Matching wheelchair users with severe spinal cord injuries to provision of electric powered indoor/outdoor wheelchairs (EPIOCS).

Abstract

Objective: : To describe the clinical features of electric powered indoor/outdoor chair (EPIOC) users with severe spinal cord injury (SCI) and explore the complexities of comorbidities, clinical features and conditions secondary to disability influencing prescription. Method: Cross-sectional survey of a clinic population. Records were reviewed by a consultant in rehabilitation medicine, data systematically extracted and entered into a computer database. Further data were entered from the clinical records. Data were extracted under three themes; demographic, diagnostic and clinical profiles and wheelchair factors. Results: Fifty-seven EPIOC users (35 men, 22 women) with SCI (mean age 52.81 ± 12.04, range 29-79 years) comprised 23 (11 men) with paraplegia and 34 (24 men) with tetraplegia. Only 10 (6 paraplegic) had SCI as the sole diagnosis. Twenty (11 tetraplegic) had one additional clinical feature, 16 had 2-3 (12 tetraplegic) and 11 had 4 or more (7 tetraplegic). Fourteen had complications related to the SCI (6 surgical, 4 scoliosis, 3 problematic pain, 1 spinal stenosis). Additional upper limb/neck problems (7 problematic shoulder/neck pain, 2 forearm/digits amputation, 2 brachial plexus lesions, I failed shoulder surgery, 1 bilateral shoulder osteoarthritis) were common. Pressure sores (n=4) or immediate pressure relief intervention (n=5) were noted. Ten required specialised seating and 29 needed tilt-in-space (13 para 16 tetra) EPIOCs. Five tetraplegic users required complex/bespoke control systems. Conclusion: Although all were already wheelchair users and known to services, the range and complexity of their wheelchair and seating needs benefitted from a holistic assessment and prescription by a specialist multidisciplinary team.