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: 10206283
• 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 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10206283
• 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移动设备，例如手动和动力轮椅， 踏板车，这个数字继续增长。移动设备被描述为最有能力的设备 临床可以为残疾人提供的技术。适当的移动设备提高功能， 独立，家庭和社区融合；活动和参与；舒适;和生活质量。然而， 电池供电的移动设备（BPMD）具有许多缺点。尽管技术进步，电池 仍然对人类和环境有害，重量（限制了可运输能力），并且与 潮湿或高度潮湿的环境。电气系统的维修和电池的更换经常是 需要。这些都是昂贵的，导致陷入困境，缺少医疗任命，缺少工作或学校， 受伤，疼痛增加，自我感知的健康，皮肤破裂，较高的住院率和降低 社区参与。我们的VA中心对轮椅和相关康复进行的调查 工程（WARE）将替代功率来源确定为退伍军人和提供者的主要研究优先事项。 压缩空气是一种比电池具有许多优势的电源，包括对两者的安全 人类与环境，重量更轻，防水性质以及缺乏任何电气组件 可以减少维修的频率。两个新型的气动驱动设备（PPMDS），一个踏板车 和轮椅，经过开发并测试了107位用户的可行性。设备更轻，有 普通用户的每个充电范围足够。没有安全或维修问题 为期11周的现场测试。装满空气箱的速度比为典型电池充电要快得多。有了飞行员资金， 然后，我们建造了两个新的踏板车和两个新的动力轮椅，并带有更长的驾驶范围。我们也发展了 便携式备用储罐系统，使我们可以轻松地在社区中重新填充或更换坦克。 这项研究的目的是临床评估PPMD对居住长期退伍军人的影响 护理设施，并从主要利益相关者那里获得有关使用的设计和可行性的反馈 长期护理中的PPMD。之所以选择长期护理，是因为它是技术的理想环境 防水（例如，与增量的天气兼容，清洁易度性以及对尿失禁和抵抗力 需要更少的维护和保养。在第1阶段（技术）中，我们将建造8个气动驱动 踏板车，8个气动轮椅，2个空气填充站，带有水流开关，可测量空气填充 时间，将有20个可以测量电池充电时间的数据仪，以及20个数据拨号器，可以监视活动 水平。第2阶段（临床评估）将完成两个目标。首先，我们将招募50名退伍军人 他们使用BPMD提供给他们的试验与他们自己的bpmd相同的品牌和型号，它 ppmd按随机顺序，每个对应物，持续6个月。我们将比较气动动力和电池 - 在功能活动性，满意度，社会心理影响方面，有动力的踏板车和轮椅 “充电时间”，维护和维修。我们假设退伍军人将具有更高水平的移动性， 与使用BPMD相比，使用PPMD时的满意度和社会心理影响。我们也是 假设PPMD将比BPMD更快地“充电”，维护和维修问题更少。 其次，我们将对临床评估的40名参与者进行定性访谈，并进行其他 54个参与PPMD和BPMD使用的主要利益相关者（例如，家庭成员/照顾者，临床医生和 技术支持人员）。我们将评估患者，设施，VA医疗保健系统以及其他可能的因素 成为使用PPMD的障碍或促进者，并确定可改进的因素，以进一步改善设计。 拟议的研究的结果将为VA内的该技术潜在采用铺平道路。 这种收养可能会对退伍军人的生活产生直接和积极的影响。这项研究有可能 国家对VA内轮椅供应过程和服务的影响。