Project 2: The Natural History and Measurement of Power Mobility Among Older Adults CanWheel AGM at RESNA June 2014 Paula Rushton, OT, PhD.

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Presentation transcript:

Project 2: The Natural History and Measurement of Power Mobility Among Older Adults CanWheel AGM at RESNA June 2014 Paula Rushton, OT, PhD

Team members Team Leads & Members  Bill Miller  Louise Demers  Jan Miller-Polgar  Alex Mihailidis  Francois Routhier  Cher Smith  Lee Kirby  Ben Mortenson  Claudine Auger Research Assistants  Kate Keetch  Sarah McCuaig  Jenn Querques  Laura Titus  Fabrizio Farronato  Elise Busilacchi  Marie-Pierre Johnson  Deborah Stewart P2: Natural Hx & Measurement

Project I: Evaluating Needs & Experiences Project II: Measurement of Mobility Outcomes Project V: Wheelchair Skills Program For Powered Mobility Project IV: Data Logger Project III: Wheelchair Innovation Project I: Evaluating Needs & Experiences

P2: Natural Hx & Measurement Project I: Evaluating Needs & Experiences Project II: Measurement of Mobility Outcomes Project V: Wheelchair Skills Program For Powered Mobility Project IV: Data Logger Project III: Wheelchair Innovation Project II: Measurement of Mobility Outcomes

P2: Natural Hx & Measurement Project I: Evaluating Needs & Experiences Project II: Measurement of Mobility Outcomes Project V: Wheelchair Skills Program For Powered Mobility Project IV: Data Logger Project III: Wheelchair Innovation Project III: Wheelchair Innovation

P2: Natural Hx & Measurement Project I: Evaluating Needs & Experiences Project II: Measurement of Mobility Outcomes Project V: Wheelchair Skills Program For Powered Mobility Project IV: Data Logger Project III: Wheelchair Innovation Project IV: Data Logger

P2: Natural Hx & Measurement Project I: Evaluating Needs & Experiences Project II: Measurement of Mobility Outcomes Project V: Wheelchair Skills Program For Powered Mobility Project IV: Data Logger Project III: Wheelchair Innovation Project V: Wheelchair Skills Program For Powered Mobility

Purpose Objective # 1: To assess the reliability and validity of a Power Wheelchair Outcomes Tool Kit. Objective # 2: To describe the natural history of power wheelchair use over a 2 year period in older adults who use a power wheelchair and their caregivers. P2: Natural Hx & Measurement

METHODS Multi-site, Multi-cohort, 2 Year Longitudinal Study P2: Natural Hx & Measurement

Sites Vancouver Toronto London Montréal Québec Halifax

Power Wheelchair Users (PWU) Caregivers NewExperienced ≥ 50 years old ≥ 19 years old Able to operate power wheelchair independently Provide a minimum of 2 hours of care on a weekly basis ≤ 1 month of experience ≥ 6 months experience Provides care for a PWU that is ≥ 50 years old Able to travel to testing site for 2/7 testing occasions Be an ‘informal’ caregiver P2: Natural Hx & Measurement Exclusion Criteria: Unable to speak, read, & write in English or French Cohorts / Participants

Procedure Baseline 1 month 3 months 6 months 12 months 18 months 24 months P2: Natural Hx & Measurement All Sites Vancouver Only

What do we measure? The Consortium on Assistive Technology Outcomes Research ( CATOR ) Framework (Jutai et al, 2005) Assistive Technology Device Outcome Vantage EffectivenessSocial SignificanceSubjective Well-Being ICF Functioning ICF Contextual Factors User Longevity Caregiving Cost Residential Care Placement Service Utilization Device Utilization Psychological Functioning Quality of Life Satisfaction P2: Natural Hx & Measurement

Power Wheelchair Outcomes Tool Kit Assistive Technology Device Outcome Vantage EffectivenessSocial SignificanceSubjective Well-Being Wheelchair Skills Test (WST) Wheelchair Skills Test Questionnaire (WST-Q) Data Logger Life Space Assessment (LSA) Caregiver Assistive Technology Outcome Measure (CATOM) Assistive Technology Outcomes Profile for Mobility (ATOP/M) Wheelchair Use Confidence Scale (WheelCon) Plus… qualitative interviews (baseline, 1, 4, & 25 mo) P2: Natural Hx & Measurement

RESULTS P2: Natural Hx & Measurement

Current Quantitative Data Collection Status T1T2T3T4T5T6T7 Exp. PWU New PWU Caregivers All Sites Vancouver Only P2: Natural Hx & Measurement

Current Qualitative Data Collection Status PWUsBaseline4 mo13 mo25 mo Vancouver Montreal 5444 Quebec City 3220 P2: Natural Hx & Measurement

Objective 1: Reliability and Validity of the Tool Kit. P2: Natural Hx & Measurement Baseline 1 month 3 months 6 months 12 months 18 months 24 months

Power Wheelchair Outcomes Tool Kit Assistive Technology Device Outcome Vantage EffectivenessSocial SignificanceSubjective Well-Being Wheelchair Skills Test (WST) Wheelchair Skills Test Questionnaire (WST-Q) Data Logger Life Space Assessment (LSA) Caregiver Assistive Technology Outcome Measure (CATOM) Assistive Technology Outcomes Profile for Mobility (ATOP/M) Wheelchair Use Confidence Scale (WheelCon) Plus… qualitative interviews (baseline, 1, 4, & 25 mo) P2: Natural Hx & Measurement

WST-P  Internally consistent  Cronbach’s alpha = 0.90  Reliable  Test Retest ICC 1,1 = 0.78  Validity  r = 0.47 (p<0.001) LSA  r = 0.47 (p<0.001) WheelCon-P  r = 0.36 (p=0.002) ATOP activity P2: Natural Hx & Measurement Rushton PW, Kirby RL, Routhier F, Smith C. Measurement Properties of the Wheelchair Skills Test Questionnaire for Powered Wheelchair Users. Disability & Rehab:AT (submitted May 2014)

Power Wheelchair Outcomes Tool Kit Assistive Technology Device Outcome Vantage EffectivenessSocial SignificanceSubjective Well-Being Wheelchair Skills Test (WST) Wheelchair Skills Test Questionnaire (WST-Q) Data Logger Life Space Assessment (LSA) Caregiver Assistive Technology Outcome Measure (CATOM) Assistive Technology Outcomes Profile for Mobility (ATOP/M) Wheelchair Use Confidence Scale (WheelCon) Plus… qualitative interviews (baseline, 1, 4, & 25 mo) P2: Natural Hx & Measurement

WheelCon-P  Internally consistent  Cronbach’s alpha = 0.92  Reliable  Test Retest ICC 1,1 = 0.85  Validity  r = 0.49 (p<0.001) WST-Q  r = 0.42 (p<0.001) WST  r = 0.47 (p<0.001) ATOP participation P2: Natural Hx & Measurement Rushton PW, Miller WC, Routhier F. Measurement Properties of the WheelCon-P. D&R:AT (in preparation)

Power Wheelchair Outcomes Tool Kit Assistive Technology Device Outcome Vantage EffectivenessSocial SignificanceSubjective Well-Being Wheelchair Skills Test (WST) Wheelchair Skills Test Questionnaire (WST-Q) Data Logger Life Space Assessment (LSA) Caregiver Assistive Technology Outcome Measure (CATOM) Assistive Technology Outcomes Profile for Mobility (ATOP/M) Wheelchair Use Confidence Scale (WheelCon) Plus… qualitative interviews (baseline, 1, 4, & 25 mo) P2: Natural Hx & Measurement

Upcoming Publications  Measurement properties of ATOP  Measurement properties of CATOM  Relationship among power mobility- related variables: Evaluation of a power wheelchair toolkit P2: Natural Hx & Measurement

Objective 2: To describe the natural history of power wheelchair use over a 2 year period in older adults who use a power wheelchair and their caregivers. P2: Natural Hx & Measurement Baseline 1 month 3 months 6 months 12 months 18 months 24 months n=67 (preliminary results)

Participant Demographics Variable Power Wheelchair Users (n=67) New (n=14) Experienced (n=53) Age in years, mean (SD)63.7 (10.1)60.1 (7.4) Sex, male (%) Months of PWC, Mean (SD) 1.4 (1.9)152.3 (125.2) Diagnosis (%) Spinal Cord Injury Multiple Sclerosis Stroke Lower Limb Amputation Muscular Dystrophy Arthritis Other P2: Natural Hx & Measurement

Experienced PWUs are More Confident than New PWUs P2: Natural Hx & Measurement

Participation is Greater in Experienced PWUs P2: Natural Hx & Measurement

Wheelchair Skill Capacity Improves Over Time for New PWUs P2: Natural Hx & Measurement

Subjective Wheelchair Skill Capacity is Higher for New PWUs P2: Natural Hx & Measurement

Experienced PWUs Travel to Farther Life Spaces P2: Natural Hx & Measurement

CATOM Graph… P2: Natural Hx & Measurement … just waiting for data to make CATOM graph… & will also add demographics slide

Discussion  Implications  Important considerations for clinicians  Research implications  Future directions P2: Natural Hx & Measurement

Acknowledgement P2: Natural Hx & Measurement