Wheelchair User’s Satisfaction and its Impact on Physical Activity and Quality of Life in People with Spinal Cord Injury

Abstract

Background Spinal cord injury (SCI) survivors rely greatly on assistive devices, spending around 9–11 hours daily in a wheelchair. It can act both as a barrier and facilitator, positively impacting their mobility, community participation, quality of life (QOL) and functional independence provided the device is satisfactory. However, there is a paucity of information on the level of user satisfication and its impact on the mobility and well being. Keeping in view the present study was conducted to determine the level of wheelchair user’s satisfaction and its impact on physical activity and QOL in SCI.

Methods A cross sectional study with a sample of 130 was conducted at Paraplegic Center, Peshawar using “Quebec User Evaluation of Satisfaction with assistive Technology (QUEST)” for wheelchair user’s satisfaction, “Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) for physical activity and World Health Organization Quality of Life (WHOQOL-BREF) for QOL.

Results Mean age of the study participants was 32.48±11.96 years. The majority of the participants were males, with most of them being manual wheelchair users. Nearly 80% were regular users. The calculated mean for the QUEST was 3.23±0.51 while 24.49±27.66 for the PASIPD. For the WHOQOL-BREF the calculated median (IQR) in the environmental 56.00 (19.00) and psychological 56.00 (12.00) domain was highest followed by physical domain 50.00(19.00). No significant correlation between participant’s satisfaction level (for wheelchair), and PASIPD (r_s=0.054, p=0.541) was observed. On the other hand significant positive correlation was found between physical (r_s=0.394, p<0.001), social (r_s=0.303, p<0.001) and environmental domain (r_s=0.425, p<0.001) except psychological domain (r_s=0.156, p=0.076) of QOL.

Conclusion The majority of the participants showed moderate levels of satisfication and the impact was observed on the physical, social and environmental domains of QOL. Appropriate wheelchairs enhancing the QOL therefore special measures should be taken to customize the device to the body structure and needs of the customers as anything that can improve their lives even to a minor extent can prove very helpful.

Zusammenfassung

Hintergrund und Ziel Überlebende einer Rückenmarksverletzung sind in hohem Maße auf Hilfsmittel angewiesen und verbringen täglich 9 bis 11 Stunden in einem Rollstuhl. Der Rollstuhl kann hinderlich, aber auch förderlich sein und sich positiv auf die Mobilität, Teilhabe an der Gemeinschaft, Lebensqualität und funktionelle Unabhängigkeit der Betroffenen auswirken. Allerdings liegen kaum Informationen über den Grad der Nutzerzufriedenheit und deren Einfluss auf Mobilität und Wohlbefinden vor. Ziel der vorliegenden Studie war es, den Grad der Zufriedenheit von Rollstuhlfahrern und deren Einfluss auf die körperliche Aktivität und Lebensqualität nach Rückenmarksverletzungen zu ermitteln.

Methodik Im Paraplegic Center, Peshawar (Pakistan) wurde eine Querschnittsstudie mit 130 Patienten durchgeführt. Dabei erfolgte die Erfassung der Rollstuhlfahrerzufriedenheit mithilfe des Instruments „Quebec User Evaluation of Satisfaction with assistive Technology“ (QUEST), der körperlichen Aktivität mithilfe der „Physical Activity Scale for Individuals with Physical Disabilities“ (PASIPD) und der Lebensqualität mithilfe des „World Health Organization Quality of Life“ (WHOQOL-BREF).

Ergebnisse Das mittlere Alter der Studienteilnehmer betrug 32,48±11,96 Jahre. Die meisten der mehrheitlich männlichen Teilnehmer benutzen einen manuellen Rollstuhl, fast 80% davon regelmäßig. Der Mittelwert der QUEST-Scores lag bei 3,23±0,51 und der für PASIPD-Scores bei 24,49±27,66. Beim Instrument WHOQOL-BREF waren die Mittelwerte [IQR] in den Bereichen „umweltbezogene“ (56,00 [19,00]) und „psychisches“ (56,00 [12,00]) Lebensqualität am höchsten, gefolgt vom Bereich „physische“ Lebensqualität (50,00 [19,00]). Es konnte kein signifikanter Zusammenhang zwischen der Zufriedenheit der Teilnehmer (mit dem Rollstuhl) und körperlicher Aktivität (PASIPD; rs=0,054, p=0,541) festgestellt werden. Demgegenüber fand sich eine signifikante positive Korrelation für die Bereiche physische (rs=0,394, p<0,001), soziale (rs=0.303, p<0.001) und umweltbezogene Lebensqualität (rs=0,425, p<0,001), nicht aber für den Bereich psychisches Lebensqualität (rs=0,156, p=0,076).

Schlussfolgerung Die Mehrheit der Teilnehmer zeigte eine mittelgradige Zufriedenheit, die sich auf die Bereiche der physischen, sozialen und umweltbezogenen Lebensqualität auswirkte. Da ein zufriedenstellender Rollstuhl die Lebensqualität verbessert, sollten bei der Konstruktion dieses Hilfsmittels besondere Anstrengungen in Hinblick auf die Nutzerzufriedenheit unternommen werden, denn alles, was das Leben von Rollstuhlfahrern auch nur ein wenig verbessern kann, leistet einen positiven Beitrag.

Key words

Wheelchair user’s satisfaction (QUEST) - quality of life - physical activity - spinal cord injury - PASIPD - WHOQOL-BREF

Schlüsselwörter

Rückenmarksverletzung - Rollstuhlfahrerzufriedenheit - Lebensqualität - gesundheitsbezogene Lebensqualität - interdisziplinäre Rehabilitation; körperliche Aktivität

Publication History

Received: 07 February 2022

Accepted: 07 June 2022

Article published online:
12 July 2022

• References

• 1 Kang Y, Ding H, Zhou H. et al. Epidemiology of worldwide spinal cord injury: a literature review. Journal of Neurorestoratology 2018; 6: s1-s9
• 2 Florio J, Arnet U, Gemperli A. et al. group Ss. Need and use of assistive devices for personal mobility by individuals with spinal cord injury. The journal of spinal cord medicine 2016; 39: 461-470
• 3 Sonenblum SE, Sprigle SH, Martin JS. Everyday sitting behavior of full-time wheelchair users. Journal of Rehabilitation Research & Development 2016; 53: 585-598
• 4 Valent L, Nachtegaal J, Faber W. et al. Experienced sitting-related problems and association with personal, lesion and wheelchair characteristics in persons with long-standing paraplegia and tetraplegia. Spinal cord 2019; 57: 603-613
• 5 Martin JJ. Benefits and barriers to physical activity for individuals with disabilities: a social-relational model of disability perspective. Disability and rehabilitation 2013; 35: 2030-2037
• 6 Riley AH, Callahan C. Shoulder Rehabilitation Protocol and Equipment Fit Recommendations for the Wheelchair Sport Athlete With Shoulder Pain. Sports medicine and arthroscopy review 2019; 27: 67-72
• 7 Moon Y, Jayaraman C, Hsu I. et al. Variability of peak shoulder force during wheelchair propulsion in manual wheelchair users with and without shoulder pain. Clinical Biomechanics 2013; 28: 967-972
• 8 Medola FO, Elui VMC, da Silva Santana C. et al. Aspects of manual wheelchair configuration affecting mobility: A review. Journal of physical therapy science 2014; 26: 313-318
• 9 Greer N, Brasure M, Wilt TJ. Wheeled mobility (wheelchair) service delivery: scope of the evidence. Annals of internal medicine 2012; 156: 141-146
• 10 Hogaboom NS, Worobey LA, Houlihan BV. et al. Wheelchair breakdowns are associated with pain, pressure injuries, rehospitalization, and self-perceived health in full-time wheelchair users with spinal cord injury. Archives of physical medicine and rehabilitation 2018; 99: 1949-1956
• 11 Khalili M, Van der Loos H, Borisoff J. editors. Towards an autonomy-based approach to design and develop mobility assistive technologies for spinal cord injury populations. Proceedings of the RESNA Annual Conference. 2018 Arlington
• 12 Chaikhot D, Reed K, Petroongrad W. et al. Effects of an upper-body training program involving resistance exercise and high-intensity arm cranking on peak handcycling performance and wheelchair propulsion efficiency in able-bodied men. The Journal of Strength & Conditioning Research 2020; 34: 2267-2275
• 13 Kirby RL, Miller WC, Routhier F. et al. Effectiveness of a wheelchair skills training program for powered wheelchair users: a randomized controlled trial. Archives of physical medicine and rehabilitation 2015; 96: 2017-2026 e2013
• 14 Chien C-S, Huang T-Y, Liao T-Y. et al. Design and development of solar power-assisted manual/electric wheelchair. Journal of Rehabilitation Research & Development 2014; 51: 1411-1426
• 15 Ekiz T, Demir SÖ, Özgirgin N. Wheelchair appropriateness in patients with spinal cord injury: a Turkish experience. Spinal cord 2014; 52: 901-904
• 16 Adriaansen JJ, Ruijs LE, van Koppenhagen CF. et al. Secondary health conditions and quality of life in persons living with spinal cord injury for at least ten years. Journal of rehabilitation medicine 2016; 48: 853-860
• 17 Rivers CS, Fallah N, Noonan VK. et al. Health conditions: effect on function, health-related quality of life, and life satisfaction after traumatic spinal cord injury. A prospective observational registry cohort study. Archives of physical medicine and rehabilitation 2018; 99: 443-451
• 18 Walford SL, Requejo PS, Mulroy SJ. et al. Predictors of shoulder pain in manual wheelchair users. Clinical Biomechanics 2019; 65: 1-12
• 19 Olaleye OA, Afolabi K. editors. Satisfaction with wheelchair use and health-related quality of life among persons with spinal cord injury in South-west Nigeria. Proceedings of the RESNA Annual Conference. 2019 Arlington
• 20 Shore S, Juillerat S. The impact of a low cost wheelchair on the quality of life of the disabled in the developing world. Medical science monitor: international medical journal of experimental and clinical research 2012; 18: CR533-CR542
• 21 Borade N, Ingle A, Nagarkar A. Lived experiences of people with mobility-related disability using assistive devices. Disability and Rehabilitation: Assistive Technology 2021; 16: 730-734
• 22 Jalayondeja C, Jalayondeja W, Suttiwong J. et al. Physical activity, self-esteem, and quality of life among people with physical disability. Southeast Asian J Trop Med Public Health 2016; 47: 546-558
• 23 Gottlieb A, Plotnik M, Kizony R. et al. Identification of clinically related requirements of a novel assistive device for people with a high spinal cord injury. PloS one 2019; 14: e0218393
• 24 de Groot S, Post M, Bongers-Janssen H. et al. Is manual wheelchair satisfaction related to active lifestyle and participation in people with a spinal cord injury?. Spinal Cord 2011; 49: 560-565
• 25 Mueller R, Landmann G, Bechir M. et al. Chronic pain, depression and quality of life in individuals with spinal cord injury: Mediating role of participation. Journal of rehabilitation medicine 2017; 49: 489-496
• 26 Washburn RA, Zhu W, McAuley E. et al. The physical activity scale for individuals with physical disabilities: development and evaluation. Archives of physical medicine and rehabilitation 2002; 83: 193-200
• 27 Samuelsson K, Wressle E. User satisfaction with mobility assistive devices: An important element in the rehabilitation process. Disability and rehabilitation 2008; 30: 551-558
• 28 Visagie S, Mlambo T, Van der Veen J. et al. Is any wheelchair better than no wheelchair? A Zimbabwean perspective. African Journal of Disability 2015; 4: 1-10
• 29 Geilen BG, de Witte L, Norman G. et al. Quality of wheelchair services as perceived by users in rural Bangalore district, India: a cross-sectional survey. Disability and Rehabilitation: Assistive Technology 2020; 1-9
• 30 Amosun S, Ndosi A, Buchanan H. Locally manufactured wheelchairs in Tanzania–are users satisfied?. African health sciences 2016; 16: 1174-1181
• 31 Sugawara AT, Seigui Oshiro M, Yamanaka EI. et al. Developing a rigid frame wheelchair in Brazil. Disability and Rehabilitation: Assistive Technology 2019; 16: 538-544
• 32 Sadiya A, Pattnaik M, Mohanty P. Exploring the impact of manual wheelchair design on user’s satisfaction and function in individuals with spinal chord injury’. Asian Journal of Science and Technology 2016; 7: 3464-3472
• 33 Shore S. The long-term impact of wheelchair delivery on the lives of people with disabilities in three countries of the world. African Journal of Disability 2017; 6: 1-8
• 34 Marchiori C, Bensmail D. Manual wheelchair satisfaction among long-term users and caregivers: A French study. Journal of rehabilitation research and development 2015; 52: 181-192
• 35 Harvey L, Chu J, Bowden J. et al. How much equipment is prescribed for people with spinal cord injury in Australia, do they use it and are they satisfied 1 year later?. Spinal cord 2012; 50: 676-681
• 36 Lee S-H. Users’ satisfaction with assistive devices in South Korea. Journal of Physical Therapy Science 2014; 26: 509-512
• 37 Chan SC, Chan AP. User satisfaction, community participation and quality of life among Chinese wheelchair users with spinal cord injury: a preliminary study. Occupational Therapy International 2007; 14: 123-143
• 38 May M, Rugg S. Electrically powered indoor/outdoor wheelchairs: recipients’ views of their effects on occupational performance and quality of life. British Journal of Occupational Therapy 2010; 73: 2-12
• 39 Stevens SL, Caputo JL, Fuller DK. et al. Physical activity and quality of life in adults with spinal cord injury. The journal of spinal cord medicine 2008; 31: 373-378
• 40 Kawanishi CY, Greguol M. Physical activity, quality of life, and functional autonomy of adults with spinal cord injuries. Adapted Physical Activity Quarterly 2013; 30: 317-337
• 41 Filipcic T, Sember V, Pajek M. et al. Quality of Life and Physical Activity of Persons with Spinal Cord Injury. International journal of environmental research and public health 2021; 18: 9148
• 42 Tomasone JR, Wesch NN, Ginis KAM. et al. Spinal cord injury, physical activity, and quality of life: A systematic review. Kinesiology Review 2013; 2: 113-129
• 43 Best KL, Miller WC. Physical and leisure activity in older community-dwelling Canadians who use wheelchairs: a population study. Journal of Aging Research 2011; 2011: 110-118