Effect of motorized scooters on quality of life and cardiovascular risk.
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.
Zagol
Brian W
BW
Department of Cardiology, Eglin Air Force Base Regional Hospital, Eglin Air Force Base, Florida, USA. bwzagol42@yahoo.com
Krasuski
Richard A
RA
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