Purpose: To evaluate children's characteristics and impact of a powered wheelchair lending program including comparisons of diagnostic sub-groups, and validation of a predictive model of powered mobility proficiency.
Methods and materials: This retrospective study included 172 children who participated in the ALYN powered mobility lending program from 3/2009-7/2022. Demographics and functional levels were measured via questionnaires; driving proficiency was evaluated when the wheelchair was returned, and parents and children were interviewed following their participation in the program.
Results: Two diagnostic groups were identified: cerebral palsy (CP) (n = 136, median = 9.75 yrs) and other neuromuscular diseases (NMD) (n = 30, median = 5.83 yrs). They differed significantly in the age they commenced PM training, the male/female ratio, walking ability and access mode. Fifty-seven percent of the participants with CP achieved powered mobility proficiency, a rate that was significantly lower than the 73% proficiency found for the NMD group. Four significant predictors were identified: communication, manual wheelchair operation, access mode and go-stop upon request. They predicted proficiency in approximately 80% of cases. Overall feedback from the parents and children indicated that their personal and family's quality of life improved as a result of their child's ability to use a powered wheelchair.
Conclusions: A lending program provides children with opportunities to improve mobility skills in an appropriate powered wheelchair. Children who can communicate verbally, propel a manual wheelchair, use a joystick and go-stop upon request are significantly more likely to become proficient drivers; however, many who were unable to complete these tasks also improved and even became proficient drivers.
Keywords: Powered wheelchair; cerebral palsy; multivariate logistic regression; neuromuscular disease; proficiency.
Children who are able to engage in verbal communication, propel a manual wheelchair for short distances, use a joystick and go-stop upon request are significantly likely to become a proficient powered wheelchair drivers.Children with cerebral palsy who have greater physical challenges (e.g., cannot walk at all or propel a manual wheelchair) can reach powered mobility proficiency following practice with a powered wheelchair borrowed from a lending program, although at a lower rate than those with other neuromuscular diseases; additional training strategies should be developed to increase the percent success for children with cerebral palsy.A multivariate logistic regression was able to correctly predict whether a child will become proficient driver in 80% of case.Training with a powered wheelchair from the lending program enabled parents to observe their children’s independent mobility in their home environment; they reported improvement in the family’s quality of life.