title: Effect of motorized scooters on quality of life and cardiovascular risk.
abstract: Physical inactivity increases cardiovascular risk. The possible adverse effects of regular motorized scooter use, recently popularized for patients with physical limitations, has not been previously examined. We performed a single-center, retrospective cohort study of 102 consecutive patients who had obtained medical approval for, and subsequently received, a motorized scooter during a 6-year period. The clinical data were collected for the 12 months before and after the intervention. Surveys assessing 11 different facets of health-related quality of life were returned by 28% of patients. The patients receiving a scooter were 68 +/- 19 years old, and 55% were women. The medical indications for scooter use, by decreasing frequency, were disabling arthritis, chronic lung disease, neurologic disorders, and heart failure. Patients returning the surveys estimated scooter use at a median of 4 hours/day, with walking confined to 30 min/day. Despite significant physical and psychological improvements in all quality-of-life categories (p <0.001), the fasting blood glucose increased from 119 +/- 39 to 133 +/- 49 mg/dl (p = 0.009), hemoglobin A1c increased from 6.3 +/- 0.8 to 6.8 +/- 1.2 (p = 0.019), and 18.7% of patients developed diabetes during the follow-up period. No significant changes in blood pressure were noted, although 20% of patients required additional antihypertensive medication. Despite improvements in total and low-density lipoprotein cholesterol over time, 50% of dyslipidemic patients required either an increase medication dose or additional medications during follow-up. In conclusion, interventions, such as scooters, that improve self-perceived quality of life, can have detrimental long-term effects by increasing cardiovascular risk, particularly insulin resistance. Physicians should carefully weigh such risks before approving their use, as well as ensure healthy levels of activity afterward.
authors.affiliation: Department of Cardiology, Eglin Air Force Base Regional Hospital, Eglin Air Force Base, Florida, USA. bwzagol42@yahoo.com
authors.forename: Brian W
authors.initials: BW
authors.lastname: Zagol
authors.forename: Richard A
authors.initials: RA
authors.lastname: Krasuski
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009043:Motor Activity; D018986:Motor Vehicles; D011788:Quality of Life; D012307:Risk Factors; D057185:Sedentary Behavior; D014910:Wheelchairs