Results of wheelchair skills training among the disabled persons with lower limb loss of vascular origin

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Abstract

BACKGROUND: Wheelchair skills training is an essential part of rehabilitation of the disabled persons with lower limb amputation (LLA) due to peripheral artery disease (PAD). However, nowadays this issue is poorly addressed in our country, there are no standardized technologies.

AIM: Investigation of dynamics of the extent of wheelchair usage among disabled persons with LLA due to PAD during adjustment to the wheelchair using the Wheelchair Skills Program (WSP, Canada).

MATERIALS AND METHODS: Altogether, 350 patients with lower limb stump [unilateral tibial stump ― 116 (33.1%), hip stump ― 223 (63.7%), bilateral tibial stumps ― 6 (1.7%), hip stump ― 5 (1.4%)] were examined in clinical settings at the Federal State Budgetary Institution “Novokuznetsk Scientific and Practical Centre for Medical and Social Expertise and Rehabilitation of Disabled Persons” Ministry of Labour and Social Protection of the Russian Federation. Male ― 268 (76.6%), female ― 82 (23.4%). Mean age 63.1±0.52 years. Cause of LLA: obliterative PAD (lower limb atherosclerotic arterial disease) ― 226 (64.6%), type 2 diabetes mellitus ― 124 (35.4%). WSP effectiveness was assessed in 227 disabled persons. Wheelchair skills retention in 1.1 (0.59–1.87) years was assessed in 48 persons, 25 persons have undergone training second time.

RESULTS: It was found that 86% of the disabled persons with LLA needed the wheelchair skills training. Upon the completion of the course the level of individual wheelchair skills was increased in all participants. This contributed to an increase in their activities and participation, which was indirectly evidenced by 1.8 fold increase in the proportion of those using the wheelchair outdoors by the time of second hospitalization.

CONCLUSION: The program provides an individual approach to training, based on the results of a study of the initial level of proficiency in wheelchair skills, the wishes of the user himself, his physical, somatic and psychological condition. Thanks to this, novice users were able to master basic skills, and relatively experienced ones ― more complex, and thereby increase their level of safe use of the wheelchair, as well as the degree of independence and everyday activity, which can indirectly be evidenced by a significant increase in the share of wheelchair users outside the house.

About the authors

Olga I. Khokhlova

Federal Scientific and Practical Centre for Medical and Social Evaluation and Rehabilitation of Disabled Persons in Novokuznetsk

Author for correspondence.
Email: hohlovaoliv@rambler.ru
ORCID iD: 0000-0003-3069-5686
SPIN-code: 2386-7820
Scopus Author ID: 2458875
ResearcherId: AAS-3498-2020

MD, Dr. Sci. (Med.), Senior Research Associate

Russian Federation, 7, Malaya street, Novokuznetsk, Kemerovo region, 654055

Elena M. Vasilchenko

Federal Scientific and Practical Centre for Medical and Social Evaluation and Rehabilitation of Disabled Persons in Novokuznetsk

Email: root@reabil-nk.ru
ORCID iD: 0000-0001-9025-4060
SPIN-code: 8910-2615
ResearcherId: AAP-8840-2020

MD, Dr. Sci. (Med.), Assistant Professor

Russian Federation, 7, Malaya street, Novokuznetsk, Kemerovo region, 654055

Vera V. Lyakhovetskaya

Federal Scientific and Practical Centre for Medical and Social Evaluation and Rehabilitation of Disabled Persons in Novokuznetsk

Email: root@reabil-nk.ru
ORCID iD: 0000-0001-6955-5627

MD

Russian Federation, 7, Malaya street, Novokuznetsk, Kemerovo region, 654055

Marina G. Zhestikova

Novokuznetsk State Extension Course Institute for Medical Practitioners Affiliated Branch of Russian Medical Academy of Continuing Vocational Education

Email: mgzh@yandex.ru
ORCID iD: 0000-0001-6378-1594
SPIN-code: 2049-7890

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Novokuznetsk

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2. Fig. Dynamics of the median indicator of the ability to perform wheelchair use skills during repeated hospitalizations of disabled people with loss of the lower limb due to peripheral artery diseases.

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