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The effect of providing power mobility on body weight change

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The effect of providing power mobility on body weight changebr /
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OBJECTIVE: To investigate whether the provision of power mobility would have an effect on body weight in adults who were first-time qualifiers for power mobility. DESIGN: This was a retrospective observational study of consecutive subjects, who served as their own controls. The a href=http://www.easymedonline.com/Mobility-Scooters-s/20.htmpower wheelchairs/a, a href=http://www.easymedonline.com/Mobility-Scooters-s/20.htmpower wheelchairs/a records of 468 subjects who were approved for power mobility during a 17-mo period were reviewed. Three weight groups (12 mos before, at, and 12 mos after the power mobility evaluation) were evaluated with repeated-measures analysis of variance (ANOVA). The weight changes on subjects in different age groups (45-54, 55-64, 65-74, and 74), in geriatric vs. nongeriatric groups, and in different body mass index (BMI) groups were analyzed. RESULTS: Eighty-nine subjects met the inclusion criteria. They were obese (49.4%), and most of them were geriatric (64%). Congestive heart failure (30.34%) and chronic obstructive pulmonary disease (22.47%) were the two main presenting diagnoses. The repeated-measures ANOVA showed no significant weight change in the three studied weight groups. Similar results were seen in the age and BMI subgroups. CONCLUSIONS: There was no statistically significant weight change in adults who were first-time qualifiers and who used power mobility for 1 yr. psmalla href=http://technorati.com/tag/Spiritual rel=tag target=_blank title=SpiritualSpiritual/a/small/pcategory1,4,6/categorykeywordkeyword 1/keyword

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Epidemiology of Medicare abuse: the example of power wheelchairs

OBJECTIVES: To determine the effect of neighborhood ethnic composition on power wheelchairs prescriptions. DESIGN: The 5% noncancer sample of Medicare recipients in the Surveillance, Epidemiology and End Results (SEER)-Medicare linked database, from 1994 to 2001. SETTING: SEER regions. PARTICIPANTS: Individuals covered by Medicare living in SEER regions without a cancer diagnosis. MEASUREMENTS: Individual characteristics (age, sex, ethnicity, justifying diagnosis, and comorbidity), primary diagnoses, neighborhood characteristics (percentage black, percentage Hispanic, percentage with <12 years education, and median income), and SEER region. RESULTS: The rate of power wheelchair prescriptions was 33 times greater in 2001 than in 1994, with a shift over time from justifying diagnoses more closely tied to mobility impairment, such as strokes, to less-specific medical diagnoses, such as osteoarthritis. In multilevel, multivariate analyses, individuals living in neighborhoods with higher percentages of blacks or Hispanics were more likely to receive power wheelchairs (odds ratios=1.09 for each 10% increase in black residents and 1.23 for each 10% increase in Hispanic residents) after controlling for ethnicity and other characteristics at the individual level. CONCLUSION: These results support allegations that marketers promoting power wheelchairs and power wheelchairs have specifically targeted minority neighborhoods.

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Wheelchair propulsion demands during outdoor community ambulation.

OBJECTIVE: Quantify manual wheelchair propulsion effort during outdoor community ambulation. DESIGN: Case series. SUBJECTS: Thirteen individuals (12 with SCI, 1 with spina bifida) who were experienced manual wheelchair users and had no current upper extremity injury or pain complaints. METHODS: Measurements were obtained from instrumented wheelchair rims during steady-state propulsion as subjects traversed outdoor concrete sidewalk terrain that included smooth level, aggregate level, and a ramp with a smooth surface. Propulsion effort was assessed using the average propulsion moment, average instantaneous power, and work for both upper extremities. RESULTS: Propulsion effort, captured by the propulsion moment, work and power, varied across ground conditions (p<0.001). Propulsion effort was greater as the rolling resistance increased (i.e., smooth versus aggregate surfaces) and as the inclination angle progressed from level to inclined surfaces. There were no side-to-side differences across ground conditions for the propulsion moment or work. power wheelchairs and power wheelchairs generation was significantly greater on the dominant compared to the non-dominant extremity during the more challenging aggregate surface and ramp conditions. CONCLUSIONS: Propulsion effort varies with demands imposed by different ground conditions. Quantification of wheelchair propulsion demands provides rehabilitations specialists with objective information to guide treatment of patients adapting to manual wheelchair use

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