Mobility Device Quality Affects Participation Outcomes for People With Disabilities: A Structural Equation Modeling Analysis

Objective To test the effect that indicators of mobility device quality have on participation outcomes in community-dwelling adults with spinal cord injury, traumatic brain injury, and stroke by using structural equation modeling. Design Survey, cross-sectional study, and model testing. Setting Clinical research space at 2 academic medical centers and 1 free-standing rehabilitation hospital. Participants Community-dwelling adults (N=250; mean age, 48±14.3y) with spinal cord injury, traumatic brain injury, and stroke. Interventions Not applicable. Main Outcomes Measures The Mobility Device Impact Scale, Patient-Reported Outcomes Measurement Information System Social Function (version 2.0) scale, including Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities, and the 2 Community Participation Indicators’ enfranchisement scales. Details about device quality (reparability, reliability, ease of maintenance) and device type were also collected. Results Respondents used ambulation aids (30%), manual (34%), and power wheelchairs (30%). Indicators of device quality had a moderating effect on participation outcomes, with 3 device quality variables (repairability, ease of maintenance, device reliability) accounting for 20% of the variance in participation. Wheelchair users reported lower participation enfranchisement than did ambulation aid users. Conclusions Mobility device quality plays an important role in participation outcomes. It is critical that people have access to mobility devices and that these devices be reliable.