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Original research| Volume 97, ISSUE 10, P1753-1760, October 2016

Type and Frequency of Reported Wheelchair Repairs and Related Adverse Consequences Among People With Spinal Cord Injury

      Abstract

      Objective

      To investigate the frequency and types of wheelchair repairs and associated adverse consequences.

      Design

      Convenience cross-sectional sample survey.

      Setting

      Nine Spinal Cord Injury Model Systems Centers.

      Participants

      People with spinal cord injury who use a wheelchair >40h/wk (N=591).

      Interventions

      Not applicable.

      Main Outcome Measures

      Number of repairs needed and resulting adverse consequences, number and types of repairs completed, and location where main repair was completed in the previous 6 months.

      Results

      There were 591 participants responded to the survey, 63.8% (377/591) of them needed ≥1 repair; of these, 27.6% (104/377) experienced ≥1 adverse consequence, including 18.2% (69/377) individuals who were stranded. Of those who needed repairs, 6.9% did not have them completed (26/377). Repairs completed on the wheels and casters were the most frequent repair to manual wheelchairs, whereas repairs to the electrical and power and control systems were the most frequent type of repair on power wheelchairs. Forty percent (79/201) of manual wheelchair users reported completing repairs at home themselves compared with 14% (21/150) of power wheelchair users. Twelve percent of the variance in the odds of facing an adverse consequence because of a wheelchair breakdown can be described as a function of occupation, funding source, and type of wheelchair.

      Conclusions

      Wheelchair repairs are highly prevalent. There are differences in types of repairs and who completes the repairs based on the type of wheelchair. Wheelchair breakdowns result in adverse consequences for users, and there is a deficit between repairs needed and those completed, highlighting the need for interventions that address these problems.

      Keywords

      List of abbreviations:

      CMS (Centers for Medicare and Medicaid Services), MWC (manual wheelchair), PWC (power wheelchair), SCI (spinal cord injury), SCIMS (Spinal Cord Injury Model Systems)
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      References

        • World Health Organization
        Guidelines on the provision of manual wheelchairs in less resourced settings.
        World Health Organization, Geneva2008
        • National Spinal Cord Injury Statistical Center
        Spinal Cord Injury Model Systems 2014 annual report.
        University of Alabama at Birmingham, Birmingham2014
        • McClure L.
        • Boninger M.
        • Oyster M.
        • et al.
        Wheelchair repairs, breakdown, and adverse consequences for people with traumatic spinal cord injury.
        Arch Phys Med Rehabil. 2009; 90: 2034-2038
        • Worobey L.
        • Oyster M.
        • Nemunaitis G.
        • Cooper R.
        • Boninger M.L.
        Increases in wheelchair breakdowns, repairs, and adverse consequences for people with traumatic spinal cord injury.
        Am J Phys Med Rehabil. 2012; 91: 463-469
        • Worobey L.
        • Oyster M.
        • Pearlman J.
        • Gebrosky B.
        • Boninger M.L.
        Differences between manufacturers in reported power wheelchair repairs and adverse consequences among people with spinal cord injuries.
        Arch Phys Med Rehabil. 2014; 95: 597-603
        • Fitzgerald S.
        • Collins D.
        • Cooper R.
        • et al.
        Issues in the maintenance and repairs of wheelchairs: a pilot study.
        J Rehabil Res Dev. 2005; 42: 853-862
      1. National Spinal Cord Injury Statistical Center. Definition and eligibility criteria 2011-2016. Available at: https://www.nscisc.uab.edu/definition_eligibility.aspx. Accessed January 9, 2016.

        • Whiteneck G.
        • Brooks C.A.
        • Charlifue S.
        • et al.
        Guide for use of the CHART: Craig Handicap Assessment and Reporting Technique.
        Craig Hospital, Englewood1992
      2. The Official U.S. Government Site for Medicare. What's Medicare? Available at: https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html. Accessed March 13, 2016.

      3. The Official U.S. Government Site for Medicare. Medicaid. Available at: https://www.medicare.gov/your-medicare-costs/help-paying-costs/medicaid/medicaid.html. Accessed March 13, 2016.

        • Sharpe D.
        Your chi-square test is statistically significant: now what? Practical Assessment, Research and Evaluation. 20. 2015: 10
        • Smith C.
        • McCreadie M.
        • Unsworth J.
        • Wickings H.
        • Harrison A.
        Patient satisfaction: an indicator of quality in disablement services centres.
        Qual Health Care. 1995; 4: 31-36
        • Cooper R.A.
        • Boninger M.L.
        • Rentschler A.
        Evaluation of selected ultralight manual wheelchairs using ANSI/RESNA standards.
        Arch Phys Med Rehabil. 1999; 80: 462-467
        • Ummat S.
        • Kirby R.
        Nonfatal wheelchair-related accidents reported to the National Electronic Injury Surveillance System.
        Am J Phys Med Rehabil. 1994; 73: 163-167
        • Kirby R.L.
        • Ackroyd-Stolarz S.A.
        Wheelchair safety-adverse reports to the United States Food and Drug Administration.
        Am J Phys Med Rehabil. 1995; 74: 308-312
        • Liu H.Y.
        • Cooper R.A.
        • Pearlman J.
        • Cooper R.
        • Connor S.
        Evaluation of titanium ultralight manual wheelchairs using ANSI/RESNA standards.
        J Rehabil Res Dev. 2008; 45: 1251-1267
        • Liu H.
        • Pearlman J.
        • Cooper R.
        • et al.
        Evaluation of aluminum ultralight rigid wheelchairs versus other ultralight wheelchairs using ANSI/RESNA standards.
        J Rehabil Res Dev. 2010; 47: 441-455
        • Gebrosky B.
        • Pearlman J.
        • Cooper R.A.
        • Cooper R.
        • Kelleher A.
        Evaluation of lightweight wheelchairs using ANSI/RESNA testing standards.
        J Rehabil Res Dev. 2013; 50: 1373-1390
        • Wang H.
        • Liu H.Y.
        • Pearlman J.
        • et al.
        Relationship between wheelchair durability and wheelchair type and years of test.
        Disabil Rehabil Assist Technol. 2010; 5: 318-322
        • Cramton P.
        • Ellermeyer S.
        • Katzman B.
        Designed to fail: the Medicare auction for durable medical equipment.
        Economic Inquiry. 2015; 53: 469-485
        • Martin Szmal P.
        • The Mobility Consultants, LLC
        Competitive bidding's impact on power mobility devices.
        in: Parks D. HomeCare The Leading Business Magazine for HMW Professionals. 2013
      4. The Official U.S. Government Site for Medicare. Competitive bidding program. Available at: https://www.medicare.gov/what-medicare-covers/part-b/competitive-bidding-program.html. Accessed March 13, 2016.

        • Fass M.V.
        • Cooper R.A.
        • Fitzgerald S.G.
        • et al.
        Durability, value, and reliability of selected electric powered wheelchairs.
        Arch Phys Med Rehabil. 2004; 85: 805-814
        • Hansen R.
        • Tresse S.
        • Gunnarsson R.
        Fewer accidents and better maintenance with active wheelchair check-ups: a randomized controlled clinical trial.
        Clin Rehabil. 2004; 8: 631-639
        • Chen W.Y.
        • Jang Y.
        • Wang J.D.
        • et al.
        Wheelchair-related accidents: relationship with wheelchair-using behavior in active community wheelchair users.
        Arch Phys Med Rehabil. 2011; 92: 892-898
        • Gaal R.
        • Rebholtz N.
        • Hotchkiss R.
        • Pfaelzer P.
        Wheelchair rider injuries: cause and consequences for wheelchair design and selection.
        J Rehabil Res Dev. 1997; 34: 58-71
      5. Orzel T. Labor tracker tackles wheelchair repairs. Available at: http://www.hmenews.com/article/labor-tracker-tackles-wheelchair-repairs. Accessed July 1, 2015.

      6. World Health Organization. Wheelchair service training package - basic level. Available at: http://www.who.int/disabilities/technology/wheelchairpackage/en/. Accessed October 24, 2014.