Education in Motion / Resources / December 2019 / Powered mobility devices assessment and cognitive impairment: a systematic review

Powered mobility devices assessment and cognitive impairment: a systematic review

Share:

Take it offline!

This Education in Motion resource is also available as a printable PDF.

ダウンロード PDF

Often, when we evaluate a powered mobility device (PMD) for a child with disabilities, as well as motor issues we must also consider cognitive issues. Many clinicians ask themselves how to get around these issues, and often ask certain questions:

Can children with cognitive impairments access these mobility technologies? Are there tools that can help clinicians in the evaluation of powered mobility devices? What are the tricks you can use to personalise the power wheelchair (PWC) and improve safety?

This position paper aims to answer these questions via a systematic review of the scientific literature, and accompanying discussion of the results.

Abstract

Objectives: to summarize and examine studies about power mobility assessment for individuals with cognitive and motor impairments exploring strategies and measures.

Method: A search of the literature including articles published from 1999 to 2015 was conducted using one electronic database. Studies involving individuals with cognitive impairments and the need of PMD (Powered Mobility Devices) assessment; key terms included power(ed) mobility, power(ed) wheelchair, and database-specific terms. Three reviewers independently screened titles, abstracts, and full-text articles. Inclusion criteria: Studies that included a description of strategy assessment or measure of power mobility skills for users with cognitive and motor impairments.

Results: Of 1111 titles, 7 articles met inclusion criteria. Some cognitive functions seem predictive variables or more related to powered mobility skill. Several studies refer to powered mobility skill measures even for individuals with cognitive impairments to organize an appropriate PMD training.

Conclusions: There is not a minimum score (at neuropsychological tests) to exclude anyone from the use of PMD before an appropriate training by AT professionals, at all ages.

Keywords: POWERED MOBILITY DEVICE, POWERED MOBILITY, POWERED WHEELCHAIR, SYSTEMATIC REVIEW, TRAINING, ASSESSMENT, COGNITIVE IMPAIRMENT, COGNITIVE FUNCTIONS, PSYCHOLOGICAL TEST

Background

Mobility is a foundational skill for participation in the roles and activities of daily life [1]. The identification of a powered mobility device (PMD; e.g., powered wheelchairs, electric scooter, balancing wheelchair) is a complex process, which requires validated strategies. However, in the Italian context, this process is rarely supported by validated instruments: in many instances it depends exclusively on the expertise of the single operator/service or refers to the technicians [2,3,4,5]. One of the main barriers to the introduction of validated measures in clinical settings is the possibility to include them in well-consolidated practices. Increasingly, professionals in the field of rehabilitation are requested to employ validated tools in each phase of the service delivery process [6], from the identification and selection of the device to the evaluation of the outcomes of the intervention, in particular when the PMD assessment is for a person with motor and cognitive impairments. 

We think appropriate to reconsider these issues and devote time and resources to the assessment process because the number of people with disabilities who use wheelchairs is constantly growing and wheelchair has become a gradually more accepted solution [2,6,7]. Furthermore, users that are often not satisfied with their mobility aids and its services [8, 9] also remind us that to provide an adequate service is essential having a process centered on resources, activities and desires of the person with disability [10].

To pursue the best "matching" between the person and the PMD it is essential to consider several factors related both to the person with disabilities and to their context: among personal factors certainly an important role have the cognitive aspects that often put the clinicians decisively in crisis [10, 11].

The purpose of this systematic review was to summarize and examine studies about power mobility assessment for individuals with cognitive and motor impairments exploring strategies and measures.

Download this article as printable PDF

Clinical Support Information Citations

Trioschi D.1,2,3, Paolini C.2,4, Agusto R. 2,5

  • 1. Sunrise Medical – Italian Team – Education in Motion Team
  • 2. Occupational Therapy Course at University of Modena and Reggio Emilia, Italy
  • 3. Occupational Therapy Course at University “Cattolica Sacro Cuore”, Claudiana - Bolzano, Italy
  • 4. Nursing home “Casa Famiglia Mattioli Garavini Onlus”– Reggio Emilia, Italy
  • 5. Azienda USL di Parma

This publication is copyrighted. Consultation for private use is permitted, for the reproduction of content is required the authorization of authors.

Contact: devis.trioschi@sunrisemedical.it

 

To mention this publication:

Trioschi D., Paolini C., Agusto R. (2019), “POWERED MOBILITY DEVICES ASSESSMENT AND COGNITIVE IMPAIRMENT: A SYSTEMATIC REVIEW OF STRATEGIES ASSESSMENT AND MEASURES”. In ESS conference proceedings 2018, Dublin; EIM -Education In Motion, Sunrise Medical, December 2019

 

References

  • 1. Hardy P. Powered wheelchair mobility: an occupational performance evaluation perspective. Aust Occup Ther J 2004; 51: 34–42.
  • 2. Spagnolin G. Mobilità e postura in carrozzina nella disabilità dell’adulto. Atti del convegno L’ausilio nel progetto riabilitativo della persona disabile. Abano Terme. 2008 Nov 5-7; 30-31
  • 3. Trioschi, D, Desideri, L., Agusto, R., et al. (2014). Proposta di programma di valutazione e training delle abilità di guida per ausili elettronici per lo spostamento. [A proposal for a Programme for power mobility devices (PMD) selection and driving skills training]. Giornale Italiano di Medicina Riabilitativa, 28(1), Suppl. 2, p.12.
  • 4. Trioschi D, Bizzarri M, Agusto R, Desideri L e e. Al., Attività e partecipazione con ausili elettronici per la mobilità: quali strumenti? Dati preliminari perla validazione della WHOM-I (Wheelchair Outcome Measure - Italian Version), GITO (Giornale Italiano di Terapia Occupazionale), pp. 74-81, Maggio 2016.
  • 5. Trioschi D, Carrozzina elettronica: controllo ambientale e accesso ai dispositivi informatici. Il Fisioterapista, Edi-Ermes, pp. 6:71-5, nov-dic 2015.
  • 6. Steel EJ, de Witte LP. Advances in European Assistive Technology service delivery and recommendations for further improvement.Technology and Disability, 2011;23:131-138.
  • 7. Russell JN, Hendershot GE, Le Clere F, Howie LJ, Adler M. Trends and differential use of assistive devices. United States. Advace data from Vital and Health Statistics of the CENTERS FOR DISEASE CONTROLAND PREVENTION/National Center for Health Statistics (292). 1997 13 nov
  • 8. Ganesh S, Hayter A, Kim J et al. Wheelchair use by veterans newly prescribed a manual wheelchair. Arch Phys Med Rehabil. 2007 Apr; 88 (4):434-9
  • 9. Mortenson WB, Miller WC. The Wheelchair Procurement Process: Perspectives of Clients and Prescribers. Can J Occup Ther. 2008 Jun; 75(3):167–175
  • 10. Mortenson WB, Miller WC, Mille-Pogar J. Measuring wheelchair intervention outcomes: development of the wheelchair outcome measure. Disability & Rehabilitation: Assistive Technology, 2007; 2:275-85
  • 11. B. Cullen, B. O'Neill e J. Evans, «Neuropsychological predictors of powered wheelchair use: a prospective follow-up study.,» Clin Rehabil., vol. Sep, n. n. 22(9), pp. pp. 836-46, 2008.
  • 12. D. Tefft, P. Guerette e J. Furumasu, «Cognitive predictors of young children's readiness for powered mobility.,» Dev Med Child Neurol, vol. Oct, n. 41(10), pp. 665-70, 1999 .
  • 13. M. Bottos, C. Bolcati, L. Sciuto, C. Ruggeri e A. Feliciangeli, «Powered wheelchairs and independence in young children with tetraplegia.,,» Dev Med Child Neurol., vol. vol. Nov, n. 43(11), pp. 769-77, 2001.
  • 14. B. Cullen, B. O'Neill e J. Evans, «Neuropsychological predictors of powered wheelchair use: a prospective follow-up study.,» Clin Rehabil., vol. Sep, n. 22(9), pp. 836-46, 2008.
  • 15. L. Nilsson, M. Eklund e P. Nyberg, « Driving to Learn in a powered wheelchair: inter-rater reliability of a tool for assessment of joystick-use.,» Aust Occup Ther J. , vol. Dec, n. 58(6), pp. 447-54, 2011.
  • 16. L. Nilsson, M. Eklund, P. Nyberg e H. Thulesius, «Driving to learn in a powered wheelchair: the process of learning joystick use in people with profound cognitive disabilities.,» Am J Occup Ther. , Vol. %1 di %2Nov-Dec, n. ;65(6), pp. 652-60 , 2011.
  • 17. L. Nilsson e P. Nyberg, « Driving to learn: a new concept for training children with profound cognitive disabilities in a powered wheelchair.;,» Am J Occup Ther. , Vol. %1 di %2 Mar-Apr, n. 57(2), pp. 229-33, 2003.
  • 18. Mountain, R. Kirby, G. Eskes, C. Smith, H. Duncan, D. MacLeod e K. Thompson, «Ability of people with stroke to learn powered wheelchair skills: a pilot study.,» Arch Phys Med Rehabil. , vol. Apr, n. n. 91(4), pp. pp. 596-601, 2010.
  • 19. D. University, «Wheelchair Skills Program,» [Online]. Available: http://www.wheelchairskillsprogram.ca/eng/index.php
  • 20. Desideri L, Trioschi D, Agusto R, Bizzarri M, Spagnolin G, et al. (2016). The Provision of Powered Mobility Devices in Italy:Linking Process with Outcomes. Technologies 2016; 4(3), 31
  • 21. Trioschi D, Paolini C, (2017). Ausili elettronici per la mobilità e deficit cognitivi: quali evidenze e quali strumenti?. Tecnologie Riabilitative; rivista n° 15, maggio 2017; 56-60

DISCLAIMER(免責事項):専門的用途としてのみご使用ください。本ウェブサイト(および本ウェブサイトで参照される文書)は、医学的なアドバイスを提供するものではありません。Sunrise Medical (US) LLC(以下、「サンライズ」)は、臨床医サービスを提供しません。本ウェブサイト(および本ウェブサイトで参照される文書)に含まれる情報(テキスト、グラフィック、画像、説明を含むが、これらに限定されない)は、情報提供のみを目的としており、臨床医およびサプライヤーが、臨床推論スキルを用いて個々の患者に最適なシーティングおよびモビリティソリューションを決定するための一般的な資料として活用されるべきものです。本ウェブサイトに掲載されている資料(または本ウェブサイトで参照されている文書)は、専門家による医療上のアドバイス、診断、治療として(またはその代わりとして)使用されることを意図していません。このウェブサイト(またはここで参照される文書)で読んだことを理由に、医療上の助言や治療を行う場合、決して専門的な医療訓練を無視してはなりません。臨床医は、本書(およびその他の資料)を慎重に検討し、ここに記載されている情報を他の情報源で確認する必要があります。このウェブサイト(およびここに含まれる情報)への信頼は、あくまでもご自身の責任において行われるものとします。