Retrospective Analysis of Predictors of Proficient Power Mobility in Young Children with Severe Motor Impairments

Publication date: Available online 5 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Shelley R.H. Mockler, Irene R. McEwen, Maria A. Jones
ObjectiveThe primary objective was to determine if (a) child characteristics, (b) maternal education, (c) intervention parameters, (d) type of wheelchair control mechanism, or a combination of these variables, were associated with proficient power mobility skills in children with severe motor impairments aged 14 to 30 months. The secondary purpose was to determine if performance on the Wheelchair Skills Checklist (WSC) was associated with performance on the Powered Mobility Program (PMP).DesignSecondary data analyses on data collected from 2 previously completed randomized controlled trials (RCT).SettingIntervention and outcomes measurements took place in natural environments.ParticipantsParticipants included 31 children who were assigned to the intervention groups in 2 RCTs.InterventionsChildren practiced maneuvering individually customized power wheelchairs for 12 months in natural environments.Main Outcome MeasuresProficiency was assessed using the WSC and the PMP. The Battelle Developmental Inventory and Merrill-Palmer-Revised were used to assess baseline cognition and motor skills. Baseline mobility was assessed using the Pediatric Evaluation of Disability Inventory.ResultsCognition, fine motor skills, and wheelchair control mechanism were associated with proficiency. Cognition, type of wheelchair control, and diagnosis all predicted proficiency while controlling for other covariates using multiple regression analysis. Agreement between the WSC and PMP was 94.7%.ConclusionsCognition, type of wheelchair control, and diagnosis might predict power mobility proficiency in young children with severe motor impairments. These factors, however, should not be used to determine whether a child has the opportunity to participate in a training program. Agreement between the WSC and PMP could help researchers and clinicians compare results across studies that use only one of these outcome measures.



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