Mobility Device Quality Affects Participation Outcomes for People With Disabilities: A Structural Equation Modeling Analysis

Abstract

Objective: To test the effect that indicators of mobility device quality have on participation outcomes in community-dwelling adults with spinal cord injury, traumatic brain injury, and stroke by using structural equation modeling.

Design: Survey, cross-sectional study, and model testing.

Setting: Clinical research space at 2 academic medical centers and 1 free-standing rehabilitation hospital.

Participants: Community-dwelling adults (N=250; mean age, 48±14.3y) with spinal cord injury, traumatic brain injury, and stroke.

Interventions: Not applicable.

Main outcomes measures: The Mobility Device Impact Scale, Patient-Reported Outcomes Measurement Information System Social Function (version 2.0) scale, including Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities, and the 2 Community Participation Indicators' enfranchisement scales. Details about device quality (reparability, reliability, ease of maintenance) and device type were also collected.

Results: Respondents used ambulation aids (30%), manual (34%), and power wheelchairs (30%). Indicators of device quality had a moderating effect on participation outcomes, with 3 device quality variables (repairability, ease of maintenance, device reliability) accounting for 20% of the variance in participation. Wheelchair users reported lower participation enfranchisement than did ambulation aid users.

Conclusions: Mobility device quality plays an important role in participation outcomes. It is critical that people have access to mobility devices and that these devices be reliable.

Keywords: Brain injuries, traumatic; Outcome and process assessment (health care); Rehabilitation; Social participation; Spinal cord injuries; Stroke; Walkers; Wheelchairs.