The Effect of Home Modifications and Wheelchair Usability on Activity and Participation
Rigor and Relevance of Disability Research Evidence
This study measured the impact of home modifications and wheelchair usability on MRADLs and participation. Results showed a strong relationship between home modifications and wheelchair usability, but a weaker connection to MRADLs and community participation. However, wheelchair usability is strongly correlated with both higher functioning MRADLs and fewer participation restrictions.
The interaction between mobility device and environment is important to the performance of mobility related activities of daily living (MRADLs), such as bathing, and community participation. This study reports the results of a cross-sectional study measuring the impact of home modifications and wheelchair usability on MRADLs and participation among 116 people who rely on a wheelchair for the majority of their mobility needs. The study was approved by Georgia Tech’s Institutional Review Board.
Self reports instruments included the Assistive Technology Outcome Measure (ATOM), a device-specific measure that assesses wheelchair usability. Unmet home modifications were assessed by Comprehensive Assessment and Solution Process for Aging Residents (CASPAR). Participation was measured by the Impact on Participation and Autonomy (IPA), which assesses participation-restriction across 5 domains. The Self Report Functional Measure (SRFM) measures the level independence in performing MRADLs.
Results showed that unmet home modification needs were linked – to different degrees – to participation, the performance of MRADLs, and wheelchair usability. For example,
Conversely, higher wheelchair usability (ATOMS) was significantly correlated with both:
This paper shows a strong relationship between home modifications and wheelchair usability, and a weaker connection to the performance of MRADLs and community participation. However, wheelchair usability is strongly correlated with higher functioning MRADLs and fewer participation restrictions. Whether some environmental facilitators can be hierarchically ranked to have a more direct impact than others on the performance of MRADLs and community activities will require more research. Clinicians and other stakeholders will benefit from a more thorough understanding that could lead them to better anticipate environmental needs during rehabilitation.