Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us.
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http://dx.doi.org/10.3390/ijerph18073338 | DOI Listing |
Stat Med
February 2025
Programme in Health Services & Systems Research, Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
Incidence of adverse outcome events rises as patients with advanced illness approach end-of-life. Exposures that tend to occur near end-of-life, for example, use of wheelchair, oxygen therapy and palliative care, may therefore be found associated with the incidence of the adverse outcomes. We propose a concept of reverse time-to-death (rTTD) and its use for the time-scale in time-to-event analysis based on partial likelihood to mitigate the time-varying confounding.
View Article and Find Full Text PDFCureus
January 2025
Neurosurgery, University of Kinshasa, Kinshasa, COD.
Pediatric spinal tumors include a variety of developmental lesions and uncommon neoplasms that differ significantly from those seen in adults. These conditions are underreported in the sub-Saharan medical literature. We present the case of a 10-year-old girl brought by her family to the University Teaching Hospital of Kinshasa in the Democratic Republic of Congo with progressive lower limb functional impairment.
View Article and Find Full Text PDFAssist Technol
January 2025
Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Valid and reliable assessment tools to test wheelchair service personnel/provider knowledge are needed to support good practice. The International Society of Wheelchair Professionals' Basic Manual Wheelchair Service Provision Test (Version 1) has been widely used across contexts and settings to assess the knowledge of personnel who provide manual wheelchair services. Test Version 2 has been recently developed according to current evidence.
View Article and Find Full Text PDFDisabil Rehabil Assist Technol
January 2025
School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio, USA.
The wheelchair service delivery process (SDP) is a large complex system and therefore has many potential points of failure; determining priorities for improvement is challenging. The complexities introduce several barriers to accessing and maintaining wheelchairs for individuals with mobility impairments. Given the breadth and depth of the barriers, it is important to know in which areas to focus future policy reform efforts.
View Article and Find Full Text PDFPLoS One
January 2025
Academy for Health Equity, Prevention and Wellbeing (AHEPW) School of Health Sciences, Bangor University, Gwynedd, United Kingdom.
Background And Objective: Personal wheelchair budgets (PWBs) are offered to everyone in England eligible for a wheelchair provided through the National Health Service (NHS) to support their choice of equipment. The WATCh (Wheelchair outcomes Assessment Tool for Children) and related WATCh-Ad for adults are patient-centred outcome measures (PCOMs) developed to help individual users express their main outcome needs when obtaining a wheelchair and rate their satisfaction with subsequent outcomes after receiving their equipment. Use was explored in a real-world setting, aiming to produce guidance for use alongside the PWB process.
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