Psychosocial Impact of Assistive Technologies for Mobility and Their Implications for Active Ageing

Abstract

Purpose: Active ageing is defined as the process of optimizing opportunities for physical, social and mental health to enable older people to actively take part in society without discrimination and to enjoy independence and good quality of life. The World Health Organization assumed this to be a process for increasing and maintaining an individual's participation in activities to enhance his/her quality of life. In this survey, the authors addressed the following question: is assistive technology (AT) for mobility contributing to enhancement of lifelong capacity and performance? Method: From June 2015 until February 2016, 96 community dwelling adults, AT users for mobility (powered wheelchairs, manual wheelchairs, lower limb prostheses, walkers, crutches and canes), aged 45-97, mean 67.02 ± 14.24 years old, 56.3% female, were interviewed using the Psychosocial Impact of Assistive Devices Scale (P-PIADS), the Activities and Participation Profile related to Mobility (APPM) and demographics, clinical and questions about AT use and training. Results and Discussion: The participants' profiles revealed moderate limitation and restrictions in participation, measured by the APPM (2.03). Most participants displayed a positive impact from AT; average scores obtained from the P-PIADS subscales were: Self-esteem 0.62, Competency 1.11 and Adaptability 1.10. The P-PIADS total was 0.96, with the powered wheelchair users scoring the highest (1.53) and the walker users scoring the lowest (0.73). All subscales and the P-PIADS total were positively correlated with the activities and participation profile. There was no relation between age and the psychosocial impact of AT or activities and participation profile. These results encourage the authors to follow up with these participants for a lifelong intervention. To accomplish that aim, currently, the protocol is implemented at the AT prescribing centers in Coimbra, Portugal in order to assess the impact of AT on participation in society, one of the domains of the Active Ageing Index, a new analytical tool to help policy makers in developing policies for active and healthy ageing.

Psychosocial Impact of Powered Wheelchair, Users’ Satisfaction and Their Relation to Social Participation

“…According to our findings, social participation does not seem to be associated to the psychosocial impact of the PW, similar to what was demonstrated by Buning, Angelo and Schmeler, who found no significant relationship between the psychosocial impact of powered mobility devices and the users' occupational performance [16]. Contrarily, a study by Martins and collaborators demonstrated a relation between the higher psychosocial impact scores and the better performance in social participation, regarding different types of AT [10]. The fact that there was no correlation between the psychosocial impact and participation profile might mean that they had such severe physical limitations that, despite the positive psychosocial impact of the PW, it is not enough to attenuate these limitations and to improve performance in the activities of the daily living and social roles.…”

“…There was no evidence of negative impact of the AT due to stigmatization, as suggested in other studies [31,32], since the self-esteem level is about the same as competency and adaptability. There was no relationship between the psychosocial impact of the PW and users' age, which indicates that the AT could be beneficial at any age, making sense to be prescribed through the lifespan, also shown by Martins and collaborators [10].…”

“…This can be explained by the particular characteristics of these participants-they are diagnosed with cerebral palsy, with severe limitations since birth, which also explains why younger users had been using their PW for a longer period of time compared to older ones, which their medical conditions, in general, had a later onset. A previous study had found no relation between age and participation profile [10]. It is important to take into consideration that the PAPM scores may be influenced by the fact that the participants only attribute a score to the activities they consider to be significant to them, choosing "not applicable" for the others [23].…”

“…It is important to objectively identify those barriers and facilitators that interact with mobility during social participation [8], as social participation could be linked with morbidity and quality of life [9]. Several studies showed the benefits of the assistive technologies (AT), particularly if they contribute to enhancing participation of adults with mobility problems, as well as on psychosocial condition [10,11].…”

Evaluating the Effect of Functional Electrical Stimulation Used for Foot Drop on Aspects of Health-Related Quality of Life in People with Multiple Sclerosis

“…35 Each item is scored from -3 (maximum negative impact) to +3 (maximum positive impact), indicating the impact of using an assistive device. 35 Taylor et al 24 reported scores double those reported by Barrett et al 22 Differences between the device type (implantable: surface FES) and intervention time (128 days: 18 weeks) may have accounted for the enhanced results observed by Taylor et al 24 In a study investigating the effect of mobility assistive devices in older adults (>45 years), 36 the PIADS domain scores were lower than those reported by Taylor et al, 24 suggesting that FES may have equivocal effects compared to other assistive device interventions. The PIADS is responsive to variables such as device stigma and the functional features of the device.…”