Safety, Mobility, and Power Wheelchairs in VA Extended-Care Facilities

Principal Investigator: Diane Collins, PhD, OTR/L

Co-Investigators: Rory A. Cooper, PhD; Annmarie Kelleher, MS, OTR/L, ATP; Amol Karmarkar, MS

2005-2006 

This study proposes to study the safety, mobility, and quality of life of veterans aged 65 years or older, who reside in VA-affiliated extended-care facilities and use power or manual wheelchairs. Compared to manual wheelchair use, use of power wheelchairs is hypothesized to decrease wheelchair-related tips, falls, and incidents in the extended-care facilities.  A prospective study is proposed to collect data on two groups of individuals who currently use wheelchairs – 50 individuals who use power wheelchairs and 100 individuals who use manuals wheelchairs. Members of both groups will be assessed up to three times over the six-month study in the outcomes of: wheelchair-related tips, falls, and incidence, injuries sustained from wheelchair-related tips and falls, frequency and distance traveled in wheelchairs, physical function, resident satisfaction with wheelchair performance and comfort, and discharge status (i.e., to home or to hospital).  

We plan to compare the wheelchair mobility of veteran participants to civilian participants to determine if quality of wheelchair differs, and if so, does the quality of the wheelchair also affect the mobility of the resident.  Demographic variables of: ECF length of stay, age, gender, and disability type (i.e., progressive vs. nonprogressive) will be compared between the groups to determine whether the groups are equal. Once consented, study participants will be assessed in frequency of wheelchair-related falls and incidents, and level of mobility, physical function, and quality of life. 

To date, 32 residents of a VA-affiliated nursing home, and 16 of a civilian nursing home local to Pittsburgh, PA, have been recruited to this study. A conference paper entitled: Monitoring Wheelchair-Related Physical Activities in Older Adults in Nursing Care Facilities, has been submitted to the Rehabilitation Engineering and Assistive Technology Society of North America Conference for publication in the 2008 proceedings.  Results of this paper indicated that civilian participants were older, had more comorbidities, and higher levels of physical impairments when compared to the veteran participants. Also, a higher proportion of female population was found in the civilian participants then the veteran participants. The veterans however were using a better quality manual wheelchair (K04), with higher proportions of veteran residents using their legs, or arms plus legs combination, as a manual wheelchair propulsion method of propulsion when compared to the civilian participants.  

For manual wheelchair- related mobility, although the average use of WC was higher for the civilian group, the veteran group was identified to be more efficient in WC propulsion. This is supported by the data related to speed and endurance of WC propulsion. The differences between the veteran and the civilian groups may be due to the veteran group being predominantly a younger, male population, with fewer impairments who had better quality wheelchairs when compared to the civilian group.