Electric powered wheelchairs for those with muscular dystrophy: Problems of posture, pain and deformity

• Published in: Disability and rehabilitation: Assistive technology 2009-01, Vol.4 (3), p.181-188
• Main Authors: Richardson, Marion, Frank, Andrew O.
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adolescent; Adult; Child; Congenital Abnormalities - etiology; Congenital Abnormalities - physiopathology; Congenital Abnormalities - rehabilitation; deformity; Disability Evaluation; Disabled Persons - rehabilitation; Electric Power Supplies - utilization; Equipment Design; Female; Follow-Up Studies; Humans; Male; Middle Aged; Muscular Dystrophies - complications; Muscular Dystrophies - physiopathology; Muscular Dystrophies - rehabilitation; muscular dystrophy; pain; Pain - etiology; Pain - physiopathology; Pain - rehabilitation; Patient Satisfaction; posture; Posture - physiology; Powered wheelchairs; Quality of Life; Retrospective Studies; specialised seating; Wheelchairs - utilization; Young Adult
• ISSN: 1748-3107; 1748-3115
• DOI: 10.1080/17483100802543114

Purpose. To identify areas of difficulty encountered by a regional wheelchair service in providing Electric Powered Indoor outdoor wheelchairs (EPIOCs) to those with muscular dystrophy (MD) in the early years of their provision - particularly posture, pain and deformity. Method. Wheelchair service records of all users between April 1997 and March 2000 were reviewed retrospectively and issues relating to weakness, pain discomfort, deformities, other medical issues, weight change, function, posture and driving were documented on a purpose-designed proforma. Adjustments and modifications were documented over the 2-year period following chair delivery. Results. Of 325 EPIOC users on the departmental database, 29 had MD (15 Duchenne's), whose users charts were reviewed. Almost 80% of users needed clinical review within 2 years, mostly due to a scoliosis. Other problems were postural (66%), medical (48%), pain (31%), functional (24%) and weight change (14%). The commonest prescriptions were for specialised seating (24%), lateral supports, headrests and footrests (21% each). Conclusions. The rate of disease progression was not planned for by the service. Most clients were seen in response to deterioration, rather than anticipating it. Planned reviews within 1 year appear essential for teenagers with MD with the dual issues of rapid maturation and progressive disease.