basic&wheelchair&maintenance&training
TRANSCRIPT
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Basic wheelchair maintenance training for manual and power wheelchair users
Maria Toro, MS1,2 Jessica Pedersen, MBA, OTR/L 3 Mary Shea, OT, ATP4 Jonathan Pearlman, PhD1,2
1 Human Engineering Research Laboratories 2 Department of Rehabilita:on Science and Technology, University of PiCsburgh 3 Rehabilita:on Ins:tute of Chicago 4 Kessler Ins:tute for Rehabilita:on
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You will be able to recognize the importance of maintenance and recommended inspecIon and acIon items.
[www.usersfirst.org]
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A wheelchair is the most enabling technology but may negaIvely impact a person’s life if it does not enable him/her to parIcipate fully.
3.6 million 273,000 SCI
[USCB, 2012], [NSCISC, 2009]
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x10
Injuries occur more frequently when wheelchairs are not maintained or repaired.
[Chen,2011]
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ANSI/RESNA wheelchair double-‐drum test
Wheelchair durability found lower than required in laboratory seYngs and repairs needed increased in the community.
[Worobey et al, 2012], [McClure et al, 2009], [Gebrosky et al, 2013]
Percentage of wheelchair users repor:ng needing repairs in the past 6 months
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Wheelchairs needing repairs has been reported as a cause of adverse consequences for wheelchair users.
Missing work Missing medical appointments
Being stranded Being injured
[Worobey et al, 2012], [McClure et al, 2009]
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Wheelchair check-‐ups are likely to reduce adverse events related to wheelchair breakdowns.
Wheelchair Maintenance Training Background Page 7
Tightening loose bolts Listening to motor noises
All wheelchairs require periodic maintenance to operate properly
Cleaning caster axles Patching a flat :re
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Scarce of wheelchair maintenance is likely related to the lack of wheelchair training provided to individuals with SCI.
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WMTP Program pilot+ 2 clinicians, 1 MWU, and 4 PWUs par:cipated in
the pilot
WMTP 2nd dra^ 3 experts reviewed
WMTP 1st dra^
5 experts reviewed
What tasks and frequency to include? +
19 experts completed survey
The Wheelchair Maintenance Training Program (WMTP) was based on exisIng materials and experts review through an iteraIve process.
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Training programs train clinicians who then train wheelchair users in a group seYng.
6-‐hour training course 2 two-‐hour group training sessions
Maintenance
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InspecIon and acIon items are included in the maintenance schedule.
Inspection
Ac:on
No problems
Found a problem
Con:nue using the wheelchair
Ac:on
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Time Activity 10:00 AM Introduction 10:05 AM Objectives and relevance 10:15 AM Manual wheelchair maintenance video 10:30 AM Manual wheelchair maintenance hands-on 12:30 PM Lunch 1:15 PM Power wheelchair maintenance video 1:30 PM Power wheelchair maintenance hands-on 2:40 PM Training materials overview 3:40 PM Discussion and summary 4:00 PM Adjournment
The WMTP for clinicians includes raIonale, hands-‐on maintenance pracIce, and overview of materials to train users.
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Time Activity 10:00 AM Introduction 10:05 AM Objectives and relevance 10:15 AM Manual wheelchair maintenance video 10:30 AM Manual wheelchair maintenance hands-on 12:30 PM Lunch 1:15 PM Power wheelchair maintenance video 1:30 PM Power wheelchair maintenance hands-on 2:40 PM Training materials overview 3:40 PM Discussion and summary 4:00 PM Adjournment
The WMTP for clinicians includes raIonale, hands-‐on maintenance pracIce, and overview of materials to train users.
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Time Activity 10:00 AM Introduction 10:05 AM Objectives and relevance 10:15 AM Manual wheelchair maintenance video 10:30 AM Manual wheelchair maintenance hands-on 12:30 PM Lunch 1:15 PM Power wheelchair maintenance video 1:30 PM Power wheelchair maintenance hands-on 2:40 PM Training materials overview 3:40 PM Discussion and summary 4:00 PM Adjournment
The WMTP for clinicians includes raIonale, hands-‐on maintenance pracIce, and overview of materials to train users.
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Wheelchair Maintenance Training Page 15
Day Duration (minutes) Time Activity
1
5 Introduction 15 Objectives and relevance 5 How to take care of a wheelchair at home DVD
60 Caring for a wheelchair at home 5 Summary
2 90 Hands-on wheelchair maintenance activity 20 Summary and discussion 5 Adjournment
The first session is mainly focused on maintenance tasks demonstraIons.
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Pneumatic tires
Wheelchair Maintenance Training: Manual Wheelchair
Tire depresses more than 5mm
Improperly inflated Ires wear quickly and make a wheelchair difficult to maneuver and propel.
5mm
Inflate
Inflate to recommended pressure Presta Schrader
Types of valves
INSPECT WEEKLY
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Wheelchair Maintenance Training Page 17
Day Duration (minutes) Time Activity
1
5 Introduction 15 Objectives and relevance 5 How to take care of a wheelchair at home DVD
60 Caring for a wheelchair at home 5 Summary
2 90 Hands-on wheelchair maintenance activity 20 Summary and discussion 5 Adjournment
The second session is mostly hands-‐on pracIce and discussion.
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Maintenance cards, a toolkit, and reminders are take-‐home resources.
Maintenance cards
Toolkit
Maintenance reminders
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Weekly inspect the condiIon of the cushion and the pressure in the pneumaIc Ires.
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Monthly inspect the wheelchair alignment and all the wheel components.
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Monthly inspect all the wheelchair supports.
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Monthly inspect the condiIon of the front and anI-‐Ip casters.
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Inspect monthly al the frame components.
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Once a month clean the wheelchair.
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Four Imes a year lubricate moving parts like the wheel locks and the folding back support mechanism.
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Have the wheelchair professionally serviced at least once a year.
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Daily pay afenIon that the wheelchair works reliably.
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Charge the wheelchair daily if you use it daily.
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Weekly inspect the condiIon of the cushion and the pressure in the pneumaIc Ires.
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Monthly pay afenIon to the wheelchair alignment, wheel bearings, and Ire condiIon.
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Monthly inspect all the wheelchair supports.
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Have the wheelchair professionally serviced at least once a year.
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Have the wheelchair professionally serviced at least once a year.
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Clean the wheelchair frame, cushion and power seat funcIon mechanisms monthly.
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Have the wheelchair professionally serviced at least once a year.
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6-‐hour training course 2 two-‐hour group training sessions
Maintenance
15 clinicians WMTP 29 pwc users WMTP
We have trained clinicians at 4 sites, are currently recruiIng wheelchair users, and planning on more disseminaIon.
QuesIons?
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This project has been supported by many people and organiza:ons!
• Volunteers for training materials • Study par:cipants
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References • Boninger, Michael L., et al. "Propulsion paCerns and pushrim biomechanics in manual wheelchair propulsion."
Archives of physical medicine and rehabilita5on 83.5 (2002): 718-‐723. • Brault, M.W., Americans with disabili5es: 2010. 2012, U.S. Census Bureau,: Washington, DC. • Chen, Wan-‐Yin, et al. "Wheelchair-‐related accidents: rela:onship with wheelchair-‐using behavior in ac:ve
community wheelchair users." Archives of physical medicine and rehabilita5on 92.6 (2011): 892-‐898. • Gebrosky, Benjamin, et al. "Evalua:on of lightweight wheelchairs using ANSI/RESNA tes:ng standards." J Rehabil
Res Dev 50.10 (2013): 1373-‐1390. • Lemay, V., et al. "Rela:onships between wheelchair skills, wheelchair mobility and level of injury in individuals
with spinal cord injury." Spinal cord (2011). • McClure, L., et al., Wheelchair repairs, breakdown, and adverse consequences for people with trauma5c spinal cord
injury. Archives of Physical Medicine and Rehabilita:on, 2009. 90: p. 2034-‐2038. • Na:onal Spinal Cord Injury Sta:s:cal Center, Facts and Figures At a Glance, in
www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.pdf, University of Alabama at Birmingham, Editor. 2013: Birmingham, AL.
• Oyster, Michelle L., et al. "Wheelchair skill performance of manual wheelchair users with spinal cord injury." Topics in spinal cord injury rehabilita5on 18.2 (2012): 138-‐139.
• Richter, W. Mark, et al. "Stroke paCern and handrim biomechanics for level and uphill wheelchair propulsion at self-‐selected speeds." Archives of physical medicine and rehabilita5on 88.1 (2007): 81-‐87.
• Worobey, L., et al., Increases in wheelchair breakdowns, repairs, and adverse consequences for people with trauma5c spinal cord injury. American Journal of Physical Medicine and Rehabilita:on, 2012. 91(6).
![Page 41: Basic&wheelchair&maintenance&training](https://reader030.vdocuments.mx/reader030/viewer/2022040605/624b1d5011230e684b791843/html5/thumbnails/41.jpg)
• American Associa:on for Healthcare. (2013). Medicare policies restric:ng power wheelchair repairs leave vulnerable beneficiaries with limited mobility. [Press release]. Retrieved from hCp://www.reuters.com/ar:cle/2013/07/26/aahomecare-‐on-‐cms-‐idUSnPNDC54135+1e0+PRN20130726
• Brault, M. W. (2012). Americans with disabili:es: 2010. Washington, DC: U.S. Census Bureau,. • Calder, C. J., & Kirby, R. L. (1990). Fatal wheelchair-‐related accidents in the United States. American journal of physical medicine & rehabilita5on, 69(4), 184-‐190. • Cooper, R. A. (2013). The basics of manual wheelchair maintenance. PN online. • Denison, I. (2006). Wheelchair Maintenance Series. Retrieved August 29, 2013, from hCp://www.assis:ve-‐technology.ca/studies/wm_full.pdf • Hanna, S. (2010). K0823 Group 2 Standard Power Wheelchair. HomeCare. • Hansen, R., Tresse, S., & Gunnarsson, R. (2004). Fewer accidents and beCer maintenance with ac:ve wheelchair check-‐ups: a randomized controlled clinical trial Clinical Rehabilita5on, 8,
631-‐639. • Khasnabis, C., & Mines, K. (2012). Wheelchair Service Training Package Basic Level: WHO • Kirby, R. L., & Ackroyd-‐Stolarz, S. A. (1995). Wheelchair safety-‐adverse reports to the United States Food and Drug Administra:on. American journal of physical medicine & rehabilita5on,
74(4), 308-‐312. • Koontz, A. M. (NA). Manual Wheelchair Maintenance. Retrieved August 28, 2013, from hCp://www.spinlife.com/spin:ps/details/k/Manual%20Wheelchair%20Maintenance/a/116/c/2 • Mann, W., Hurren, D., Charvat, B., & Tomita, M. (1996). Problems with wheelchairs experienced by frail elders. Technology and Disability, 5, 101-‐111. • McClure, L., Boninger, M., Oyster, M., Williams, S., Houlihan, B., Lieberman, J., & Cooper, R. (2009). Wheelchair repairs, breakdown, and adverse consequences for people with trauma:c
spinal cord injury. Archives of Physical Medicine and Rehabilita5on, 90, 2034-‐2038. • Na:onal Spinal Cord Injury Sta:s:cal Center. (2012). The 2012 Annual Sta:s:cal Report for the Spinal Cord Injury Model Systems. In University of Alabama at Birmingham (Ed.).
Birmingham, AL: University of Alabama at Birmingham,. • Na:onal Spinal Cord Injury Sta:s:cal Center. (2013). Facts and Figures At a Glance. In University of Alabama at Birmingham (Ed.), h\ps://
www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.pdf. Birmingham, AL. • Toro, M. L., Garcia, Y., Ojeda, A. M., Dausey, D. J., & Pearlman, J. (2012). Quan:ta:ve exploratory evalua:on of the frequency, causes and consequences of rehabilita:on wheelchair
breakdowns delivered at a paediatric clinic in Mexico. Disability, CBR and Inclusive Development, 23(3). • Toro, M. L., Pearlman, J., Oyster, M., & Boninger, M. (2014, June 11-‐15). Type and Frequency of Reported Wheelchair Repairs and Adverse Consequences Among People with Spinal Cord
Injury. Paper presented at the Rehabilita:on Engineering and Assis:ve Technology Society of North America Conference, Indianapolis. • Ummat, S., & Kirby, R. (1994). Nonfatal wheelchair-‐related accidents reported to the Na:onal Electronic Injury Surveillance System. American Journal of Physical Medicine and
Rehabilita5on, 73(3), 163-‐167. • United States Government Accountability Office. (2008). Tes::mony Before the SubcommiCee on Health, CommiCee on Ways and Means, House of Representa:ves: Medicare
compe::ve bidding for medical equipment and supplies could reduce program payments but adequate oversight is cri:cal. • World Health Organiza:on. (2008). Guidelines on the provision of manual wheelchairs in less resourced se^ngs. Geneva: World Health Organiza:on. • Worobey, L., Oyster, M., Nemunai:s, G., Cooper, R., & Boninger, M. L. (2012). Increases in wheelchair breakdowns, repairs, and adverse consequences for people with trauma:c spinal
cord injury. American Journal of Physical Medicine and Rehabilita5on, 91(6). • Young, J. B., Belfield, P. W., Mascie-‐Taylor, B. H., & Mulley, G. P. (1985). The neglected hospital wheelchair. Bri5sh Medical Journal, 291, 1388-‐1389.