A143 Wheelchair Mobility through participation

1. Mobility as a Motor for Inclusion
Engagement of Mobility Guides to Support
Participation in and through Sport
Research Institute for Inclusion
through Physical Activity and Sport (FIBS gGmbH)
www.fi-bs.de
Edinburgh, October 26th 2016
Tanja Bungter
Patrick Heydenreich
Dr. Volker Anneken

2. Project “Mobility is Participation“
• Period of Time: January 2012 – June 2015
• Sponsor: DGUV research funding
• Project partners: German Wheelchair Sport Association
(DRS e.V.); Clinics of the employers' liability insurance
association (BG) in Bochum, Duisburg, Frankfurt, Halle,
Hamburg, Murnau, Tuebingen, Clinic “Hohe Warte“ Bayreuth
• Target group:
– Persons with acquired SCI
– Insured persons of statutory accident insurances
– Dependent on a wheelchair in everyday life
• Project Aim: Movement-oriented after-care concept to improve
participation

3. Methodology
• Activity Test on Wheelchair
Mobility (AMR®): Objective
measurement of individual
performance in wheelchair handling
• Information on wheelchair mobility
and physical activity: Questionnaire
to identify need for consultation

4. Activity Assessment on Wheelchair Mobility (AMR®)
• Aim: Objective measurement of individual performance in
wheelchair handling
• Origin: mobi sheets (Starter Kit DRS), testing and advice by
patients and clinical experts
• Content: Items from the fields of locomotion, overcoming
obstacles and handling of slopes
• Final versions: Para-version: 17 Items
Tetra-version: 16 Items
• Evaluation: 5 ability levels (min: 1; max: 5)
Time measurement
• Implementation: Used in 17 rehabilitation clinics in Germany,
Austria and Switzerland

5. Project Concept
Clinic
Test and
questionnaire,
implementation
and
documentation
Mobility
guides
Research,
exchange with
other guides,
documentation,
consultation
FIBS
Sighting,
reports,
data input,
event
information
Insuredpersons
Statutory accident insurances
Documentation of patients‘ mobility
Through sport
therapy via
mail to
Questions via
phone or
email,
organization
of mobility
training
Via email to
Checklist via
email
Advice
via
phone /
email
Quest-
ions
Report via
mail or email
Report via mail,
project information
Project
information,
consultation
Test dates

6. Sample Description
• N= 308
– 91,9% male, 46 ± 11 years old
– 76,3% paraplegia
– 54,2% complete
– 15,3% first releases
53.9
24.7
11.0
4.5
2.6 2.3 0.6
0.3
Murnau
Halle
Hamburg
Tübingen
Bochum
Duisburg
Bayreuth
Frankfurt
Figure: Allocation to clinics in percentage (N=308).

7. Need for Consultation and Action
• AMR®-results: 40,3% middle to high need for action
• Consultation requests: 59,7% of the total sample
• 161 consultations were conducted by five guides
n Min Max Av SD
Number of contacts between mobility guides and insured persons 161 1 10 2,88 1,44
Time span mobility test in clinics – receipt of records by mobility
guides (in days)
161 0 257 22,46 29,31
Time span receipt of records by mobility guides – initial contact to
insured persons (in days)
161 0 255 35,99 48,36
Time span mobility test in clinics – initial contact to insured
persons (in days)
161 0 261 58,44 53,76
Time span mobility test in clinics – call from professional aid to
mobility guide (in days)
3 24 167 91,33 71,86

8. Consultation Requests, Sport Motivation
• Need for consultation mobility training:
– First releases: 63,8%
– Resumptions: 34,9%
• Need for consultation physical activities:
– First releases: 74,4%
– Resumptions: 59,6%
• 63,3% of all resuming persons are already physically active
– Highly significantly (p≤.001) higher AMR®-values:
• Average AMR® Para physically active = 73
• Average AMR® Para physically inactive = 62
• 77% can imagine to exercise or to try new sports in the future

9. Interventions of the Mobility Guides
1.2
3.1
4.3
8.7
13.7
18.0
36.6
48.4
52.2
88.2
0 10 20 30 40 50 60 70 80 90 100
Kontaktvermittlung zu Handbikern
Informationen zu Auto/Führerschein
Informationen zu Messen, Veranstaltungen
Gespräche mit Vereinen/Fitnesstudios
Informationen zu Sanitätshäusern, Sportrollstühlen, Handbikes
Recherche korrekte Kontaktdaten
Ausschreibungen zu Mobilitätstrainings, Schnupperangeboten, Camps
Kontaktübermittlungen Ansprechpartner/Angebote
Recherchen geeigneter Sportarten
Lotsenkontakt für Rückfragen
in percentage
Figure: Interventions of the mobility guides (N=161).
Contact to guides for further consultations
Search for suitable activities
Forwarding information to contact persons
Advertisements for mobility trainings, trial offers, camps
Research of contact information
Information on health care supply stores, sport wheelchairs, handbikes
Contact to sport clubs or fitness studios
Information on fairs and events
Information concerning cars / driving licence
Contact mediation to handbikers

10. Evaluation of the Concept
• 94,5% of all interviewed participants rate the mobility guide
concept as useful.
• 27,4% participated regularly in proposed activities, 13,7%
participated irregularly and 28,8% would like to participate in
proposed activities in the future.
• 18,6% joined a sports club subsequently to consultations, 20%
plan on doing so.

11. Conclusion and Prospects
• The AMR®-test can be used economically in combination with
short questionnaires to evaluate wheelchair mobility. The
instruments reveal needs for consultation and support.
• The mobility guides were perceived as capable interlocutors.
• Patients could be successfully imparted to sport activities.
• The German statutory accident insurances (DGUV) wants to
apply the concept in its clinics after the end of the project.

12. Guidelines for Future Application
Clinic, physiotherapy/
sports therapy
AMR®-test and
questionnaire,
implementation and
documentation
Mobility
guides
Research,
exchange with
other guides,
documentation,
consultation
Insuredpersons
Statutory accident insurances
Documentation of patients‘ mobility
Questions and feedback
via phone or email
Advice in
clinics,
via
phone or
email
Questions
Arrangement
of test dates
Information,
consultation if
needed
Test dates
Test results via email,
mail or fax to
Reports via
mail or email
for
information

13. Thank you for your attention!
Further information on the project is available at www.fi-bs.de
Contact: Tanja Bungter, +49-2234-2052-372, bungter@fi-bs.de