A clinical trial of a rehabilitation expert clinician versus usual care for providing manual wheelchairs.

Abstract:

OBJECTIVES:To determine the effect of differing methods of dispensing wheelchairs. DESIGN:Quasi-experimental by day of week. SETTING:Department of Veterans Affairs Medical Center. PARTICIPANTS:Eighty-four community-dwelling, cognitively intact patients prescribed a standard manual wheelchair. INTERVENTION:A multifactorial intervention consisting of an expert physical/occupational therapist who used a scripted evaluation that included an evaluation based on medical record review and self-reported and physical performance measures; individualization of the wheelchair and initiation of orders for additional occupational/physical therapy, equipment, or home modifications as needed; multimodal patient education; and telephone follow-up at 3 and 6 weeks. MEASUREMENTS:The primary outcome was amount of wheelchair use. Secondary outcomes were shoulder pain, wheelchair comfort and confidence, and home modifications. RESULTS:The intervention group had significantly greater wheelchair use than usual care at 2 weeks, 3 months, and 6 months (P=.01). Wheelchair use declined monotonically over time for the entire study sample (P<.001). There were no significant differences between the two groups in shoulder pain, wheelchair comfort or confidence, or home modifications. CONCLUSION:New wheelchair owners used the wheelchair more often if they received it from an expert therapist using a multifactorial intervention.

journal_name

J Am Geriatr Soc

authors

Hoenig H,Landerman LR,Shipp KM,Pieper C,Pieper C,Richardson M,Pahel N,George L

doi

10.1111/j.1532-5415.2005.53502.x

subject

Has Abstract

pub_date

2005-10-01 00:00:00

pages

1712-20

issue

10

eissn

0002-8614

issn

1532-5415

pii

JGS53502

journal_volume

53

pub_type

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