Effect of the Assistive Technology Professional on the Provision of Mobility Assistive Equipment.

Abstract

The purpose of this study was to examine factors associated with variability in satisfaction with functional mobility (as measured by the Functional Mobility Assessment [FMA]) in users of mobility devices. Our primary hypothesis was that device type and Assistive Technology Professional (ATP) involvement will be the most significant predictors of FMA score. Our secondary hypothesis was that ATP involvement is associated with use of more custom-fitted manual wheelchairs and group 3 and 4 power wheelchairs. Retrospective cohort study. Data were collected from equipment suppliers who collaborate with clinicians to administer the FMA and associated Uniform Data Set within various settings (ie, rehabilitation clinic, school, supplier place of business). A data set of 4743 cases was included in the analysis (N=4743). Not applicable. FMA questionnaire collected at baseline, client age, gender, primary diagnosis, years since disability onset, device type, device age, living situation, ATP involvement, and geographic area. Ordinal logistic regression modeling showed that geographic area, device type, ATP involvement, primary diagnosis, gender, age, device age, and years since onset of disability significantly predicted the variance in FMA scores at P<.05. Device type was the most significant predictor of variance in FMA score. Involvement of an ATP had a significant effect on the type of device that participants used (χ²²⁰=1739.18, P<.001; odds ratio, 0.589; 95% confidence interval, 0.49-0.708). If an ATP was involved, there were significantly higher proportions (all P<.05) of individuals using custom-fitted manual wheelchair and high-end groups 3 and 4 power wheelchairs prescribed compared with when no ATP was involved or when involvement was uncertain. The relationship between ATP involvement and functional outcome supports the concept that ATP certification recognizes demonstrated competence in analyzing the needs of consumers with disabilities and selection of appropriate mobility assistive equipment with improved functional outcomes.