Poojary-Mazzotta, Prerna
(2017)
WHEELCHAIR RELATED FALL RISK AND FUNCTION IN NURSING HOME RESIDENTS: FACTORS RELATED TO WHEELCHAIR FIT.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Background: Poor wheelchair fit may lead to increased pressure on bony prominences, reduced ability to propel the wheelchair and inability to reach, increasing pressure ulcer risk. Wheelchair fit impacts falls; the most frequently reported adverse event among nursing home residents.
Purpose: This research aimed to assess effect of individually-configured lightweight wheelchairs on wheelchair-related fall risk for nursing home residents. Secondary aims were to assess effect of wheelchair fit on the functional status of nursing home residents measured with the Functioning Everyday with a Wheelchair (FEW-C) and Nursing Home Life Space Diameter (NHLSD) measurements, and the relationship between FEW-C and pressure ulcer risk measured with the Braden Scale.
Methods: This study was a secondary analysis of data from a randomized clinical trial (RCT) on wheeled mobility for preventing pressure ulcers. A total of 258 residents were randomized into either a control group (n=131) provided a skin protection cushion with related adjustments to his/her nursing home wheelchair, or into a treatment group (n=127), receiving a wheelchair assessment and an individually configured manual lightweight wheelchair with skin protection cushion.
Results: The primary aim found in the treatment and control groups, 25/127 (19.69%) and 30/131 (22.90%) of individuals had a wheelchair-related fall (p=0.55), respectively. Significant differences were found between groups for change in FEW-C independence between pre-randomization and endpoint (p = 0.008), and between groups for change in FEW-C safety between pre-randomization and endpoint (p = 0.027). Trends towards significance were found between groups for change in NHLSD between pre-randomization and endpoint (p = 0.087) and FEW-C independence between pre-randomization and day 14 (p = 0.075). Significant associations were observed for relationships between total Braden Scale and FEW-C independence (p < 0.0001), Braden activity-mobility sub-scale and FEW-C independence (p = 0.021), and total Braden and FEW-C safety scores (p = 0.012).
Conclusion: Wheelchair and seating assessments for manual wheelchair users is an important factor for improving functional outcomes. Even though not statistically significant, the incidence of wheelchair-related falls in the treatment group were lower than the control group. Improved function can be attained with provision of wheelchair technology without adversely affecting fall risk.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
| Creators | Email | Pitt Username | ORCID  |
|---|
| Poojary-Mazzotta, Prerna | prp19@pitt.edu | prp19 | |
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| ETD Committee: |
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| Date: |
23 January 2017 |
| Date Type: |
Publication |
| Defense Date: |
30 March 2016 |
| Approval Date: |
23 January 2017 |
| Submission Date: |
11 January 2017 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
232 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Health and Rehabilitation Sciences > Rehabilitation Science and Technology |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
wheelchairs |
| Date Deposited: |
23 Jan 2017 16:05 |
| Last Modified: |
23 Jan 2019 06:15 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/30673 |
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