title: Barriers to wheelchair use in the winter.
abstract: OBJECTIVE
  To test the hypothesis that challenges to community participation posed by winter weather are greater for individuals who use scooters, manual and power wheelchairs (wheeled mobility devices [WMDs]) than for the general ambulatory population, and to determine what WMD users identify as the most salient environmental barriers to community participation during the winter.
  
  
  METHODS
  Cross-sectional survey organized around 5 environmental domains: technological, natural, physical, social/attitudinal, and policy.
  
  
  METHODS
  Urban community in Canada.
  
  
  METHODS
  Convenience sample of WMD users or their proxy (N=99).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Not applicable.
  
  
  RESULTS
  Forty-two percent identified reduced outing frequency in winter months, associated with increased age (χ(3)=6.4, P=.04), lack of access to family/friends for transportation (χ(2)=8.1, P=.04), and primary type of WMD used in the winter (scooter χ(2)=8.8, P=.003). Most reported tires/casters becoming stuck in the snow (95%) or slipping on the ice (91%), difficulty ascending inclines/ramps (92%), and cold hands while using controls or pushing rims (85%); fewer identified frozen wheelchair/scooter batteries, seat cushions/backrests, or electronics. Sidewalks/roads were reported to be problematic by 99%. Eighty percent reported needing additional help in the winter. Limited community access in winter led to a sense of loneliness/isolation, and fear/anxiety related to safety. Respondents identified policies that limited participation during winter.
  
  
  CONCLUSIONS
  People who use WMDs decrease their community participation in cold weather because of multiple environmental barriers. Clinicians, researchers, and policymakers can take a multidimensional approach to mitigate these barriers in order to enhance community participation by WMD users in winter.
authors: Department of Occupational Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: Jacquie.Ripat@umanitoba.ca.
authors: Jacquie D
authors: JD
authors: Ripat
authors: Department of Occupational Therapy, College of Rehabilitation Sciences, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
authors: Cara L
authors: CL
authors: Brown
authors: Section of Physical Medicine and Rehabilitation, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
authors: Karen D
authors: KD
authors: Ethans
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety; D002170:Canada; D003080:Cold Temperature / Q000009:adverse effects; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005239:Fear; D006801:Humans; D007053:Ice; D008132:Loneliness; D008875:Middle Aged; D011640:Public Policy; D012621:Seasons; D012914:Snow; D012934:Social Isolation; D058992:Social Participation; D011795:Surveys and Questionnaires; D014186:Transportation; D014505:Urban Population; D014910:Wheelchairs; D055815:Young Adult
chemical_list: D007053:Ice
keywords: Cold temperature; Rehabilitation; Snow; Social participation; Wheelchairs