Use of Powered Wheelchairs and Scooters – Individual and Organizational Perspectives

In all the Nordic countries, it is a political aim that people with mobility limitations should have the same opportunities to participate in society as the rest of the population. Provision of mobility devices, such as powered wheelchairs or scooters, is an intervention with potential to enable people with functional limitations to move around in different environmental arenas, and enhance the performance of daily activities.

Not an isolated intervention
There are some differences between powered wheelchairs and scooters, and also the intended areas of use. Prescription of a powered wheelchair or scooter is one intervention among others in the rehabilitation process and could be combined with others, e.g. housing adaptations. Therefore, it is essential to not consider the intervention in isolation – it should be considered in context and also in conjunction with other interventions.

Satisfaction and effectiveness
The aim of this project is to investigate the outcomes of powered wheelchair and scooter interventions, and to generate further knowledge on person-environment-activity-transactions while using these types of mobility devices, from individual and organisational perspectives. A further aim is to investigate what kinds of services are provided in connection with the delivery of powered wheelchairs/scooters, and their influence on user satisfaction with and effectiveness of the devices.

The project has two arms:

1) Using Powered Wheelchairs and Scooters: Environmental Factors and Barriers to Activity and Participation
In order to make the intervention provision of powered wheelchair/scooter as effective as possible, and to allow the users to be mobile and active, it is important to consider the users’ experiences. To some extent this has been studied with people who received a powered wheelchair or scooter for the first time and were followed up over one year.



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To a large extent, they stated that they had their expectations fulfilled and that they were able to perform the activities intended. Further, their need for assistance in mobility decreased, while their independence increased. However, the users did not perform any new activities and the reason for this is unknown.

New demands
In another study, four users who received housing adaptations were followed over a period of ten years. This case study demonstrated that in addition to new housing adaptations they also used more heavy mobility devices, such as powered wheelchairs and scooters. This places new demands on housing and neighbourhood design. Studies in progress will results in more in-depth knowledge on person-environment-activity transactions among powered wheelchair/scooter users.

2) Effectiveness of and satisfaction with powered wheelchairs and scooters and related service delivery – A follow-up study among adult users in Nordic countries
Since many resources are spent on powered wheelchairs and scooters, it is important to have knowledge about their effectiveness for the user, and to be able to judge whether the political ambitions for this kind of intervention are fulfilled. The demand for evidence-based practise in health and social care is increasing, but studies on effectiveness of assistive devices and service delivery (SD) processes are still scarce.

Closely linked
The same applies to some extent for user satisfaction because satisfaction is considered to be closely linked to the quality of the services given. There are structural differences between the SD systems in the Nordic countries, hence the SD processes also differ, and further, based on different legislations, the services given probably differ.

So far, no knowledge about how different services influence effectiveness and user satisfaction is available, i.e. knowledge which might form a base for optimising SD related to powered wheelchairs and scooters. The overarching aim of this project is to investigate the effects of powered wheelchairs and scooters and the related SD processes. Examples of specific aims are:
•To what extent powered wheelchairs and scooters contribute to mobility-related participation among adult users
•To what extent adult users of powered wheelchairs and scooters are satisfied and/or dissatisfied with different aspects of the SD process
•To investigate what kinds of services are provided in connection with delivery of powered wheelchairs and scooters, and how these services influence user satisfaction with and effectiveness of the devices

In a first descriptive cross-sectional study we investigated the documentation of and satisfaction with the SD process of electric powered scooters among adult users in different national contexts. Eighty-six Norwegian and 50 Danish adult informants were interviewed; the SD process was documented by therapists in municipalities and assistive technology centres, by means of a study-specific structured questionnaire.

Significant differences
The results show that user satisfaction with their SD process was high in both samples. The findings of significant differences between two national samples in time spent on assessments, administration, follow-up services and total time confirm the assumption that structure of the services is associated with the SD process. The study did not support that the SD process is associated with the outcomes in terms of user satisfaction with the SD process.

Raises a question
It may be questioned whether user satisfaction with the SD process actually is an outcome in terms of effects on the lives of users and their environment, or rather a quality indicator and hence evidence for more or less successful service delivery processes. Ongoing studies will contribute to method development in this field, and deliver knowledge about outcomes of these kinds of interventions over time.