Relationships Between Cognitive Functioning And Power Wheelchair Performance, Confidence And Life-Space Mobility Among Experienced Power Wheelchair Users: An Exploratory Study

Objectives: To explore: (i) relationships between power wheelchair performance, confidence, mobility and the severity of user's cognitive impairment; (ii) relationships between cognitive functioning and power wheelchair performance, confidence and mobility; and (iii) how cognitive scores influence power wheelchair performance, confidence and mobility. Design: Cross-sectional exploratory study. Subjects: Independent power wheelchair users; >= 18 years. Outcome measures: Cognitive assessments (Montreal Cognitive Assessment, Motor-Free Visual Perception Test, and Dysexecutive Questionnaire) and power wheelchair driving assessments (Power mobility Indoor Driving Assessment, Wheelchair-Skills Test-Questionnaire, and Life-Space Assessment). Analyses were completed using multivariate analy sis of variance and principal component analysis. Results: There were a total of 30 participants (with a mean (SD) age of 58 (15) years, who had a mean (SD) of 3 (6.2) years of experience of power wheelchair use, and a mean (SD) score of 22 (5) on the Montreal Cognitive Assessment. There were statistically significant differences in all power wheelchair driving assessments, depending on the severity of cognitive impairment (moderate, p = 0.009; mild, p = <0.001; none, p = 0.009). The first principal component suggested that cognitive functioning, visual perception, and performance explained 69% of the variability in the first principle componenent. The second and third principal components suggested that confidence and the built and social environments also played significant roles in power wheelchair use. Conclusion: There are correlations between cognitive functioning and power wheelchair use in experienced users, with the severity of cognitive impairment influencing power wheelchair driving outcomes.