Electric powered wheelchairs for those with muscular dystrophy: problems of posture, pain and deformity.
OBJECTIVE
To identify areas of difficulty encountered by a regional wheelchair service in providing Electric Powered Indoor/outdoor wheelchairs (EPIOCs) to those with muscular dystrophy (MD) in the early years of their provision--particularly posture, pain and deformity.


METHODS
Wheelchair service records of all users between April 1997 and March 2000 were reviewed retrospectively and issues relating to weakness, pain/discomfort, deformities, other medical issues, weight change, function, posture and driving were documented on a purpose-designed proforma. Adjustments and modifications were documented over the 2-year period following chair delivery.


RESULTS
Of 325 EPIOC users on the departmental database, 29 had MD (15 Duchenne's), whose users charts were reviewed. Almost 80% of users needed clinical review within 2 years, mostly due to a scoliosis. Other problems were postural (66%), medical (48%), pain (31%), functional (24%) and weight change (14%). The commonest prescriptions were for specialised seating (24%), lateral supports, headrests and footrests (21% each).


CONCLUSIONS
The rate of disease progression was not planned for by the service. Most clients were seen in response to deterioration, rather than anticipating it. Planned reviews within 1 year appear essential for teenagers with MD with the dual issues of rapid maturation and progressive disease.
Richardson
Marion
M
Stanmore Specialist Wheelchair Service, Royal National Orthopedic Hospital, Brockley Hill, Stanmore, UK.
Frank
Andrew O
AO
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D002648:Child; D000013:Congenital Abnormalities / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D011211:Electric Power Supplies / Q000706:statistics & numerical data*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009136:Muscular Dystrophies / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D010146:Pain / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D017060:Patient Satisfaction; D011187:Posture / Q000502:physiology*; D011788:Quality of Life; D012189:Retrospective Studies; D014910:Wheelchairs / Q000706:statistics & numerical data*; D055815:Young Adult