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A Clinical Trial of a Rehabilitation Expert Clinician Versus Usual Care for Providing Manual Wheelchairs
Author(s) -
Hoenig Helen,
Landerman Lawrence R.,
Shipp Kathy M.,
Pieper Carl,
Pieper Carl,
Richardson Margaret,
Pahel Nancy,
George Linda
Publication year - 2005
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.53502.x
Subject(s) - wheelchair , medicine , physical therapy , intervention (counseling) , rehabilitation , manual wheelchair , veterans affairs , physical medicine and rehabilitation , randomized controlled trial , occupational therapy , musculoskeletal injury , nursing , alternative medicine , surgery , pathology , world wide web , computer science
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.