Article

The aim of this study is to describe the clinical features of powered
wheelchair users with severely disabling multiple sclerosis (MS) and explore the
problematic clinical features influencing prescription.
METHOD: Retrospective
review of electronic and case note records of recipients of electric-powered
indoor/outdoor powered wheelchairs (EPIOCs) attending a specialist wheelchair
service between June 2007 and September 2008. Records were reviewed by a
consultant in rehabilitation medicine, data systematically extracted and entered
into a computer database. Further data were entered from clinical records. Data
were extracted under three themes; demographic, diagnostic, clinical and
wheelchair factors. RESULTS: Records of 28 men mean age 57 (range 37-78, SD 12)
years and 63 women mean age 57 (range 35-81, SD 11) years with MS were reviewed a
mean of 64 (range 0-131) months after receiving their wheelchair. Twenty two
comorbidities, 11 features of MS and 8 features of disability were thought to
influence wheelchair prescription. Fifteen users were provided with specialised
seating and 46 with tilt-in-space seats. CONCLUSIONS: Our findings suggest that
people with severe MS requiring an EPIOC benefit from a holistic assessment to
identify problematic clinical features that influence the prescription of the
EPIOC and further medical and therapeutic interventions. IMPLICATIONS FOR
REHABILITATION: People with multiple sclerosis (MS),
referred for an EPIOC,
require a full clinical assessment to identify problematic clinical features that
are potentially treatable and/or can be accommodated through specialised seating
and tilt. The beneficial effects of TIS should be considered for all EPIOC users
with MS and particularly for those with comorbidity Poorly controlled spasticity,
when identified in people with MS, should be managed through positioning in the
chair, pressure-relieving cushion and referral for medical management.

Langue : ANGLAIS