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: 10669627
• 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/10669627
• 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; Family member; Feedback; Foundations; Frequencies; Funding; Health; Health care facility; Healthcare Systems; Home; Hour; Human; Human Resources; Incontinence; Injury; Interview; Joystick; Legal patent; Licensing; Long-Term Care; Maintenance; Manual wheelchair; Manufacturer; 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; Weather; Weight; Wheelchairs; battery replacement; cost; design; disability; feasibility testing; field study; functional improvement; hospitalization rates; improved; instrument; 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24万残疾退伍军人使用手动和电动轮椅等移动设备，以及 滑板车，而且这个数字还在继续增长。移动设备被描述为最有能力的 临床医生可以为残疾人提供的技术。适当的移动设备改善了功能， 独立、家庭和社区融合；活动和参与；舒适度；以及生活质量。然而， 电池供电的移动设备(BPMD)有许多缺点。尽管技术进步，电池 仍然对人类和环境有害，笨重(这限制了可移植性)，与 潮湿或高度潮湿的环境。对电力系统的维修和电池的更换是频繁的 需要的。这些费用很高，会导致滞留、错过医疗预约、错过工作或学校， 受伤、疼痛增加、自我感觉健康降低、皮肤破裂、更高的住院率以及 社区参与。由退伍军人管理局轮椅和相关康复中心进行的调查 工程(WARE)将替代电源确定为退伍军人和供应商的首要研究重点。 压缩空气是一种能源，它比电池有许多优点，包括对两者都是安全的 人与环境，重量轻，防水性能好，没有任何电子元器件 可以减少维修的次数。两种新型气动移动设备(PPMD)，一种滑板车 和轮椅，开发并测试了107个用户的可行性。这些设备更轻，而且有 对于普通用户来说，每次充电有足够的行驶里程。没有遇到安全或维修问题 为期11周的实地测试。给油箱加满油也比给普通电池充电快得多。有了试点资金， 然后，我们制造了两辆新的滑板车和两辆新的电动轮椅，行驶里程更长。我们还开发了 便携式后备油箱系统，允许我们在社区内轻松加油或更换油箱。 本研究的目的是临床评估PPMD对长期生活的退伍军人的影响 护理设施，并从主要利益攸关方那里获得关于设计和使用 长期护理中的PPMDs。选择长期护理是因为这是一种理想的技术环境 防水(例如，与恶劣天气兼容，易于清洁，抗大小便失禁 只需更少的维护和维护。在第一阶段(技术)，我们将建造8个气动 滑板车，8辆气动轮椅，2个空气加气站，带有测量空气加气量的流量开关 Time，将测量电池充电时间的20个数据记录器，以及将监视活动的20个数据记录器 级别。第二阶段(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考试 在试验中，他们使用提供给他们的BPMD，该BPMD与他们自己的BPMD具有相同的品牌和型号，并且其 PPMD对应的随机顺序，每个为期6个月。我们将比较气动和电池- 电动滑板车和轮椅在功能灵活性、满意度、心理社会影响方面， “充电时间”，保养和维修。我们假设退伍军人会有更高的机动性， 与使用BPMDs时相比，使用PPMDs时的满意度和心理社会影响。我们也 假设PPMD比BPMD“充电”更快，维护和维修问题也更少。 第二，我们将对临床评估的40名参与者和另外一名参与者进行定性访谈 54参与PPMD和BPMD使用的关键利益相关者(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、退伍军人医疗保健系统和其他可能 成为使用PPMD的障碍或促进者，并确定可能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这项技术铺平道路。 这样的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 国家对退伍军人事务部内轮椅供应过程和服务的影响。