title: The use of environmental control units by occupational therapists in spinal cord injury and disease services.
abstract: OBJECTIVE
  This study investigated issues related to the use of environmental control units (ECUs) with persons who have spinal cord injury and disease (SCI/D) to ascertain what, if any, changes are needed to optimize occupational therapy service delivery in this area.
  
  
  METHODS
  A questionnaire was mailed to 120 occupational therapists employed by facilities nationwide that serve person with SCI/D. The survey addressed the occupational therapist's role in the recommendation and use of ECUs, funding sources, and training needs. The response rate was 89% (n = 107).
  
  
  RESULTS
  Most respondents (88%) indicated that occupational therapists were the predominant professionals in their facilities who evaluated and recommended ECUs. The majority of respondents (84%) reported using ECUs in hospital-based treatment with persons with SCI/D. However, respondents only recommended ECUs for home use for fewer than 25% of their clients. High cost and the lack of third-party reimbursement were the primary reasons that deterred respondents from recommending ECUs for home use. Fifty-five percent of the respondents reported a need for basic training and 86% for more in-depth education and training in environmental control technologies.
  
  
  CONCLUSIONS
  Outcomes data are needed to support the use of ECUs and to educate third-party payers about the benefits of ECUs for clients with quadriplegia in order to increase rates of reimbursement. In addition, occupational therapists themselves may need improved training in evaluating and training clients in the use of ECU technology.
authors.affiliation: Department of Veterans Affairs, Puget Sound Health Care System, Seattle, Washington 98108, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Holme
authors.forename: E M
authors.initials: EM
authors.lastname: Kanny
authors.forename: M R
authors.initials: MR
authors.lastname: Guthrie
authors.forename: K L
authors.initials: KL
authors.lastname: Johnson
mesh_terms: D003143:Communication Devices for People with Disabilities; D004496:Education, Continuing; D004780:Environment, Controlled; D006801:Humans; D009788:Occupational Therapy / Q000193:education / Q000379:methods*; D012656:Self-Help Devices / Q000191:economics / Q000706:statistics & numerical data; D013118:Spinal Cord Diseases / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014481:United States