C LI NI C IA N TASK F OR C E
USING COMMUNITY DATA TO UNDERSTAND THE BREAKDOWN AND REPAIR OF WHEELCHAIRS AND IMPACT ON USERS Written by: JACK FRIED, BS; ANAND MHATRE, PHD; GEDE PRAMANA, PHD; AND MARK SCHMELER, PHD, OTR/L, ATP
The World Health Organization (WHO) estimates 75 million people with spinal cord injury, cerebral palsy and similar diagnoses need mobility devices for their independence and social participation.1 Despite mobility devices, such as wheelchairs, being pivotal in the lives of people with disabilities, this equipment is known to breakdown frequently. More than 50% of wheelchairs experience a breakdown every six months in resourced settings and every three months in adverse environments typically observed in rural areas and low- and middle-income countries.2–4 One-third of these breakdowns result in negative consequences for wheelchair users including injuries, being stranded in the street or loss of access to work and/or school.2 Without a functional wheelchair, the user may have to stay in the home in a regular chair or bed, increasing risk of pressure injuries and rehospitalization.The downward spiral of health outcomes following breakdowns negatively impacts the user’s quality of life and increases the public health burden.4,5 Casters, wheels, brakes, armrests, footplates and electrical components are just some of the wheelchair components that experience frequent breakdown.2,5 To address this problem within the community, a team of engineers, clinicians and researchers at the University of Pittsburgh Rehabilitation Engineering Research Center (Pitt RERC) have begun to collect fieldgenerated breakdown and repair data to understand the prevalence of these breakdowns and improve the quality of wheelchair parts using wheelchair standards testing. These trends in equipment part breakdown directly impact the health of the user and are crucial for users, clinicians, manufacturers, suppliers and policymakers to understand. Findings regarding caster quality and battery performance are discussed below to inform suppliers, clinicians, manufacturers, payers and the users themselves of current product quality and best practices for maintenance and repair.
FIGURE 1
Caster failures in tilt-in-space wheelchairs, Manufacturers 1 and 2.
FIGURE 2
Caster failures in ultra lightweight wheelchairs, Manufacturers 2 and 3.
THE WHEELCHAIR REPAIR REGISTRY (WRR) The WRR is a wheeled mobility device breakdown and repair registry developed by the Pitt RERC from wheelchair repair claims. The claims were reported by repair technicians from a network of wheelchair suppliers using Labor Tracker, a repair data collection software developed by the Van G. Miller Group and U.S. Rehab. The registry currently contains over 60,000 repairs conducted on more than 5,000 wheelchair devices from 25 manufacturers. The devices include 60% power wheelchairs, 35% manual wheelchairs and 5% scooters.6
CASTER BREAKDOWN ANALYSIS A total of 6,470 caster breakdowns and 151 caster-related service repairs were reported and associated with four manufacturers and five wheelchair models. The most prevalent manual wheelchair types were tilt-in-space and ultra lightweight wheelchairs. Figures 1 and 2 illustrate these specific caster failures for each type of wheelchair, respectively, including high-risk breakdowns (e.g., wheel or stem fractures and bent casters) and low-risk breakdowns (e.g., bearing fractures and worn-out tires). Analysis showed tilt-in-space wheelchairs CONTINUED ON PAGE
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DIRECTIONS 2022.2
