Fewer accidents and better maintenance with active wheelchair check-ups: a randomized controlled clinical trial

Abstract

Objective: To investigate whether active intervention using a compiled checklist for wheelchair check-ups increases user satisfaction and/or decreases accidents, near accidents and pressure sores. Design: A randomized controlled trial comparing active intervention versus standard intervention for prescribed, manually propelled wheelchairs. Setting: Patients within primary health care of Bora°s and Bollebygd municipalities, a mixed urban and rural population. Subjects: Users of manually propelled wheelchairs over 16 years of age. Interventions: The accident rate, extent of pressure sores, number and extent of repairs, reconditioning, adjustments as well as user satisfaction were measured initially and at one year. In the standard intervention, the user and carer were encouraged to initiate contact when necessary. In the active intervention, an occupational therapist performed a scheduled, thorough check-up of the wheelchair, following a compiled checklist for safety, comfort and positioning, manoeuvrability and transportation. Results: Of 253 registered wheelchair users, 216 were suitable and randomized. In the active intervention group, 99% (95% confidence interval 96 / 100%) of the inspected wheelchairs required maintenance. The incidence of accidents was unchanged in the standard intervention group, but decreased to ‘no accidents’ in the active intervention group (p / 0.03). User satisfaction was not affected by the active intervention. Conclusion: Most wheelchair users are unable to determine on their own when adjustments are needed. An active check-up on manually propelled wheelchairs seems to reduce accidents. More information is available at http://www.wheelchair.se