Planning wheelchair service provision in motor neurone disease: implications for service delivery and commissioning

摘要

Purpose: The purpose of this study was to identify a timeline for mapping the different types of wheelchair used by people with motor neurone disease (MND) from diagnosis to death. It also reviewed the use of the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) and the site of disease onset as predictors of wheelchair need and how this could influence commissioning and service delivery.Method: Retrospective data were collected from a clinical database to map when different types of wheelchair were provided to 62 people with MND from diagnosis to death. ALSFRS and site of disease onset were identified when each wheelchair was issued.Findings: The average number of months between diagnosis and the provision of different wheelchairs and death are mapped on a timeline. Higher ALSFRS scores indicate that wheelchairs that are less supportive are required and lower scores indicate that more supportive and complex wheelchairs are required. People with bulbar-onset disease need each type of wheelchair more rapidly than people with limb-onset disease.Conclusion: The timeline could be used by wheelchair services to map the likely intervention and resources required for their MND population. The use of ALSFRS scores and the site of onset of disease on referrals into wheelchair services can further help to predict the likely course of need.