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The Effect of Mobility Device Use on Strength, Fatigue and Quality of Life in Persons with Multiple Sclerosis

Woollard, Fabrisia Ambrosio (2005) The Effect of Mobility Device Use on Strength, Fatigue and Quality of Life in Persons with Multiple Sclerosis. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract: The variability of symptoms in persons with multiple sclerosis (MS) leads to dilemmas in clinical decision-making related to mobility device prescription. When is a good time to consider a switch to wheeled mobility? What is the best type of wheeled mobility? What are the changes one can expect as they transition? Three studies addressed these questions. First, we investigated the characteristics of individuals with MS who are about to transition to wheeled mobility. Seven ambulatory individuals with MS performed the timed 25-foot walk test (T25FW), and completed questionnaires measuring quality of life (QoL), self-reported fatigue, and participation. These individuals were not able to ambulate at functional speeds and had "sedentary" activity levels. They also had QoL below that of the general population. Next, we investigated changes that accompany a transition in primary means of mobility. Eleven individuals with MS or other chronic conditions leading to a decline in mobility function participated. We collected strength, fatigue, participation and QoL data at baseline, and after mobility intervention. Substantive results revealed that individuals may not experience the expected declines in strength and endurance as they transition. Furthermore, they experienced improvements in QoL concomitant with amount of daily device use. Methodological results revealed difficulties in conducting longitudinal mobility studies, and addressed research design barriers. Finally, we investigated whether a difference exists in the type of wheeled mobility issued to veterans with MS when compared to veterans with a spinal cord injury (SCI). Using the National Prosthetic Patient Database, we isolated all veterans with MS or an SCI who received a wheelchair or scooter in 2000 and 2001. We found that the quality of wheeled mobility devices issued to individuals with MS was inferior to those issued to individuals with SCI. These studies provide preliminary evidence that individuals with MS may be waiting too long to transition to the use of wheeled mobility. When they do receive a wheelchair, veterans with MS tend to receive a lower quality of wheelchair. Finally, we made suggestions for conducting longitudinal mobility research in this population, and emphasized the need for future studies.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Woollard, Fabrisia
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBoninger, Michael Lmlboning@pitt.eduMLBONING
Committee MemberLiu, BettyLiuby@upmc.eduBETTYL
Committee MemberCooper, Rory Arcooper@pitt.eduRCOOPER
Committee MemberFitzgerald, Shirley
Committee MemberSchwid,
Date: 28 August 2005
Date Type: Completion
Defense Date: 1 June 2005
Approval Date: 28 August 2005
Submission Date: 15 August 2005
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: assistive technology; fatigue; multiple sclerosis; quality of life; strength; wheelchair
Other ID:, etd-08152005-135950
Date Deposited: 10 Nov 2011 19:59
Last Modified: 19 Dec 2016 14:37


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