Appropriateness of the standard manual wheelchair for occupational performance by wheelchair users in the Thulamela Municipality of the Vhembe District, Limpopo, South Africa

Abstract

Background: Wheelchairs are an essential assistive device that assists with the facilitation of engagement in occupation especially those that require mobility. Anecdotally, there have been identified gaps in implementation of areas of wheelchair service delivery which included the referral, assessments, prescription, user and provider training, follow up and maintenance. Therefore, there was a need to investigate the appropriateness of the standard manual wheelchair for occupational performance in Thulamela Municipality Vhembe District, Limpopo.

Methods: An observational cross-sectional descriptive design using simple random sampling was used to select n=60 wheelchair users who were issued with standard manual wheelchairs between 2014 and 2018. The Wheelchair Outcome Measure was used to investigate the participants' level of satisfaction in engagement in ADL and IADL and the suitability of the wheelchair in terms of the user’s comfort and satisfaction with positioning and prevention of skin breakdown. Descriptive statistics were used to analyse the data.

Results:  The wheelchair users viewed activity participation in the home as important and were generally satisfied with their standard manual wheelchairs while performing occupational activities at home and outside the home. A total of (n=46; 78%) of the participants felt comfortable in their wheelchair.

Conclusions: Wheelchair prescription should take into consideration the occupational choices of the user. Further qualitative studies to explore the factors that determined the participants' choices for their activity participation goals should be undertaken.

Implications for practice

• Implementation of training programmes is necessary for new occupational therapy staff in each facility within the Thulamela district to ensure they acquire the competence to prescribe wheelchairs effectively.
• Occupational therapists should prioritise clients' occupational preferences when prescribing wheelchairs, with due cognisance of the importance the wheelchair user places on activity participation both at home and in the community.
• Occupational therapists need to prescribe wheelchairs  that facilitate participation in a wide range of occupational choices ranging from self-care activities, leisure activities like watching TV in the home to visiting friends and family and attending community events.