Dolan Michael John, Bolton Megan Jennifer, Henderson Graham Iain
a Southeast Mobility and Rehabilitation Technology Centre , NHS Lothian, Astley Ainslie Hospital , Edinburgh , UK.
Disabil Rehabil Assist Technol. 2019 Jan;14(1):56-61. doi: 10.1080/17483107.2017.1393701. Epub 2017 Oct 26.
To profile and compare the seating and powered characteristics and functions of electrically powered wheelchairs (EPWs) in a general user population including equipment costs.
Case notes of adult EPW users of a regional NHS service were reviewed retrospectively. Seating equipment complexity and type were categorized using the Edinburgh classification. Powered characteristics and functions, including control device type, were recorded.
482 cases were included; 53.9% female; mean duration EPW use 8.1 years (SD 7.4); rear wheel drive 88.0%; hand joystick 94.8%. Seating complexity: low 73.2%, medium 18.0%, high 8.7%. Most prevalent diagnoses: multiple sclerosis (MS) 25.3%, cerebral palsy (CP) 18.7%, muscular dystrophy (8.5%). Compared to CP users, MS users were significantly older at first use, less experienced, more likely to have mid-wheel drive and less complex seating. Additional costs for muscular dystrophy and spinal cord injury users were 3-4 times stroke users.
This is the first large study of a general EPW user population using a seating classification. Significant differences were found between diagnostic groups; nevertheless, there was also high diversity within each group. The differences in provision and the equipment costs across diagnostic groups can be used to improve service planning. Implications for Rehabilitation At a service planning level, knowledge of a population's diagnostic group and age distribution can be used to inform decisions about the number of required EPWs and equipment costs. At a user level, purchasing decisions about powered characteristics and functions of EPWs and specialised seating equipment need to be taken on a case by case basis because of the diversity of users' needs within diagnostic groups. The additional equipment costs for SCI and MD users are several times those of stroke users and add between 60 and 70% of the cost of basic provision.
剖析并比较普通用户群体中电动轮椅(EPW)的就座情况、动力特性及功能,包括设备成本。
对某地区国民健康服务(NHS)机构成年电动轮椅用户的病历进行回顾性研究。使用爱丁堡分类法对座椅设备的复杂性和类型进行分类。记录动力特性及功能,包括控制设备类型。
纳入482例病例;女性占53.9%;电动轮椅平均使用时长8.1年(标准差7.4);后轮驱动占88.0%;手动操纵杆占94.8%。座椅复杂性:低73.2%,中18.0%,高8.7%。最常见诊断:多发性硬化症(MS)25.3%,脑瘫(CP)18.7%,肌肉萎缩症(8.5%)。与脑瘫用户相比,多发性硬化症用户首次使用时年龄显著更大,经验更少,更有可能使用中轮驱动且座椅复杂性更低。肌肉萎缩症和脊髓损伤用户的额外成本是中风用户的3至4倍。
这是首次对普通电动轮椅用户群体进行的大型座椅分类研究。在不同诊断组之间发现了显著差异;然而,每组内部也存在高度多样性。不同诊断组在配置和设备成本方面的差异可用于改进服务规划。对康复的启示 在服务规划层面,了解人群的诊断组和年龄分布可用于为所需电动轮椅数量和设备成本的决策提供信息。在用户层面,由于诊断组内用户需求的多样性,关于电动轮椅动力特性及功能和专用座椅设备的购买决策需要逐案进行。脊髓损伤和肌肉萎缩症用户的额外设备成本是中风用户的数倍,占基本配置成本的60%至70%。