Rates and Predictors of Manual and Powered Wheelchair Use for Persons With Stroke: A Retrospective Study in a Canadian Rehabilitation Center

Mountain AD, Kirby RL, MacLeod DA, Thompson K. Rates and predictors of manual and powered wheelchair use for persons with stroke: a retrospective study in a Canadian rehabilitation center.ObjectivesTo determine the rates of manual and powered wheelchair use at discharge for people with stroke admitted to a rehabilitation center and to determine whether any predictors of wheelchair use at discharge could be identified.DesignRetrospective cohort study.SettingRehabilitation center.ParticipantsConsecutive former inpatients (N=100) with a primary diagnosis of stroke, a sample of convenience.InterventionsNone.Main Outcome MeasuresWe reviewed the inpatient health records to determine the rates of wheelchair use at discharge and to record some readily available demographic and clinical data that might serve as predictors of wheelchair use.ResultsAt discharge, 40 people (40%) were using manual wheelchairs, 1 person (1%) was using a powered wheelchair, and 59 (59%) were not using a wheelchair. Of the patients who were walkers on admission (ie, walking FIM scores of 6 or 7), none (0%) used wheelchairs at discharge. Of those with nonwalking FIM scores (1–5) on admission, 56% were using wheelchairs at discharge. Multivariate analyses revealed that the adjusted odds ratios of using a wheelchair (manual or powered) were 3.33 (95% confidence interval [CI], 1.33–8.33) for those with left-hemisphere versus right-hemisphere strokes (P=.010), .94 (CI, .91–.96) for each point rise in the total raw FIM score on admission (P<.0001), and 19.46 (CI, 6.33–59.81) if the total admission FIM score was less than 80 versus greater than or equal to 80 (P<.0001).ConclusionsOn discharge from our rehabilitation center, 40% of people with stroke were using manual wheelchairs and 1% powered wheelchairs. People who were not walking on admission, those with left-hemisphere strokes, and those with lower total admission FIM scores were more likely to use a wheelchair. These findings may permit clinicians to predict wheelchair use better early in the rehabilitation process, when it can affect rehabilitation planning.