Activity restriction among wheelchair users

OBJECTIVES: To identify factors associated with activity restriction. DESIGN: Cohort study. SETTING: Patients prescribed a new wheelchair at one of two teaching hospitals (one Veterans Affairs and one private hospital). PARTICIPANTS: One hundred fifty-three consecutive, community-dwelling wheelchair users, who had a Short Portable Mental Status Score greater than 6 out of 10 and could be interviewed within 7 to 21 days of receiving the wheelchair. MEASUREMENTS: Dependent variables were self-reported nonmedical visits and medical visits in the preceding week (any vs no visits and the number of visits). Independent variables were self-reported sociodemographic and health characteristics, mobility limitations, and environmental barriers. RESULTS: Study subjects reported, on average, 1.79 mobility limitations, 11.17 hours out of bed, and 5.56 hours of personal assistance per day. Multivariate analyses show that higher income was the only significant sociodemographic factor; it was associated with more medical visits (beta = 0.44, P < .01). Of health status characteristics, more comorbid conditions predicted fewer nonmedical visits (beta = -0.14, P < .10) and amputation was associated with fewer medical visits (beta - 0.82, P < .05). Regarding mobility limitations, more mobility limitations was associated with lower odds of any nonmedical visit (odds ratio (OR)= 0.71, P < .5) and fewer nonmedical visits (beta = -0.28, P < .05); more hours out of bed predicted more nonmedical visits(beta = 0.05, P < .5) and lower odds any medical visit (OR = 0.92, P < .05). More environmental barriers predicted fewer nonmedical (beta = -0.32, P < .01) or medical visits (beta = -0.2 1, P < .05). CONCLUSION: Mobility limitations and environmental barriers were associated with restricted participation in diverse activities outside the home.