Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA.
Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA.
Arch Phys Med Rehabil. 2021 Oct;102(10):1895-1901. doi: 10.1016/j.apmr.2021.03.024. Epub 2021 Apr 20.
The purpose of this study was to examine factors associated with variability in satisfaction with functional mobility (as measured by the Functional Mobility Assessment [FMA]) in users of mobility devices. Our primary hypothesis was that device type and Assistive Technology Professional (ATP) involvement will be the most significant predictors of FMA score. Our secondary hypothesis was that ATP involvement is associated with use of more custom-fitted manual wheelchairs and group 3 and 4 power wheelchairs.
Retrospective cohort study.
Data were collected from equipment suppliers who collaborate with clinicians to administer the FMA and associated Uniform Data Set within various settings (ie, rehabilitation clinic, school, supplier place of business).
A data set of 4743 cases was included in the analysis (N=4743).
Not applicable.
FMA questionnaire collected at baseline, client age, gender, primary diagnosis, years since disability onset, device type, device age, living situation, ATP involvement, and geographic area.
Ordinal logistic regression modeling showed that geographic area, device type, ATP involvement, primary diagnosis, gender, age, device age, and years since onset of disability significantly predicted the variance in FMA scores at P<.05. Device type was the most significant predictor of variance in FMA score. Involvement of an ATP had a significant effect on the type of device that participants used (χ=1739.18, P<.001; odds ratio, 0.589; 95% confidence interval, 0.49-0.708). If an ATP was involved, there were significantly higher proportions (all P<.05) of individuals using custom-fitted manual wheelchair and high-end groups 3 and 4 power wheelchairs prescribed compared with when no ATP was involved or when involvement was uncertain.
The relationship between ATP involvement and functional outcome supports the concept that ATP certification recognizes demonstrated competence in analyzing the needs of consumers with disabilities and selection of appropriate mobility assistive equipment with improved functional outcomes.
本研究旨在探讨与使用移动设备的患者对功能性移动能力满意度（通过功能性移动评估[FMA]测量）的变化相关的因素。我们的主要假设是，设备类型和辅助技术专家（ATP）的参与将是 FMA 评分的最重要预测因素。我们的次要假设是，ATP 的参与与使用更定制的手动轮椅和第 3 组和第 4 组电动轮椅有关。
回顾性队列研究。
数据来自与临床医生合作在各种环境（例如康复诊所、学校、供应商营业地点）中管理 FMA 和相关统一数据集的设备供应商收集。
纳入分析的数据集包含 4743 例（N=4743）。
不适用。
基线时收集的 FMA 问卷、客户年龄、性别、主要诊断、残疾发生后年限、设备类型、设备年龄、生活状况、ATP 参与情况和地理位置。
有序逻辑回归模型显示，地理位置、设备类型、ATP 参与、主要诊断、性别、年龄、设备年龄和残疾发生后年限在 P<.05 时显著预测 FMA 评分的差异。设备类型是 FMA 评分差异的最显著预测因素。ATP 的参与对参与者使用的设备类型有显著影响（χ=1739.18，P<.001；优势比，0.589；95%置信区间，0.49-0.708）。如果涉及 ATP，则使用定制的手动轮椅和高端第 3 组和第 4 组电动轮椅的比例明显更高（所有 P<.05），而不涉及 ATP 或涉及情况不确定时则比例较低。
ATP 参与和功能结果之间的关系支持了 ATP 认证认可的概念，即认证认可了在分析残疾消费者的需求和选择具有改善功能结果的适当移动辅助设备方面表现出的能力。
