Clinical Evaluation of Pneumatic Technology for Powered Mobility Devices

动力移动设备气动技术的临床评估

• 批准号: 10454797
• 负责人: RORY A. COOPER
• 金额: --
• 依托单位: VETERANS HEALTH ADMINISTRATION
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10454797
• 关键词: Absenteeism at work; Activities of Daily Living; Adoption; Affect; Air; Automobile Driving; Caregivers; Charge; Clinical; Communities; Community Integration; Community Participation; Cross-Over Trials; Data; Devices; Disadvantaged; Engineering; Enrollment; Environment; Evaluation; Family Caregiver; Family member; Feedback; Foundations; Frequencies; Funding; Health; Health care facility; Healthcare Systems; Home; Hour; Human; Human Resources; Incontinence; Injury; Interview; Joystick; Legal patent; Long-Term Care; Maintenance; Manual wheelchair; Manufacturer Name; Measures; Modeling; Monitor; Nature; Nurses; Pain; Participant; Patients; Personal Satisfaction; Persons; Phase; Power Sources; Powered wheelchair; Process; Provider; Quality of life; Quebec; Rain; Research; Research Priority; Resistance; Safety; Schools; Self-Help Devices; Services; Skin; Surveys; System; Technology; Testing; Time; Travel; Veterans; Water; Weather; Wheelchairs; cost; design; disability; feasibility testing; field study; hospitalization rates; improved; improved functioning; instrument; light weight; medical appointment; mobility aid; novel; portability; psychosocial; rehabilitation engineering; repaired; research clinical testing; satisfaction

Over 240,000 Veterans with disabilities use mobility devices such as manual and power wheelchairs and scooters, and this number continues to grow. Mobility devices have been described as the most enabling technology a clinician can provide to a person with a disability. Appropriate mobility devices improve function, independence, home and community integration; activity and participation; comfort; and quality of life. Yet, battery-powered mobility devices (BPMDs) have many drawbacks. Despite advances in technology, batteries are still hazardous to humans and the environment, heavy (which limits transportability), and incompatible with wet or highly humid environments. Repairs to electrical systems and replacement of batteries are frequently needed. These are costly and result in being stranded, missing medical appointments, missing work or school, injury, increased pain, lower self-perceived health, skin breakdown, higher hospitalization rates, and reduced community participation. Surveys conducted by our VA Center on Wheelchairs and Associated Rehabilitation Engineering (WARE) identified alternative power sources as a top research priority of Veterans and providers. Compressed air is a power source that has many advantages over batteries, including safety to both humans and the environment, lighter weight, waterproof nature, and lack of any electrical components which can reduce the frequency of repairs. Two novel pneumatically-powered mobility devices (PPMDs), a scooter and wheelchair, were developed and tested for feasibility with 107 users. The devices were lighter and had sufficient driving range per charge for the average user. There were no safety or repair issues encountered in the 11-week field test. Filling air tanks was also much faster than charging a typical battery. With pilot funds, we then built two new scooters and two new power wheelchairs with longer driving ranges. We also developed a portable backup tank system that allows us to refill or replace the tanks easily in the community. The purpose of this study is to clinically evaluate the impact of PPMDs on Veterans living in long-term care facilities, and to obtain feedback from key stakeholders regarding the design and feasibility of use of PPMDs in long-term care. Long-term care was chosen because it is an ideal setting for technology that is water-proof (e.g., compatible with inclement weather, ease of cleaning, and resistant to incontinence and requires less maintenance and upkeep. In Phase 1 (Technical), we will build 8 pneumatically-powered scooters, 8 pneumatically-powered wheelchairs, 2 air filling stations with flow switches that measure air filling time, 20 dataloggers that will measure battery charging time, and 20 dataloggers that will monitor activity levels. Phase 2 (clinical evaluation) will comprise two aims. First, we will enroll 50 Veterans into a cross-over trial in which they use a BPMD provided to them that is the same make and model as their own BPMD, and its PPMD counterpart in random order, each for 6 months. We will compare pneumatically-powered and battery- powered scooters and wheelchairs with respect to functional mobility, satisfaction, psychosocial impact, “charging time,” maintenance and repairs. We hypothesize that Veterans will have higher levels of mobility, satisfaction, and psychosocial impact when using PPMDs compared to when using BPMDs. We also hypothesize that PPMDs will be faster to “charge” and have fewer maintenance and repair issues than BPMDs. Second, we will conduct qualitative interviews of the 40 participants in the clinical evaluation and an additional 54 key stakeholders involved in PPMD and BPMD use (e.g., family members/caregivers, clinicians, and technical support personnel). We will assess patient, facility, VA healthcare system, and other factors that may be barriers or facilitators to use of PPMDs and identify modifiable factors that may further improve the design. Results of the proposed study will pave the way for potential adoption of this technology within the VA. Such adoption could have a direct and positive impact on Veterans' lives. This research has the potential for national impact on the wheelchair provision process and services within the VA.

超过 240,000 名残疾退伍军人使用手动和电动轮椅等移动设备 踏板车，而且这个数字还在持续增长，被认为是最有能力的移动设备。 临床医生可以为残疾人提供适当的移动设备来改善功能， 独立性、家庭和社区融合；活动和参与；然而， 尽管技术不断进步，电池供电的移动设备 (BPMD) 仍存在许多缺点。 仍然对人类和环境有害，重量重（限制了运输性），并且与 潮湿或高度潮湿的环境中经常需要维修电气系统和更换电池。 这些都是昂贵的，会导致滞留、错过医疗预约、错过工作或上学， 受伤、疼痛加剧、自我健康感降低、皮肤破损、住院率更高以及减少 社区参与由我们的 VA 轮椅和相关康复中心进行。 工程 (WARE) 将替代能源确定为退伍军人和供应商的首要研究重点。 压缩空气是一种比电池具有许多优点的电源，包括对两者的安全性 人类和环境，重量更轻，防水性质，并且没有任何电气元件 可以减少维修频率 两种新型气动移动设备（PPMD），一辆踏板车。 和轮椅，开发并测试了 107 位用户的可行性。这些设备更轻，并且具有更多功能。 对于普通用户来说，每次充电可以行驶足够的里程 没有遇到安全或维修问题。 为期 11 周的现场测试也比给典型电池充电快得多。 然后，我们制造了两款新型踏板车和两款具有更长行驶里程的新型电动轮椅。 便携式备用水箱系统，使我们能够在社区轻松地补充或更换水箱。 本研究的目的是临床评估 PPMD​​ 对长期生活在中的退伍军人的影响 护理设施，并从主要利益相关者那里获取有关设计和使用可行性的反馈 选择长期护理中的 PPMD​​ 是因为它是技术的理想环境。 防水（例如，适应恶劣天气、易于清洁、防失禁和 需要较少的维护和保养 在第一阶段（技术），我们将建造 8 个气动动力。 踏板车、8 辆气动轮椅、2 个带流量开关（可测量空气填充量）的空气填充站 时间、20 个数据记录器（用于测量电池充电时间）和 20 个数据记录器（用于监控活动） 第 2 阶段（临床评估）将包括两个目标：首先，我们将招募 50 名退伍军人参加交叉项目。 在试验中，他们使用提供给他们的 BPMD，该 BPMD 与他们自己的 BPMD 的品牌和型号相同，并且其 PPMD 对应的随机顺序，每个为期 6 个月，我们将比较气动驱动和电池驱动。 动力滑板车和轮椅在功能移动性、满意度、社会心理影响方面， “充电时间”，维护和维修，我们努力让退伍军人拥有更高的机动性， 与使用 BPMD 相比，使用 PPMD​​ 时的满意度和社会心理影响。 与 BPMD 相比，PPMD 的“充电”速度更快，并且维护和修理问题更少。 其次，我们将对临床评估的 40 名参与者进行定性访谈，并额外进行 54 个参与 PPMD​​ 和 BPMD 使用的关键利益相关者（例如家庭成员/护理人员、 我们将评估患者、设施、VA 医疗保健系统以及其他可能影响的因素 是使用 PPMD​​ 的障碍还是促进因素，并确定可以进一步改进设计的可修改因素。 拟议研究的结果将为退伍军人管理局可能采用该技术铺平道路。 这种采用可能会对退伍军人的生活产生直接和积极的影响。 国家对 VA 内轮椅提供流程和服务的影响。