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Holistic assessment needed for wheelchair users with multiple sclerosis

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People with multiple sclerosis (MS) need to be holistically assessed when being offered an electric wheelchair, a study at Brunel University London has found.

The unique study of 91 wheelchair users, each severely affected by MS, found that 15% of the trial group had problematic pain, showing the need for a much more professional assessment.

It also noted that chairs with a tilt-in-space (TIS) function had the potential to relieve some of the pain should they replace older wheelchairs without TIS.

Overall, 30% of the study group had health conditions prone to aggravation by constant sitting – sores, clots, osteoporosis and severe swelling.

By looking at people with advanced MS, the study also highlighted 10 health problems including fractures, stroke, amputation and chronic joint pain that would benefit from a medical evaluation in addition to the usual assessment by a multi-professional team of therapists and engineers.

Current guidelines on MS now need updating so that risks of osteoporosis, deep vein thrombosis, obesity and coronary heart disease are managed from an early stage. So, although wheelchair users are prone to falls, diet and medication could reduce osteoporotic fractures.

Lorraine De Souza, Professor of Rehabilitation and Director of the Centre for Research in Rehabilitation, said: “We tend to treat MS as symptoms develop but, by looking ahead at those severely affected, we can see what we can do now to prevent or delay other potentially life-threatening health problems.

“We can also see where healthcare could do more to help those with advanced MS live a fuller and more comfortable life for longer.”

The paper ‘Problematic clinical features of powered wheelchair users with severely disabling multiple sclerosis’, by Lorraine H De Souza and Andrew O Frank, is published here.