WHEELCHAIRS AS MOBILITY RESTRAINTS - PREDICTORS OF WHEELCHAIR ACTIVITY IN NONAMBULATORY NURSING-HOME RESIDENTS

OBJECTIVE: The purpose of this paper is to describe factors affecting wheelchair mobility in nonambulatory nursing home (NH) residents. DESI GN: Prospective descriptive study of a convenience sample of nonambula tory NH residents. SETTING: Seven nursing homes. PARTICIPANTS: Sixty-f ive nonambulatory residents. MEASUREMENTS: One-minute, time-sampled ob servations of behavior for each resident were made every 15 minutes fo r 8 to 11 hours across 2 days, noting wheelchair propulsion activity f or the dependent variable; independent variables included measures of wheelchair level of assistance, speed, endurance, handgrip strength, a nd balance. MAIN RESULTS: A stepwise Multiple Regression analysis foun d wheelchair speed to be the single best predictor of the percentage o f time residents were behaviorally observed wheelchair propelling (Mul tiple r = .45, P < .02). Handgrip strength and wheelchair endurance me asures were highly intercorrelated with wheelchair speed. Wheelchairs that were either dysfunctional or inappropriately fitted to the reside nts' size were a major barrier to wheelchair use, affecting 46% of res idents using wheelchairs.. CONCLUSION: Improving wheelchair skills wit h targeted intervention programs, along with making chairs more ''user friendly'' (e.g., grip extensions on brakes, foot pedals that one can move without bending over), could result in more wheelchair propulsio n with resultant improvements in the NH resident's independence, freed om of movement, and quality of life.