The Accuracy of New Wheelchair Users' Predictions About Their Future Wheelchair Use

• Type of Material: Article
• Authors: Helen Hoenig, Duke University; Patricia Griffiths, Emory University; Shanti Ganesh, Hines Veterans Affairs Medical Center; Kevin Caves, Duke University; Frances Harris, Georgia Institute of Technology
• Language: English
• Date: 2012-06-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 Wolters Kluwer Health, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/PHM.0b013e3182555e4c
• Title of Journal or Parent Work: American Journal of Physical Medicine and Rehabilitation
• ISSN: 0894-9115
• Volume: 91
• Issue: 6
• Start Page: 511
• End Page: 518
• Grant/Funding Information: This work was supported in part by the Paul Beeson Faculty Scholar Program from the American Federation for Aging Research.; This work also was supported in part by the National Institute of Health, National Institute on Aging, Duke University Claude D. Pepper Older Americans Independence Center, Grant #2P60AG11268 and by the National Institute of Disability and Rehabilitation Research, RERC on Wheeled Mobility, Grant #H133E030035-04.
• Keywords: LIFE; REHABILITATION; Self-Help Devices; Sport Sciences; Predictive Model; Prognosis; Rehabilitation; ASSISTIVE TECHNOLOGY; STROKE; Mobility Disability; TRIAL; Science & Technology; Statistical Model; Life Sciences & Biomedicine; Delivery of Health Care; Wheelchair
• Research Categories: Health Sciences, Public Health; Health Sciences, Rehabilitation and Therapy

Abstract

OBJECTIVE: This study examined the accuracy of new wheelchair user predictions about their future wheelchair use. DESIGN: This was a prospective cohort study of 84 community-dwelling veterans provided a new manual wheelchair. RESULTS: The association between predicted and actual wheelchair use was strong at 3 mos (ϕ coefficient = 0.56), with 90% of those who anticipated using the wheelchair at 3 mos still using it (i.e., positive predictive value = 0.96) and 60% of those who anticipated not using it indeed no longer using the wheelchair (i.e., negative predictive value = 0.60, overall accuracy = 0.92). Predictive accuracy diminished over time, with overall accuracy declining from 0.92 at 3 mos to 0.66 at 6 mos. At all time points, and for all types of use, patients better predicted use as opposed to disuse, with correspondingly higher positive than negative predictive values. Accuracy of prediction of use in specific indoor and outdoor locations varied according to location. CONCLUSIONS: This study demonstrates the importance of better understanding the potential mismatch between the anticipated and actual patterns of wheelchair use. The findings suggest that users can be relied upon to accurately predict their basic wheelchair-related needs in the short-term. Further exploration is needed to identify characteristics that will aid users and their providers in more accurately predicting mobility needs for the long-term.