Wheelchair Users Are Not Necessarily Wheelchair Bound

OBJECTIVES: To determine the patterns of wheelchair use in terms of locations of use, whether wheelchair use in one location was related to wheelchair use in other locations, and factors associated with wheelchair use in different locations. DESIGN: Longitudinal cohort study. SETTING: Patients prescribed wheelchairs by clinicians at one of two teaching hospitals (one Veterans Affairs hospital and one private hospital). PARTICIPANTS: One hundred fifty-three consecutive persons who were prescribed a new wheelchair, resided in the community, had a Short Portable Mental Status Questionnaire score of greater than six out of 10, and who could be interviewed within 7 to 21 days of receiving the wheelchair. MEASUREMENTS: Patient, wheelchair, and environmental characteristics and self-reported wheelchair use in life spaces. RESULTS: Wheelchair use in the 24 hours before the interview was inconsistent across life spaces. The correlation between wheelchair use in the bath and in the kitchen was 0.66, between locations near and far from home was -0.08, and between locations in the home and outside the home was 0.08. Predictors of wheelchair use in the home were using help from another person to propel the wheelchair (odds ratio (OR) = 0.14, 95% confidence interval (CI) = 0.04-0.45), the number of impairments (OR = 0.80, 95% CI = 0.67-0.96), a report that the wheelchair did not meet the subject's needs (OR = 3.71, 95% CI = 1.27-10.81), and having adapted the home to accommodate the wheelchair (OR = 3.75, 95% CI = 1.47-8.18). Having adapted the home was also positively associated with use of the wheelchair in areas near the home (OR = 4.77, 95% CI = 1.94-11.71). The only factor associated with wheelchair use in distant locations was older age (OR = 0.62, 95% CI = 0.46-0.83 per 10-year increment). CONCLUSIONS: Personal factors (e.g., using help to propel the wheelchair) and environmental factors (e.g., home adaptations to accommodate the wheelchair) influenced wheelchair use. In addition, wheelchair use, and the factors influencing wheelchair use, differed by location. Wheelchair users appear to use their wheelchairs selectively, depending on their physical needs and the constraints of their environment.