Enabling children who use wheelchairs to participate: What's the evidence?

With increasing numbers of children who use wheelchairs, advancements in technology and finite resources, it is vital that as prescribing occupational therapists we evidence the effectiveness of wheelchair provision. With the... [ view full abstract ]

With increasing numbers of children who use wheelchairs, advancements in technology and finite resources, it is vital that as prescribing occupational therapists we evidence the effectiveness of wheelchair provision. With the implementation of the WHO (2001) ICF-CY wheelchairs can be used to address the complex needs of children, specifically body structures and functions (mobility impairment), activity and participation across a range of environmental contexts.

This paper presents the results of a Cochrane systematic literature review investigating the evidence that wheelchair provision facilitates children's participation. Despite a significant volume of research exploring the use of wheelchairs the primary focus has been on design, efficient propulsion, wheelchair skills training programmes, and readiness to drive. Little research has focused on functional outcomes for these children. This Cochrane review found one eligible study with promising results that powered wheelchairs can facilitate the development, participation and performance of children as young as 14 months. No evidence was found on whether manual wheelchairs promote child participation.

Currently it appears that wheelchairs are still primarily provided to compensate for mobility limitations. This review highlights that there is a need for greater clinical emphasis focusing on wheelchairs as a potential enabler, facilitating children's development, participation and performance in everyday activities at home, school and in the community. Further, more research employing robust methodologies with randomisation is needed to help develop an evidence base for the provision of wheelchairs to children.