Effect of the Assistive Technology Professional on the Provision of Mobility Assistive Equipment |
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| Affiliation: | 1. Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA;2. Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, Pittsburgh, PA;3. Human Engineering Research Laboratories, VA Pittsburgh Healthcare System, Pittsburgh, PA;1. Department of Rehabilitation Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan;2. World Health Organization Cooperative Training and Research Center in Rehabilitation, Wuhan;3. Institute of Rehabilitation and Medical Robotics, State Key Lab of Digital Manufacturing Equipment and Technology, Huazhong University of Science and Technology, Wuhan, China;1. School of Kinesiology, University of the Fraser Valley, Chilliwack, British Columbia, Canada;2. Department of Physical Therapy & Athletic Training, Boston University, Boston, MA;3. Section of Rheumatology, Boston University School of Medicine, Boston, MA;4. School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada;5. Department of Surgery, Division of Orthopaedics, Dalhousie University, Halifax, Nova Scotia, Canada;6. Department of Surgery, McMaster University, Hamilton, Ontario, Canada;7. School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada;8. Department of Surgery, Affiliated Scientist Nova Scotia Health Authority, Halifax, Nova Scotia, Canada;1. Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN;3. Department of Physical Medicine and Rehabilitation, Osher Center for Integrative Medicine, Vanderbilt University Medical Center, Nashville, TN;4. Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD;5. Department of Neurological Surgery, University of Cincinnati College of Medicine, Cincinnati, OH;6. Howell Allen Clinic, Saint Thomas Medical Partners, Nashville, TN;7. Steamboat Orthopedic and Spine Institute, Steamboat Springs, CO;8. Department of Physical Medicine and Rehabilitation, Johns Hopkins Medicine, Baltimore, MD |
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| Abstract: | ObjectiveThe purpose of this study was to examine factors associated with variability in satisfaction with functional mobility (as measured by the Functional Mobility Assessment [FMA]) in users of mobility devices. Our primary hypothesis was that device type and Assistive Technology Professional (ATP) involvement will be the most significant predictors of FMA score. Our secondary hypothesis was that ATP involvement is associated with use of more custom-fitted manual wheelchairs and group 3 and 4 power wheelchairs.DesignRetrospective cohort study.SettingData were collected from equipment suppliers who collaborate with clinicians to administer the FMA and associated Uniform Data Set within various settings (ie, rehabilitation clinic, school, supplier place of business).ParticipantsA data set of 4743 cases was included in the analysis (N=4743).InterventionsNot applicable.Main Outcome MeasuresFMA questionnaire collected at baseline, client age, gender, primary diagnosis, years since disability onset, device type, device age, living situation, ATP involvement, and geographic area.ResultsOrdinal logistic regression modeling showed that geographic area, device type, ATP involvement, primary diagnosis, gender, age, device age, and years since onset of disability significantly predicted the variance in FMA scores at P<.05. Device type was the most significant predictor of variance in FMA score. Involvement of an ATP had a significant effect on the type of device that participants used (χ220=1739.18, P<.001; odds ratio, 0.589; 95% confidence interval, 0.49-0.708). If an ATP was involved, there were significantly higher proportions (all P<.05) of individuals using custom-fitted manual wheelchair and high-end groups 3 and 4 power wheelchairs prescribed compared with when no ATP was involved or when involvement was uncertain.ConclusionsThe relationship between ATP involvement and functional outcome supports the concept that ATP certification recognizes demonstrated competence in analyzing the needs of consumers with disabilities and selection of appropriate mobility assistive equipment with improved functional outcomes. |
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