Power wheelchairs enhance quality of life by enabling occupation, improving self-esteem and facilitating social interaction. Despite these benefits, there are risks associated with power mobility use; and accidents, which may occur, are a serious concern. As there is no gold standard to assess when a client is unsafe with power mobility, therapists generally rely on their clinical reasoning to make a decision. This paper presents the findings of the first phase of a two-part study to develop client-centred guidelines for power mobility. In the first phase of the study, 18 in-depth, qualitative interviews were conducted with a variety of stakeholders, including power mobility users, other residents, staff and family members. A thematic analysis of the interviews revealed four main themes: 1) "the meaning of power mobility," 2) "learning the rules of the road," 3) "red flags: concerns about safety," and 4) "solutions." The findings of this study have important implications for the safe use of power mobility.Power mobility has a strong impact on the quality of life of its users. Power mobility facilitates participation in self-care, productivity and leisure occupations in adults (Brandt,
Abstract-Although power mobility has many potential benefits for users, power mobility incidents and accidents are a serious concern. To date, little research has explored power mobility safety, and no gold standard exists to determine whether the user is a safe driver. As a possible alternative to a facility unilaterally imposing regulations on power mobility users, we conducted a research project in which power mobility users and other stakeholders used the Delphi method to develop guidelines for power mobility use within a residential facility setting. This article presents the overarching principles for power mobility use and noteworthy items from the safety guidelines that participants developed. These findings highlight the safety issues that are encountered in residential care settings and suggest some strategies to deal with them.
BackgroundPressure ulcers pose significant negative individual consequences and financial burden on the healthcare system. Prolonged sitting in High Fowler’s position (HF) is common clinical practice for older adults who spend extended periods of time in bed. While HF aids in digestion and respiration, being placed in a HF may increase perceived discomfort and risk of pressure ulcers due to increased pressure magnitude at the sacral and gluteal regions. It is likely that shearing forces could also contribute to risk of pressure ulcers in HF. The purpose of this study was to evaluate the effect of a low-tech and time-efficient Trunk Release Manuever (TRM) on sacral and gluteal pressure, trunk displacement and perceived discomfort in ambulatory older adults.MethodA randomized controlled trial was used. We recruited community-living adults who were 60 years of age and older using posters, newspaper advertisements and word-of-mouth. Participants were randomly allocated to either the intervention or control group. The intervention group (n = 59) received the TRM, while the control group (n = 58) maintained the standard HF position.ResultsThe TRM group had significantly lower mean (SD) PPI values post-intervention compared to the control group, 59.6 (30.7) mmHg and 79.9 (36.5) mmHg respectively (p = 0.002). There was also a significant difference in trunk displacement between the TRM and control groups, +3.2 mm and −5.8 mm respectively (p = 0.005). There were no significant differences in perceived discomfort between the groups.ConclusionThe TRM was effective for reducing pressure in the sacral and gluteal regions and for releasing the trunk at the point of contact between the skin and the support surface, but did not have an effect on perceived discomfort. The TRM is a simple method of repositioning which may have important clinical application for the prevention of pressure ulcers that may occur as a result of HF.
Results from this study highlight the need for further research to inform weight-shifting techniques and to build a more comprehensive understanding of weight-shifting education practices.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.