Wheelchair Breakdowns Are Associated With Pain, Pressure Injuries, Rehospitalization, and Self-Perceived Health in Full-Time Wheelchair Users With Spinal Cord Injury

Arch Phys Med Rehabil. 2018 Oct;99(10):1949-1956. doi: 10.1016/j.apmr.2018.04.002. Epub 2018 Apr 24.


Objectives: To evaluate the relation between wheelchair breakdowns, their immediate consequences, and secondary health complications after spinal cord injury. "Immediate consequences" occur when part of a wheelchair breaks and leaves an individual stranded or injured, or causes him or her to miss medical appointments, work, or school.

Design: Survey, cross-sectional.

Setting: Spinal Cord Injury Model Systems Centers.

Participants: Full-time wheelchair users (N=771) with SCI from 9 Spinal Cord Injury Model Systems Centers, with data collected between 2011 and 2016.

Interventions: Not applicable.

Main outcome measures: Incidence of self-reported wheelchair breakdowns within the past 6 months that did or did not result in immediate consequences (ie, injury, being stranded, missing a medical appointment, or an inability to attend school/work); self-perceived health status scale; pain severity numerical rating scale; rehospitalizations; and self-reported pressure injury development within the past 12 months.

Results: A total of 610 participants with complete data sets were included in the analyses. When compared to those who reported no breakdowns, participants who reported 1 or more immediate consequences had worse secondary complications: higher self-perceived health status and pain scores (partial -η2=.009-.012, P<.05), and higher odds of rehospitalization (odds ratio: 1.86, P<.05) and pressure injury development (odds ratio: 1.73, P<.05). Secondary health complications were not different in those who reported no immediate consequences compared to those who reported no breakdown.

Conclusions: Wheelchair breakdowns that resulted in injury, being stranded, missing medical appointments, and/or an inability to attend work/school appear to have far-reaching impacts on health and secondary injury. Preventing wheelchair breakdowns, through either better maintenance or manufacturing, may be a means of decreasing secondary disability.

Keywords: Pain; Pressure ulcer; Rehabilitation; Spinal cord injuries; Wheelchairs.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Diagnostic Self Evaluation
  • Equipment Failure*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Readmission / statistics & numerical data*
  • Pressure Ulcer / etiology*
  • Spinal Cord Injuries / psychology*
  • Surveys and Questionnaires
  • Wheelchairs / adverse effects*
  • Wheelchairs / psychology