New research could strengthen case for PWC repair reform

PITTSBURGH – Industry stakeholders are pursuing multiple regulatory and legislative avenues to improve the power wheelchair (PWC) service and repair process for both providers and users. Now, new research led by Mark Schmeler at the University of Pittsburgh suggests a potential root cause that may be contributing to persistent repair challenges.

Schmeler, PhD, OTR/L, ATP, associate professor and vice chairman for clinical services and policy in the Department of Rehabilitation Science & Technology at UPitt and director of the Center for Assistive Technology at UPMC, recently traveled with a research team to a conference in New Zealand to present their latest findings.

“We may have discovered a flaw in how devices are tested, which might further add to why some devices break down prematurely,” he said. “Wheelchairs are required to be tested to 200,000 cycles on a double drum test. This appears to be equivalent to about 7% of the overall 5-year reasonable useful life expectation based on our Permobil study. So, from my opinion, we need to either increase the testing protocol to align more with 5 years or acknowledge that these devices should be inspected and repaired regularly.”

Study examines real-world power wheelchair usage

In the Permobil study, researchers analyzed data from the company’s connected PWCs to:

• Calculate the mean daily distance traveled in 2022 across a large sample of U.S. users
• Compare mean daily distance traveled and use days across five PWC models
• Compare usage patterns between Group 3 and Group 4 PWCs

Key results included:

• PWC users drove on average 1,365 meters per day
• Group 4 PWCs logged significantly higher daily distances than Group 3 PWCs
• PWCs were used on average 301 days per year

Researchers concluded: “Study results could inform scheduled maintenance, repairs, and replacements based on usage versus current indicator of device age.”

Data-driven insights could support policy changes

Schmeler says this type of evidence is critical for advancing policy improvements around service and repair.

“Repair issues are growing,” he said. “Is it because equipment isn’t as good as it was or is it because people are using their wheelchairs more and are out and about in them more? We’re finding it’s probably a little bit of both.”

Following a survey last year that revealed widespread dissatisfaction with the current wheelchair service delivery process—especially around follow-up, service, and repair—Schmeler has continued conversations with industry stakeholders. Those discussions have highlighted several pain points and potential solutions:

• Consumer education: Providers can better prepare users for what to expect after delivery, he says.
• Business model: The reimbursement system must evolve to reflect the ongoing support required to maintain a wheelchair’s expected lifespan.

The industry is also making progress in establishing best practices. iNRRTS, with input from clinicians including Schmeler, released service and repair guidelines in 2023.

“It’s a long process, but to have a guideline with consensus moves things forward,” he said. “CMS likes it when we do that. They don’t like to dictate practice.”

More research ahead on maintenance protocols

Regulatory and legislative advocacy will remain essential, but Schmeler hopes these research insights will give stakeholders an additional tool to push for change.

“Our next research project is doing some clinical trials on maintenance protocols,” he said. “If we do the maintenance, are we seeing better outcomes and are we saving money. All we have is one study out of Sweden that’s 20 years old, but that showed the group that got maintenance had no wheelchair failures and no adverse events.”