There was no published evidence (Levels 1 to 4) that lightweight, manoeuvrable, individualised manual wheelchairs reduce shoulder pain/injuries in people with spina bifida, who use a manual wheelchair as their main form of mobility

Prepared by:

Alison Jones
Occupational Therapy Dept
The Children's Hospital
Westmead
Sydney NSW, Australia
alisonj@chw.edu.au

Date:

23 October 2004

Review Date:

23 October 2007

Clinical Question:

Do lightweight, manoeuvrable, individualised manual wheelchairs reduce shoulder pain/injuries in people with spina bifida, who use a manual wheelchair as their main form of mobility?

Clinical Scenario:

Adults with spina bifida who use a wheelchair as their main form of mobility often complain of shoulder pain, and suffer shoulder injuries.  During their childhood and adolescence, these adults did not have the benefit of lightweight, individualised, manual wheelchairs.

Children and adolescents with spina bifida, who use a wheelchair as their main form of mobility, now have the opportunity of receiving lightweight, manoeuvrable, manual wheelchairs.  These chairs are more costly than standard, manual, folding wheelchairs.

This CAT investigated whether individualized, lightweight, manoeuvrable wheelchairs should be provided throughout childhood and adolescence to people with spina bifida, to prevent pain and shoulder injuries.

Clinical Bottom Line:

These children/young people should have the opportunity to:-

1. Use a lightweight manoeuvrable manual wheelchair, which is set up to meet their individual needs;
2. Learn energy conserving wheel propulsion methods;
3. Build up good upper body strength;
4. Stretch to maintain more normal joint range of movement; and
5. Participate in regular sport and exercise, as these activities have a positive effect on wheeling efficiency, aerobic capacity, muscle strength and self concept.

In the process of appraising related literature, a number of recommendations regarding appropriate wheelchair prescription/recommendations for these children and young people with spina bifida became apparent.  These have been collated into a guideline

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