Demographic and socioeconomic factors associated with disparity in wheelchair customizability among people with traumatic spinal cord injury.
OBJECTIVE
To determine if a standard of care for wheelchair provision exists within the participating centers and if there is disparity in wheelchair customizability among the study sample.


METHODS
Convenience sample survey.


METHODS
Thirteen Model Spinal Cord Injury Systems that provide comprehensive rehabilitation for people with traumatic spinal cord injury (SCI) and that are part of the national database funded through the US Department of Education.


METHODS
A total of 412 people with SCI who use wheelchairs over 40 hours a week.


METHODS
Survey information was obtained from subjects via telephone and in-person interviews and from the national database. Collected information included age, race, education, level of injury, and wheelchair funding source.


METHODS
Number and type (manual or power) of wheelchairs. Wheelchair customizability as defined by design features (eg, adjustable axle position, programmable controls).


RESULTS
Ninety-seven percent of manual wheelchair users and 54% of power wheelchair users had customizable wheelchairs. No power wheelchair user received a wheelchair without programmable controls. Minorities with low socioeconomic backgrounds (low income, Medicaid/Medicare recipients, less educated) were more likely to have standard manual and standard programmable power wheelchairs. Older subjects were also more likely to have standard programmable power wheelchairs.


CONCLUSIONS
The standard of care for manual wheelchair users with SCI is a lightweight and customizable wheelchair. The standard of care for power wheelchairs users has programmable controls. Unfortunately, socioeconomically disadvantaged people were less likely to receive customizable wheelchairs.
Hunt
Peter Cody
PC
Human Engineering Research Laboratories, Department of Physical Medicine and Rehabilitation, School of Medicine, University of Pittsburgh, PA, USA.
Boninger
Michael L
ML
Cooper
Rory A
RA
Zafonte
Ross D
RD
Fitzgerald
Shirley G
SG
Schmeler
Mark R
MR
D000203:Activities of Daily Living; D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D001696:Biomechanical Phenomena; D011211:Electric Power Supplies; D004867:Equipment Design; D006804:Ergonomics; D005260:Female; D019983:Guideline Adherence / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D010347:Patient Care Planning / Q000191:economics / Q000592:standards*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards*; D055656:Prescriptions / Q000191:economics / Q000592:standards*; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000523:psychology / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D015599:Trauma Severity Indices; D014481:United States; D014910:Wheelchairs / Q000191:economics / Q000592:standards*