Problematic clinical features of children and adults with cerebral palsy who use electric powered indoor/outdoor wheelchairs: A cross-sectional study

Abstract

Aim: To describe the clinical features of electric powered indoor/outdoor wheelchair (EPIOC) users with cerebral palsy (CP) that are problematic to optimal prescription; and explore the complexities of comorbidities, features of CP and conditions secondary to disability impacting on equipment provision for children and adults. Method: Cross-sectional study of EPIOC users (n=102) with a primary diagnosis of CP. Retrospective review of electronic and case note records. Records were reviewed by a rehabilitation consultant. Data were extracted under three themes; demographic, diagnostic/clinical and wheelchair factors. Further data were entered from clinical records (charts). Results: There were 48 males mean age 27.5 (range 8-70 sd 13.9) years and 54 females, mean age 29.5 (range 7-68 sd 14.6) years with CP. Sixteen comorbidities, nine features of CP and five features of disability influenced wheelchair prescription. Sixty-four users were provided with specialised seating (SS) and 47 with tilt-in-space (TIS) seats. Complex controls were provided to 16 users, 12 tray-mounted. The majority of users had both SS and TIS. Conclusions: Powered wheelchair prescription has important therapeutic roles in clinical management in addition to enhancing mobility, independence and participation. Clinical features such as spasticity and problematic pain appeared less well managed in adults than in children.