an interactive educational wheelchair program effectively increases medical students' understanding of manual wheelchair use. The addition of an educational interactive wheelchair program to medical student curricula is recommended to improve medical students' understanding of manual wheelchair use and its impact on users.
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Affiliation(s)
- Courtney Gilbert
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Shelly Hsieh
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Jayne Donovan
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Trevor Dyson-Hudson
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Foundation, West Orange, New Jersey, USA
| | - Mary Cabarle
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Syndi Granger
- Kessler Institute for Rehabilitation, West Orange, New Jersey, USA
| | - Steven Kirshblum
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, New Jersey, USA.,Kessler Institute for Rehabilitation, West Orange, New Jersey, USA.,Kessler Foundation, West Orange, New Jersey, USA
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18
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Worobey LA, Heinemann AW, Anderson KD, Fyffe D, Dyson-Hudson TA, Berner T, Boninger ML. Factors Influencing Incidence of Wheelchair Repairs and Consequences Among Individuals with Spinal Cord Injury. Arch Phys Med Rehabil 2021; 103:779-789. [PMID: 33845000 DOI: 10.1016/j.apmr.2021.01.094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/13/2021] [Accepted: 01/19/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the frequency and consequences of wheelchair repairs, looking at the relationship to usage, components, out-of-pocket costs, number of days affecting the user, and factors associated with the need for repairs or consequences. DESIGN Survey, cross-sectional. SETTING Nine spinal cord injury (SCI) Model Systems centers. PARTICIPANTS Wheelchair users with SCI (N=533). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Cost and incidence of wheelchair repairs and consequences and wheelchair usage within the past 6 months. RESULTS A total of 310 participants (56%) reported repairs, 127 (42%) of whom experienced at least 1 adverse consequence lasting a median of 5 days (interquartile range [IQR], 2-17.3 days). Repair rates were highest for the seating system, electronics, and tires. Participants were most often stranded at home or forced to use a backup chair. Median out-of-pocket costs were $150 (IQR, $50-$620). Active users, based on type of mobility and terrain, experienced more repairs and consequences than less active users. Repairs were more common among those who were Black (odds ratio [OR], 2.42) or power wheelchair (PWC) users (OR, 1.84), whereas consequences were more common among those who were Black (OR, 2.27), PWC (OR, 2.08) or power assist users (OR, 2.76), and those who had public insurance (OR, 1.70). CONCLUSIONS Wheelchair repairs continue to affect more than 50% of wheelchair users with significant financial and personal cost. High repair rates limited participation inside and outside of the home. Consequences lasted longer than 2 weeks for many and may be minimized by a working backup chair. Disparities exist based on participant and wheelchair factors; repairs and adverse consequences appear to hit those most vulnerable with the least financial resources. Costs may be a barrier to repair completion for some individuals. This ongoing problem of high repair rates and their associated effects requires action such as higher standards, access to quicker service, and better training of users on wheelchair maintenance and repair.
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Affiliation(s)
- Lynn A Worobey
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA.
| | | | | | | | | | - Theresa Berner
- The Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Michael L Boninger
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare system, Pittsburgh, PA
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19
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Understanding the Global Challenges to Accessing Appropriate Wheelchairs: Position Paper. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073338. [PMID: 33804868 PMCID: PMC8036353 DOI: 10.3390/ijerph18073338] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 03/18/2021] [Indexed: 11/17/2022]
Abstract
Introduction: Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. Approach: To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. Conclusion: The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us.
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20
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Ardianuari S, Goldberg M, Pearlman J, Schmeler M. Development, validation and feasibility study of a remote basic skills assessment for wheelchair service providers. Disabil Rehabil Assist Technol 2020; 17:462-472. [PMID: 32862734 DOI: 10.1080/17483107.2020.1799250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The purpose of this study was to develop, validate and conduct a feasibility study of three remote basic skills assessment modalities for wheelchair service providers (WSP) including an online case study quiz (m1), an in-person skills assessment (m2) and a video conference skills assessment (m3). METHODS We conducted a literature review; developed and validated 3 basic skills assessments; and conducted a feasibility study of each modality. RESULTS The literature review revealed that a validated remote basic skills assessment for WSP that reflects all World Health Organization (WHO) 8 wheelchair service provision steps did not exist. We recruited a total of 12 participants for the feasibility study. Two participants dropped out of the study prior to completing a second testing modality. Related to test performance, the results show that our first hypothesis was rejected because only m1 mean score was comparable to the International Society of Wheelchair Professionals (ISWP) Basic Knowledge Test (SD = 0.44). This is in contrast with the Wilcoxon signed-rank test results that show a statistically significant difference between these two modalities. We are therefore not confident that the knowledge test was an appropriate comparison to m1 skills assessment. Hypothesis two was not rejected. The feasibility results reveal 86% success. CONCLUSION M1, 2 and 3 have the potential to serve as remote basic skills assessments. However, according to both test performance and feasibility criteria, we believe that m2 has the highest potential to be included in certification processes for basic wheelchair service providers, like the one offered by ISWP.IMPLICATIONS FOR REHABILITATIONA universal remote basic skills assessment that can be accessed across the globe, especially in remote locations where a skilled and experienced provider is not available, is needed.Such test can be an asset to training or professional organisations like ISWP as a way to test WSP competency or to warrant certification.WSP clinical knowledge and skills are essential for the prescription of an appropriate wheelchair to avoid physical harm, abandonment of the device and unnecessary expenses.Properly prescribed wheelchairs allow people with impaired mobility to gain increased ability to perform ADLs, participate in communities, and reduce secondary medical complications such as upper limb repetitive strain injuries, pain, and/or pressure sores.
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Affiliation(s)
- Satria Ardianuari
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.,Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA.,Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Mark Schmeler
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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21
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Henderson GV, Boninger ML, Dicianno BE, Worobey LA. Type and frequency of wheelchair repairs and resulting adverse consequences among veteran wheelchair users. Disabil Rehabil Assist Technol 2020; 17:331-337. [DOI: 10.1080/17483107.2020.1785559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Geoffrey V. Henderson
- Department of Bioengineering, Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael L. Boninger
- Department of Bioengineering, Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, Department of Veterans Affairs, Pittsburgh, PA, USA
| | - Brad E. Dicianno
- Department of Bioengineering, Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, Department of Veterans Affairs, Pittsburgh, PA, USA
| | - Lynn A. Worobey
- Department of Bioengineering, Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Human Engineering Research Laboratories, Department of Veterans Affairs, Pittsburgh, PA, USA
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Eshraghi M, Sawatzky B, Mortenson WB. Feasibility of a peer-led, manual wheelchair maintenance skills training programme to improve wheelchair efficiency, and knowledge and confidence about wheelchair maintenance: a pre-post study. Disabil Rehabil Assist Technol 2020; 16:918-926. [PMID: 32275453 DOI: 10.1080/17483107.2020.1749897] [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: 10/24/2022]
Abstract
BACKGROUND Wheelchair users typically receive little training about wheelchair maintenance. Therefore, we developed a peer-led, manual wheelchair skills maintenance training programme, with the intention of evaluating its efficacy in a future experimental study. PURPOSE The purpose of this feasibility study was to examine how well we were able to implement the training programme and to evaluate the feasibility of conducting a larger scale clinical trial. SETTING Spinal cord injury research centre. PARTICIPANTS Five mentors and fifteen mentees were recruited to complete this feasibility study. METHOD We collected information about recruitment capability and sample characteristics, data collection procedure, acceptability of the training programme, resources required, and participants' responses to the intervention. Participants completed all the items and we had little missing data. Participants did not face any difficulty answering the questionnaires or performing the tests. Therefore, we could conclude data collection was feasible moving forward to perform larger efficacy trials. The acceptability of the wheelchair maintenance programme was more than 90%. There was a statistically significant improvement in wheelchair maintenance knowledge test and total rolling resistance. Confidence of mentees increased significantly after the training. Improvements in the 3-cone test and the 6-min push test results were not significant. CONCLUSIONS If recruitment and scheduling challenges can be overcome, our data suggested that it is feasible to conduct a larger experimental study to test the efficacy of the programme.Implications for RehabilitationWheelchair maintenance skills are important to help wheelchair users keep their wheelchairs working safely and efficiently.The findings from this study suggest that a peer-led wheelchair maintenance training programme may improve participants' wheelchair maintenance knowledge and maintenance self-confidence.The study also suggests that a peer-led wheelchair maintenance training programme may decrease the rolling resistance of participants' wheelchairs.A larger clinical trial is needed to demonstrate the efficacy of this intervention authoritatively.
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Affiliation(s)
- Mehdi Eshraghi
- International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada
| | - Bonita Sawatzky
- International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada.,Department of Orthopaedics, University of British Columbia, Vancouver, BC, Canada
| | - W Ben Mortenson
- International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada.,GF Strong Rehabilitation Research Program, Vancouver, BC, Canada
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Rushton PW, Fung K, Gauthier M, Goldberg M, Toro M, Seymour N, Pearlman J. Development of a toolkit for educators of the wheelchair service provision process: the Seating and Mobility Academic Resource Toolkit (SMART). HUMAN RESOURCES FOR HEALTH 2020; 18:14. [PMID: 32070363 PMCID: PMC7029573 DOI: 10.1186/s12960-020-0453-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 02/03/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Insufficient wheelchair training among rehabilitation professionals has been identified as an important factor that hinders access to appropriate wheelchair services. The aim of this study was to develop a toolkit to promote the integration of wheelchair education into academic curricula of rehabilitation programs. METHODS A participatory action research design was carried out in three phases: (1) development of the Initial and Alpha Versions involving secondary analyses of surveys (n = 72), interviews (n = 14), and academic training partners meeting presentations (n = 16); (2) development of the Beta Version based on feedback from collaborators (n = 21); and (3) development of the Launch Version based on feedback from participants attending presentations of the Beta Version at conferences, symposiums, and webinars (n = 94). RESULTS Over 100 individuals participated in reviews of the Seating and Mobility Academic Resource Toolkit (SMART). Initial development addressed modifiable factors that perpetuate insufficient wheelchair education in academic curricula (e.g., limited awareness, limited expertise). Internal feedback on the web-based Alpha Version resulted in modifications of appearance and multimedia, structure and design, and navigation. External feedback then led primarily to fine-tuning the navigation of SMART. Positive reviews were received from global wheelchair professionals (i.e., educators, researchers, clinicians). The Launch Version of the SMART (smart.wheelchairnetwork.org) provides a forum for sharing and accessing resources to inform the integration and enhancement of wheelchair content into university rehabilitation programs. CONCLUSIONS As an open-source open-access online "living document," SMART has the potential to promote the integration of wheelchair service provision education into academic curricula of rehabilitation programs. Future studies will explore the ease of use and the effectiveness of the SMART.
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Affiliation(s)
- Paula W Rushton
- School of Rehabilitation, University of Montréal, Montréal, Canada.
- CHU Sainte-Justine Research Centre, 5200 rue Bélanger, Montréal, QC, H1T 1C9, Canada.
| | - Karen Fung
- School of Rehabilitation, University of Montréal, Montréal, Canada
- CHU Sainte-Justine Research Centre, 5200 rue Bélanger, Montréal, QC, H1T 1C9, Canada
| | - Mélina Gauthier
- School of Rehabilitation, University of Montréal, Montréal, Canada
| | - Mary Goldberg
- Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, USA
- Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, USA
| | - Maria Toro
- Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, USA
- Department of Physical Therapy, Universidad CES, Medellín, Colombia
| | - Nicky Seymour
- Motivation Charitable Trust, Cape Town, South Africa
| | - Jon Pearlman
- Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, USA
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24
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Kirby RL, Doucette SP. Relationships Between Wheelchair Services Received and Wheelchair User Outcomes in Less-Resourced Settings: A Cross-Sectional Survey in Kenya and the Philippines. Arch Phys Med Rehabil 2019; 100:1648-1654.e9. [DOI: 10.1016/j.apmr.2019.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 11/28/2022]
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25
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Dicianno BE, Joseph J, Eckstein S, Zigler CK, Quinby E, Schmeler MR, Schein RM, Pearlman J, Cooper RA. The Voice of the Consumer: A Survey of Veterans and Other Users of Assistive Technology. Mil Med 2019; 183:e518-e525. [PMID: 29635318 DOI: 10.1093/milmed/usy033] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/12/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction A total of 3.6 million Americans and over 250,000 veterans use wheelchairs. The need for advancements in mobility-assistive technologies is continually growing due to advances in medicine and rehabilitation that preserve and prolong the lives of people with disabilities, increases in the senior population, and increases in the number of veterans and civilians involved in conflict situations. The purpose of this study is to survey a large sample of veterans and other consumers with disabilities who use mobility-assistive technologies to identify priorities for future research and development. Materials and Methods This survey asked participants to provide opinions on the importance of developing various mobility-assistive technologies and to rank the importance of certain technologies. Participants were also asked to provide open-ended comments and suggestions. Results A total of 1,022 individuals, including 500 veterans, from 49 states within the USA and Puerto Rico completed the survey. The average age of respondents was 54.3 yr, and they represented both new and experienced users of mobility-assistive technologies. The largest diagnostic group was spinal cord injury (SCI) (N = 491, 48.0%). Several themes on critical areas of research emerged from the open-ended questions, which generated a total of 1,199 comments. Conclusion This survey revealed several themes for future research and development. Advanced wheelchair design, smart device applications, human-machine interfaces, and assistive robotics and intelligent systems emerged as priorities. Survey results also demonstrated the importance for researchers to understand the effects of policy and cost on translational research and to be involved in educating both consumers and providers.
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Affiliation(s)
- Brad E Dicianno
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - James Joseph
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Stacy Eckstein
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA
| | - Christina K Zigler
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Eleanor Quinby
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | - Mark R Schmeler
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Richard M Schein
- Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Jon Pearlman
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| | - Rory A Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.,Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA.,Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
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26
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Múnera S, Pearlman J, Toro M, Worobey L, Boninger M, Cooper RA. Development and efficacy of an online wheelchair maintenance training program for wheelchair personnel. Assist Technol 2019; 33:49-55. [PMID: 31169455 DOI: 10.1080/10400435.2019.1619632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES To develop an online version of the wheelchair maintenance training program (WMTP) and compare learning outcomes from the in-person and online programs using the wheelchair maintenance training questionnaire (WMT-Q), administered before and after the intervention. DESIGN Iterative development of an online version of the WMTP and implementation. SETTING Online. PARTICIPANTS 26 graduate and undergraduate students. INTERVENTION Web-based training. These results are compared with those from another study of the in-person WMTP with 10 participants. MAIN OUTCOME MEASURES Feedback survey and WMT-Q. RESULTS The training program was well-received and valued by all 26 participants. A significant increase in all scores after the online training program was found, based on pre-/post-intervention scores. In manual wheelchair open-ended questions, knowledge increased from 16% to 21%, p < .05; in power wheelchair open-ended questions, from 9% to 31%, p < .05; in multiple-choice questions related to knowledge, from 27% to 59%, p < .05; confidence increased from 8% to 80%, p < .05; and capacity from 12% to 88%, p < .05. There was no statistical difference in WMT-Q scores between individuals who participated in the in-person and online programs. CONCLUSION This study indicates that there was a similar-increased knowledge for participants, indicating that web-based training may be a viable approach for delivering maintenance training.
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Affiliation(s)
- Sara Múnera
- El Comité de Rehabilitación , Medellín, Colombia
| | - Jon Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Maria Toro
- School of Physical Therapy, Universidad CES , Medellín, Colombia
| | - Lynn Worobey
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Michael Boninger
- Department of Physical Medicine & Rehabilitation, University of Pittsburgh , Pittsburgh, Pennsylvania, USA
| | - Rory A Cooper
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System , Pittsburgh, Pennsylvania, USA
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27
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Fung K, Miller T, Rushton PW, Goldberg M, Toro ML, Seymour N, Pearlman J. Integration of wheelchair service provision education: current situation, facilitators and barriers for academic rehabilitation programs worldwide. Disabil Rehabil Assist Technol 2019; 15:553-562. [PMID: 31012755 DOI: 10.1080/17483107.2019.1594408] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: An estimated 75 million people with disabilities need wheelchairs globally, of whom 5-15% have one. Access to an appropriate wheelchair requires rehabilitation professionals trained to provide wheelchair service. One aim of the International Society of Wheelchair Professionals (ISWP) is to promote and facilitate the integration of wheelchair service provision education into academic rehabilitation programs worldwide. To inform the development of integration strategies, the purpose of this study was to develop an in-depth global portrait of the wheelchair service provision education offered in academic rehabilitation programs, the process of its integration and the associated facilitators and barriers.Method: Semi-structured qualitative interviews were conducted with a purposive sample of 14 representatives from academic rehabilitation programs (i.e., occupational therapy, physical therapy, and prosthetics and orthotics) in 11 countries, including low, middle and upper resourced settings.Findings: Thematic data analyses identified three overarching themes. The first theme, "impact of context", portrays factors related to local population needs, governance and supply chain of equipment and service delivery. The second theme, "current and planned wheelchair education", describes the content, pedagogic approach, student evaluation and feedback process. The third theme, "integration process", details five states of this process.Conclusions: This study describes in-depth the wheelchair service provision education across academic rehabilitation programs and resource settings, illustrating the context-dependent nature of its integration. This understanding may assist the global community of educators in preparing future rehabilitation professionals to better serve wheelchair users. This work has informed the development of ISWP's Seating and Mobility Academic Resource Toolkit (http://smart.wheelchairnetwork.org/).Implications for RehabilitationThe Dynamics of Context-Dependent Integration of Wheelchair Service Provision Education in Curricula model, depicting the findings of this study, may help to inform key stakeholders (i.e., academic institutions, health care providers and policy makers) about potential barriers and facilitators to the implementation of adequate wheelchair service provision education in the curricula of academic rehabilitation program.Study findings may lead to creative strategies, such as the expansion of ISWP's Seating and Mobility Academic Resource Toolkit (SMART; http://smart.wheelchairnetwork.org/), that may enable academic rehabilitation programs to be a part of the solution to strengthening rehabilitation systems worldwide, through appropriately trained rehabilitation professionals in wheelchair service provision.
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Affiliation(s)
- Karen Fung
- School of Occupational Therapy, Université de Montréal, Montreal, Quebec, Canada
| | - Taavy Miller
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Paula W Rushton
- School of Occupational Therapy, Université de Montréal, Montreal, Quebec, Canada
| | - Mary Goldberg
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Maria L Toro
- Department of Physical Therapy, Universidad CES, Medellín, Colombia
| | - Nicky Seymour
- Motivation Charitable Trust, Cape Town, South Africa
| | - Jonathan Pearlman
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
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28
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Hogaboom NS, Worobey LA, Houlihan BV, Heinemann AW, Boninger ML. Wheelchair Breakdowns Are Associated With Pain, Pressure Injuries, Rehospitalization, and Self-Perceived Health in Full-Time Wheelchair Users With Spinal Cord Injury. Arch Phys Med Rehabil 2018; 99:1949-1956. [PMID: 29698640 DOI: 10.1016/j.apmr.2018.04.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 02/28/2018] [Accepted: 04/07/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the relation between wheelchair breakdowns, their immediate consequences, and secondary health complications after spinal cord injury. "Immediate consequences" occur when part of a wheelchair breaks and leaves an individual stranded or injured, or causes him or her to miss medical appointments, work, or school. DESIGN Survey, cross-sectional. SETTING Spinal Cord Injury Model Systems Centers. PARTICIPANTS Full-time wheelchair users (N=771) with SCI from 9 Spinal Cord Injury Model Systems Centers, with data collected between 2011 and 2016. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Incidence of self-reported wheelchair breakdowns within the past 6 months that did or did not result in immediate consequences (ie, injury, being stranded, missing a medical appointment, or an inability to attend school/work); self-perceived health status scale; pain severity numerical rating scale; rehospitalizations; and self-reported pressure injury development within the past 12 months. RESULTS A total of 610 participants with complete data sets were included in the analyses. When compared to those who reported no breakdowns, participants who reported 1 or more immediate consequences had worse secondary complications: higher self-perceived health status and pain scores (partial -η2=.009-.012, P<.05), and higher odds of rehospitalization (odds ratio: 1.86, P<.05) and pressure injury development (odds ratio: 1.73, P<.05). Secondary health complications were not different in those who reported no immediate consequences compared to those who reported no breakdown. CONCLUSIONS Wheelchair breakdowns that resulted in injury, being stranded, missing medical appointments, and/or an inability to attend work/school appear to have far-reaching impacts on health and secondary injury. Preventing wheelchair breakdowns, through either better maintenance or manufacturing, may be a means of decreasing secondary disability.
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Affiliation(s)
- Nathan S Hogaboom
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lynn A Worobey
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Bethlyn V Houlihan
- Spaulding New England Regional SCI Center, Boston, Massachusetts; The Health and Disability Research Institute, Department of Health Policy and Management School of Public Health, Boston University, Boston, Massachusetts
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, Illinois; Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, Illinois
| | - Michael L Boninger
- Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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29
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Dicianno BE, Joseph J, Eckstein S, Zigler CK, Quinby EJ, Schmeler MR, Schein RM, Pearlman J, Cooper RA. The future of the provision process for mobility assistive technology: a survey of providers. Disabil Rehabil Assist Technol 2018; 14:338-345. [PMID: 29557196 DOI: 10.1080/17483107.2018.1448470] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the opinions of providers of mobility assistive technologies to help inform a research agenda and set priorities. MATERIALS AND METHODS This survey study was anonymous and gathered opinions of individuals who participate in the process to provide wheelchairs and other assistive technologies to clients. Participants were asked to rank the importance of developing various technologies and rank items against each other in terms of order of importance. Participants were also asked to respond to several open-ended questions or statements. RESULTS A total of 161 providers from 35 states within the USA consented to participation and completed the survey. CONCLUSIONS This survey revealed themes of advanced wheelchair design, assistive robotics and intelligent systems, human machine interfaces and smart device applications. It also outlined priorities for researchers to provide continuing education to clients and providers. These themes will be used to develop research and development priorities. Implications for Rehabilitation • Research in advanced wheelchair design is needed to facilitate travel and environmental access with wheelchairs and to develop alternative power sources for wheelchairs.• New assistive robotics and intelligent systems are needed to help wheelchairs overcome obstacles or self-adjust, assist wheelchair navigation in the community, assist caregivers and transfers, and aid ambulation.• Innovations in human machine interfaces may help advance the control of mobility devices and robots with the brain, eye movements, facial gesture recognition or other systems.• Development of new smart devices is needed for better control of the environment, monitoring activity and promoting healthy behaviours.
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Affiliation(s)
- Brad E Dicianno
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA.,b Department of Physical Medicine and Rehabilitation , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.,c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
| | - James Joseph
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA
| | - Stacy Eckstein
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA
| | - Christina K Zigler
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA.,b Department of Physical Medicine and Rehabilitation , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Eleanor J Quinby
- b Department of Physical Medicine and Rehabilitation , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA
| | - Mark R Schmeler
- c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
| | - Richard M Schein
- c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
| | - Jon Pearlman
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA.,c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
| | - Rory A Cooper
- a Human Engineering Research Laboratories , VA Pittsburgh Healthcare System , Pittsburgh , PA , USA.,b Department of Physical Medicine and Rehabilitation , University of Pittsburgh School of Medicine , Pittsburgh , PA , USA.,c Department of Rehabilitation Science and Technology , University of Pittsburgh School of Health and Rehabilitation Sciences , Pittsburgh , PA , USA
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30
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Pearlman J, Cooper R. Editorial. Afr J Disabil 2017; 6:423. [PMID: 29134180 PMCID: PMC5675921 DOI: 10.4102/ajod.v6i0.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
No abstract available.
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Affiliation(s)
- Jonathan Pearlman
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, United States
- Department of Rehabilitation Sciences and Technology, University of Pittsburgh, United States
| | - Rory Cooper
- International Society of Wheelchair Professionals, University of Pittsburgh, United States
- Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, United States
- School of Health and Rehab Sciences, University of Pittsburgh, United States
- Department of Rehabilitation Science and Technology, Uniformed Services University of Health Sciences, United States
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31
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Fung KH, Rushton PW, Gartz R, Goldberg M, Toro ML, Seymour N, Pearlman J. Wheelchair service provision education in academia. Afr J Disabil 2017; 6:340. [PMID: 28936415 PMCID: PMC5594266 DOI: 10.4102/ajod.v6i0.340] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 06/21/2017] [Indexed: 12/03/2022] Open
Abstract
Background An estimated 70 million people with disabilities need wheelchairs. To address this global crisis, the World Health Organization (WHO) proposed an eight-step wheelchair service provision model to ensure service quality regardless of resource setting. The International Society of Wheelchair Professionals (ISWP) aims to facilitate the integration of the WHO eight-step model into professional rehabilitation programmes. Objective To develop an enhanced understanding of the current wheelchair service provision education provided in professional rehabilitation programmes worldwide. Methods In a cross-sectional design, an online survey was distributed to ISWP contacts of educational institutions. Quantitative responses were analysed through summary statistics and qualitative answers were analysed by content analyses. When relevant, educational institutions were stratified into resource settings. Results Seventy-two representatives of educational institutions in 21 countries completed the survey. Wheelchair content was taught in 79% of represented institutions, of which 75% of respondents reported using original course material, 10% of respondents used WHO Wheelchair Service Training Packages and 15% of respondents used other available resources. The majority of educational institutions teaching with their own wheelchair-related course material taught ≤ 20 hours. Fourteen of the 15 respondents without wheelchair education, expressed an interest in integrating wheelchair education into their academic curricula. Conclusion The majority of the educational institutions teach wheelchair education; however, there is great variability in what and how it is taught and evaluated. The results demonstrate the need for more in-depth investigation regarding the integration process of wheelchair education in educational institutions, with the ultimate goal of improving wheelchair service provision worldwide.
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Affiliation(s)
- Karen H Fung
- School of Rehabilitation, Université de Montréal, Canada.,Marie Enfant Rehabilitation Center, Sainte-Justine University Hospital Research Center, Canada
| | - Paula W Rushton
- School of Rehabilitation, Université de Montréal, Canada.,Marie Enfant Rehabilitation Center, Sainte-Justine University Hospital Research Center, Canada
| | - Rachel Gartz
- Rehabilitation Science & Technology, University of Pittsburgh, United States
| | - Mary Goldberg
- Rehabilitation Science & Technology, University of Pittsburgh, United States.,Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, United States
| | - Maria L Toro
- Department of Physiotherapy, Universidad CES, Colombia
| | | | - Jonathan Pearlman
- Rehabilitation Science & Technology, University of Pittsburgh, United States.,Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, United States
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