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Mobility Device Quality Affects Participation Outcomes for People With Disabilities: A Structural Equation Modeling Analysis

Published:August 04, 2017DOI:https://doi.org/10.1016/j.apmr.2017.06.030

      Abstract

      Objective

      To test the effect that indicators of mobility device quality have on participation outcomes in community-dwelling adults with spinal cord injury, traumatic brain injury, and stroke by using structural equation modeling.

      Design

      Survey, cross-sectional study, and model testing.

      Setting

      Clinical research space at 2 academic medical centers and 1 free-standing rehabilitation hospital.

      Participants

      Community-dwelling adults (N=250; mean age, 48±14.3y) with spinal cord injury, traumatic brain injury, and stroke.

      Interventions

      Not applicable.

      Main Outcomes Measures

      The Mobility Device Impact Scale, Patient-Reported Outcomes Measurement Information System Social Function (version 2.0) scale, including Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities, and the 2 Community Participation Indicators' enfranchisement scales. Details about device quality (reparability, reliability, ease of maintenance) and device type were also collected.

      Results

      Respondents used ambulation aids (30%), manual (34%), and power wheelchairs (30%). Indicators of device quality had a moderating effect on participation outcomes, with 3 device quality variables (repairability, ease of maintenance, device reliability) accounting for 20% of the variance in participation. Wheelchair users reported lower participation enfranchisement than did ambulation aid users.

      Conclusions

      Mobility device quality plays an important role in participation outcomes. It is critical that people have access to mobility devices and that these devices be reliable.

      Keywords

      List of abbreviations:

      CFA (confirmatory factor analysis), CI (confidence interval), PROMIS (Patient-Reported Outcomes Measurement Information System), RMSEA (root mean square error of approximation), SCI (spinal cord injury), SEM (structural equation modeling), TBI (traumatic brain injury), TLI (Tucker-Lewis index)
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