The Relationship Between Wheelchair Mobility Patterns and Community Participation Among Individuals With Spinal Cord Injury

Participation is considered the most meaningful outcome of rehabilitation. The purpose of this study was to investigate whether there were correlations between wheelchair activity recorded with a data logger and community participation as measured by the Participation Survey/Mobility. Data from 16 participants were included in this study. Data collected during a two week period using a data logging device were analyzed to determine the mobility characteristics of participants. Among manual wheelchair users, significant positive correlations were found between average speed traveled and the community participation content areas of transportation (r_s = .837, p = .019) and socialization (r_s = .772, p = .042). In addition, for manual wheelchair users there was a trend toward a significant correlation between average speed traveled and total community participation score (r_s = .714, p = .071). Among power wheelchair users, there was a trend toward a significant negative correlation between average speed traveled and the community participation content area of leisure activity (r_s =??.635, p = .066). Understanding the relationship between wheelchair speed and community participation can be useful information to enable clinicians to recommend the most appropriate mobility devices designed to enhance community participation.     

Using Reactive Hyperemia to Assess the Efficacy of Local Cooling on Reducing Sacral Skin Ischemia Under Surface Pressure in People With Spinal Cord Injury: A Preliminary Report

Objectives

To investigate the efficacy of local cooling on reducing sacral skin ischemia in a weight-bearing position, and to identify the underlying physiological mechanisms using wavelet-based spectrum analysis of reactive hyperemia in people with spinal cord injury (SCI).

Design

Repeated-measures and before-after trial design.

Setting

University research laboratory.

Participants

Wheelchair users with SCI with injury level between C4 and T5 (n=10) and able-bodied controls (n=10).

Interventions

Three protocols consisting of pressure without temperature changes, pressure with local cooling (Δt=−10°C), and pressure with local heating (Δt=+10°C) were tested. Each protocol consisted of a 10-minute baseline period, a 20-minute loading period at 60mmHg, and a 20-minute recovery period (reactive hyperemia). A 30-minute washout period was allowed between protocols.

Main Outcome Measures

A compound sensor head consisting of laser Doppler and heating and cooling probes was used to measure sacral skin blood flow and control skin temperature. Reactive hyperemic response to pressure and temperature stimuli was characterized in the time and frequency (metabolic [.0095–.02Hz], neurogenic [.02–.05Hz], and myogenic [.05–.15Hz] components) domains.

Results

Pressure with local cooling resulted in a smaller reactive hyperemic response in both people with SCI and able-bodied controls as compared with pressure with local heating (P<.017) and pressure without temperature changes (P<.017), and the smaller hyperemia was attributed to reduced metabolic and neurogenic activities. People with SCI showed an attenuated response in reactive hyperemia (P<.017).

Conclusions

This study supports the concept of using local cooling to reduce skin ischemia under surface pressure in people with SCI.     

RESNA Position on the Application of Power Wheelchairs for Pediatric Users

ABSTRACT

This document, approved by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) Board of Directors in March 2007, shares typical clinical applications and provides evidence from the literature supporting the use of power wheelchairs for children.     

Assistive Technology for Young Children: Creating Inclusive Learning Environments,by Kathleen Curry Sadao,EdD, and Nancy B. Robinson,PhD, CCC-SLP

ABSTRACT

This study sought to compare road safety of new drivers with low vision who have followed a specific pilot bioptic training program with other groups of drivers all matched for age and driving experience. A quasi-experimental design was used two years after drivers obtained their license. Drivers were classified in the experimental group (n?=?10, they followed a pilot bioptic training program and had license restrictions: weight of the car, requirement of a yearly medical exams, requirement to wear glasses/contacts, use of a bioptic telescope), the comparison group (n?=?17, similar license restrictions except the use of a bioptic telescope) and the regional population (n?=?1,690, no license restriction). The number of new drivers involved in at least one accident and who committed at least one offense is not greater for users of a bioptic telescope than for drivers of in the other groups. The results of this study indicate that driving with a bioptic telescope does not increase the risk of accidents and offenses, with more scientific evidence than in previous studies, among drivers aged between 25 and 35 who have a congenital visual impairment and who have completed an eight-week pilot bioptic training program.     

RESNA Position on the Application of Wheelchair Standing Devices

ABSTRACT

This document, approved by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) Board of Directors in March 2007, shares typical clinical applications and provides evidence from the literature supporting the use of wheelchair standers.     

Rehabilitation for individuals with fibrodysplasia ossificans progressiva

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder characterized by skeletal malformations and progressive heterotopic ossification of soft tissue. As heterotopic bone accumulates, range of motion is progressively lost and leads, eventually, to near-complete immobility. Proper rehabilitation helps to preserve health and function despite great impairment. Present and future rehabilitation approaches to enhance activities of daily living, mobility, education, vocation, and sexuality are discussed.