title: Evaluation of CIR-whirlwind wheelchair and service provision in Afghanistan.
abstract: OBJECTIVE
  The Center for International Rehabilitation (CIR) developed a wheelchair provision strategy that combines central fabrication with regional distribution and local service provision by trained practitioners. A field study was initiated in Kabul, Afghanistan to evaluate this plan.
  
  
  METHODS
  The CIR-Whirlwind Wheelchair (study wheelchair) is an adult size, manual wheelchair designed to be adjustable to accommodate the individual user and durable to withstand rugged terrain. Manufactured in India, the study wheelchairs, with seat cushions, were packaged as kits and shipped to Afghanistan. Local practitioners in Kabul were trained on user assessment, fitting and training, and wheelchair assembly, maintenance and repair. One hundred subjects with previous experience of independently propelling a manual wheelchair participated in the study. This 4-month study entailed three subject visits for initial wheelchair fitting and training and then follow-up at 3 and 10 weeks. Subject training included wheelchair use and maintenance, and wheelchair skill activities.
  
  
  RESULTS
  The study wheelchair was rated favorably by the subjects in all of five categories. Adjustments made to the wheelchairs during the study were typical for maintaining or improving the fit or function of a manual wheelchair. With the exception of brake handles, the need to repair or replace components on the wheelchairs was minimal. The subjects' proficiency at wheelchair skill activities increased throughout the study.
  
  
  CONCLUSIONS
  Data collected indicates that the study wheelchair performed very well. The data also served to identify those aspects of the wheelchair that may require additional development and testing prior to further production. To gain additional information on long term wheelchair use and performance, the CIR plans to extend this study by interviewing the same subjects at nine and fifteen months from the date they originally received the study wheelchair.
authors.affiliation: Center for International Rehabilitation, Chicago, Illinois 60611, USA. engineeringsupport@cirnetwork.org
authors.forename: William
authors.initials: W
authors.lastname: Armstrong
authors.forename: Kim D
authors.initials: KD
authors.lastname: Reisinger
authors.forename: William K
authors.initials: WK
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000346:Afghanistan; D003695:Delivery of Health Care; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D013673:Technology Assessment, Biomedical; D014910:Wheelchairs