Predictors of Mobility Among Wheelchair Using Residents in Long-Term Care

Mortenson WB, Miller WC, Backman CL, Oliffe JL. Predictors of mobility among wheelchair using residents in long-term care. Arch Phys Med Rehabil 2011;92: 1587-93. Objective: To identify predictors of mobility among long-term care residents who use wheelchairs as their main means of mobility. Based on the Matching Person to Technology Model, we hypothesized that wheelchair-related, personal, and environmental factors would be independent predictors of mobility. Design: Cross-sectional study. Setting: Eleven long-term residential care facilities in the lower mainland of British Columbia, Canada. Participants: Residents (N=268): self-responding residents (n=149) and residents who required proxy respondents (n=119). Interventions: Not applicable. Main Outcome Measures: Mobility was measured using the Nursing Home Life-Space Diameter. Standardized measures of personal, wheelchair-related, and environmental factors were administered and sociodemographic data were collected as independent variables. Results: Independent mobility decreased as the distance from the resident's room increased: 63% of participants were independently mobile on their units, 40% were independently mobile off their units within the facilities, and 20% were independently mobile outdoors. For the total sample, the significant predictors of mobility, in descending order of importance, were: wheelchair skills (including the capacity to engage brakes and maneuver), functional independence in activities of daily living, having 4 or more visits per week from friends or family, and use of a power wheelchair. This regression model accounted for 48% of variance in mobility scores. Conclusions: Limited independent mobility is a common problem among facility residents. Residents may benefit from interventions such as wheelchair skills training or provision of powered mobility, but the effectiveness of these interventions needs to be evaluated.