The Impact of Powered Mobility on Functional Independence: Executive Summary

Assistive Technology Research Institute

In the Fall and Winter of 2004, the Assistive Technology Research Institute (ATRI) conducted a retrospective investigation on the effects on functional independence of providing Pride Mobility power wheelchairs to individuals with disabilities. Pride Mobility provided a list of names, telephone numbers, and addresses of recent customers to ATRI, from which a sample was drawn for data collection.

Data Collection Tool

ATRI created a data collection instrument that was based on an existing instrument for assessing functional independence, OTFact. The instrument included items that could be subject to change with use of a powered mobility system, and excluded items that were not conceptually linked. This process resulted in the reduction of items from 1000 in OTFact to 280 in the investigation. Respondents were able to indicate that they were dependent in an activity, required assistance, or were independent in an activity. Alternatively, they were able to indicate that the activity was not applicable to them.

The instrument scoring combines these many items to produce a percentage of functional independence in each of five areas of performance. These areas are:

Role Integration. This includes the ability to participate in and balance relationships and roles in daily life. These roles include such personal activities as being the giver and receiver of care, being a parent, being a friend, and the more impersonal roles of being a member of the community or an employee.

Activities of Performance. This area includes the ability to perform specific daily activities such as bathing or toileting, managing a household, or hiring an employee.

Integrated Skills of Performance. This area deals with psychological and social skills that allow individuals to manage their daily lives. These include managing peer relationships, stress management, and coping skills.

Components of Performance. This includes the physical and cognitive capacity to perform. This area includes strength, endurance, joint mobility and skin integrity as well as self-efficacy and body image.

Environmental Access relates to the ability of the individual to navigate both the physical and social environment. Access to the physical environment includes movement within the home, the neighborhood, and the community. Access to the social environment includes the ability to use social support systems, banking, libraries, and the medical system.

Results of Providing a Powered Chair

An aging group of individuals with declining health would be expected to show a decrease in functional independence over time. With the provision of a Pride Mobility wheelchair, the sampled showed a general gain in functional independence in all areas of the investigation.

Role Integration

For a group of elders who are experiencing a decline in health status, the expected change in role integration, without intervention, would be a decrease in the number of roles participated in, and a decrease in the functional independence within those roles. With the provision of a Pride Mobility wheelchair, this did not occur. The sample showed an increase from 60% functional independence to 64% functional independence in role participation and balance.

Activities of Performance

This area, which includes the activities of daily life, showed an increase from 77% to 82% functional independence. Two areas that did not show a significant gain in independence were toileting and bathing. This lack of gain seems to stem from the difficulty in getting a power wheelchair into a conventional bathroom.

Integrated Skills of Performance

The sample showed an increase in functional independence from 87% to 92% in cognitive and psychological skills following the provision of a power wheelchair. This gain appears to derive from the increased energy reserves available with the reduction in demand for moving from place to place. With increased energy, participants were better able to manage the cognitive and psychological stresses of their lives.

Respondents in this area indicated that, with decreased mobility they tended to feel disconnected and sorry for themselves. With the mobility provided by their Pride wheelchairs, they were able to be more involved in their roles and directors of activities, felt more autonomous, and had higher self esteem.

Components of Performance

The participants showed the greatest gains in functional independence of any area in the study in the components of performance: physical well being and self-efficacy. The area of Components of Performance rose from 59% prior to acquiring a wheelchair to 73% after using the wheelchair. This gain seems to reflect the reduction in energy required to move through the environment, so that participants felt that they had more energy for other activities, and were more in control of their lives.

Environmental Access

While the participants showed an overall increase in independence in environmental access from 65% to 72%, this gain was primarily in indoor mobility. Community mobility did not show a great increase in independence because of the reported difficulty in transporting a wheelchair in a conventional automobile. Many respondents indicated that, due to the difficulty in transporting their wheelchairs, they seldom left their homes. Additionally, respondents noted difficulty in getting their wheelchairs into their bathrooms, which limited independence in bathing and toileting.

Overall, participants were very pleased with their powered mobility devices. They indicated that they felt more in control of their lives, were better able to participate in activities, and had much more energy. They showed a particular increase in interest in shopping, suggesting possible accessories.

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