Wheelchairs as mobility restraints: predictors of wheelchair activity in nonambulatory nursing home residents.
OBJECTIVE
The purpose of this paper is to describe factors affecting wheelchair mobility in nonambulatory nursing home (NH) residents.


METHODS
Prospective descriptive study of a convenience sample of nonambulatory NH residents.


METHODS
Seven nursing homes.


METHODS
Sixty-five nonambulatory residents.


METHODS
One-minute, time-sampled observations of behavior for each resident were made every 15 minutes for 8 to 11 hours across 2 days, noting wheelchair propulsion activity for the dependent variable; independent variables included measures of wheelchair level of assistance, speed, endurance, handgrip strength, and balance.


RESULTS
A stepwise Multiple Regression analysis found wheelchair speed to be the single best predictor of the percentage of time residents were behaviorally observed wheelchair propelling (Multiple r = .45, P < .02). Handgrip strength and wheelchair endurance measures were highly intercorrelated with wheelchair speed. Wheelchairs that were either dysfunctional or inappropriately fitted to the residents' size were a major barrier to wheelchair use, affecting 46% of residents using wheelchairs.


CONCLUSIONS
Improving wheelchair skills with targeted intervention programs, along with making chairs more "user friendly" (e.g., grip extensions on brakes, foot pedals that one can move without bending over), could result in more wheelchair propulsion with resultant improvements in the NH resident's independence, freedom of movement, and quality of life.
Simmons
S F
SF
Borun Center for Gerontological Research, UCLA School of Medicine, Reseda 91335, USA.
Schnelle
J F
JF
MacRae
P G
PG
Ouslander
J G
JG
D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D010353:Patient Education as Topic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011597:Psychomotor Performance; D012044:Regression Analysis; D012149:Restraint, Physical / Q000009:adverse effects; D014910:Wheelchairs / Q000706:statistics & numerical data