title: One size does not fit all-mobility device type affects speed, collisions, fatigue, and pain.
abstract: OBJECTIVE
  To determine whether differences could be detected in mobility outcomes during community mobility and home mobility tasks according to type of mobility assistive device.
  
  
  METHODS
  Randomized, repeated measures.
  
  
  METHODS
  Community mobility task: traversing 341.4m between the rehabilitation clinic and hospital entrance; home mobility task: traversing 39m into and out of a patient training bathroom and bedroom.
  
  
  METHODS
  Community-dwelling, cognitively intact ambulatory veterans (N=59) who used a mobility device within the 14 days prior to the study.
  
  
  METHODS
  Participants tested 3 types of mobility assistive devices with wheels: 4-wheeled walker (WW), manual wheelchair (MWC), and powered wheelchair (PWC). The first and last devices used by each participant were randomly assigned as either MWC or WW. The PWC was always the second device.
  
  
  METHODS
  Speed (m/s), collisions (total), fatigue (0-10 Likert scale), and pain (0-10 Likert scale, diagram).
  
  
  RESULTS
  The community mobility task was performed with all 3 devices by 52 (88%) veterans, and the home mobility task was performed with all 3 devices by 53 (90%) participants. In each task, 28 participants used the WW and 28 participants used the MWC as the final device. In the community mobility task, statistically significant differences (P<.05) were seen with ≥1 device comparison for all studied outcomes (eg, standardized mean difference for the MWC compared with the PWC showed -.67 fewer collisions for the MWC). In the home mobility task, speed, collisions, and fatigue showed statistically significant (P<.05) device-related differences (eg, standardized mean difference for the WW compared with the MWC showed -.88 fewer collisions for the WW).
  
  
  CONCLUSIONS
  We found statistically significant and substantively different effects from 3 commonly used mobility assistive devices with wheels on diverse mobility outcomes when used in typical community mobility and home mobility tasks, providing proof of concept support for a research methodology applicable to comparative outcome studies of diverse mobility aids.
authors.affiliation: Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC; Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC. Electronic address: helen.hoenig@va.gov.
authors.forename: Helen
authors.initials: H
authors.lastname: Hoenig
authors.affiliation: Center on Aging, Duke University Medical Center, Durham, NC.
authors.forename: Michelle
authors.initials: M
authors.lastname: Morgan
authors.affiliation: Center on Aging, Duke University Medical Center, Durham, NC.
authors.forename: Christy
authors.initials: C
authors.lastname: Montgomery
authors.affiliation: Center on Aging, Duke University Medical Center, Durham, NC.
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Landerman
authors.affiliation: Speech and Audiology, Department of Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Kevin
authors.initials: K
authors.lastname: Caves
mesh_terms: D000054:Acceleration; D000368:Aged; D011211:Electric Power Supplies; D004867:Equipment Design; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D010147:Pain Measurement; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans; D014853:Walkers; D014910:Wheelchairs
keywords: Mobility limitation; Outcome and process assessment; Rehabilitation; Self-help devices; Walkers; Wheelchairs