title: Problematic clinical features of children and adults with cerebral palsy who use electric powered indoor/outdoor wheelchairs: A cross-sectional study.
abstract: This article aims to describe the clinical features of electric powered indoor/outdoor wheelchair (EPIOC) users with cerebral palsy (CP) that are problematic to optimal prescription and to explore comorbidities, features of CP, and conditions secondary to disability impacting on equipment provision for children and adults. The method is a cross-sectional study of EPIOC users (n = 102) with a primary diagnosis of CP. This is a retrospective review of electronic and case note records of EPIOC recipients attending a specialist wheelchair service in 2007-2008. Records were reviewed by a rehabilitation consultant. Data were extracted under three themes; demographic, diagnostic/clinical and wheelchair factors. There were 48 males mean age 27.5 (range 8-70, SD 13.9) years and 54 females, mean age 29.5 (range 7-68, SD 14.6) years with CP. Sixteen comorbidities, nine features of CP, and five features of disability influenced wheelchair prescription. Sixty-four users were provided with specialized seating (SS) and 47 with tilt-in-space (TIS) seats. Complex controls were provided to 16 users, 12 tray-mounted. The majority of users had both SS and TIS. Powered wheelchair prescription has important therapeutic roles in clinical management in addition to enhancing mobility, independence and participation. Clinical features such as spasticity and problematic pain appeared less well managed in adults than in children.
authors.affiliation: a Stanmore Specialist Wheelchair Service , Royal National Orthopaedic Hospital , Brockley Hill, Stanmore , UK (since disbanded).|b Department of Clinical Sciences, College of Health and Life Sciences , Brunel University London , Uxbridge, Middlesex , UK.
authors.forename: Andrew O
authors.initials: AO
authors.lastname: Frank
authors.affiliation: c Department of Clinical Sciences, College of Health and Life Sciences , Brunel University London , Uxbridge, Middlesex , UK.
authors.forename: Lorraine H
authors.initials: LH
authors.lastname: De Souza
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging; D002547:Cerebral Palsy / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation; D002648:Child; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014910:Wheelchairs; D055815:Young Adult
keywords: adaptive seating; aging; cerebral palsy; comorbidity; powered wheelchairs