Mobility as a Motor for InclusionEngagement of Mobility Guides to Support

Participation in and through Sport

Research Institute for Inclusion through Physical Activity and Sport (FIBS gGmbH)

www.fi-bs.de

Edinburgh, October 26th 2016

Tanja BungterPatrick HeydenreichDr. Volker Anneken

Project “Mobility is Participation“

• Period of Time: January 2012 – June 2015• Sponsor: DGUV research funding• Project partners: German Wheelchair Sport Association

(DRS e.V.); Clinics of the employers' liability insurance association (BG) in Bochum, Duisburg, Frankfurt, Halle, Hamburg, Murnau, Tuebingen, Clinic “Hohe Warte“ Bayreuth

• Target group:– Persons with acquired SCI – Insured persons of statutory accident insurances– Dependent on a wheelchair in everyday life

• Project Aim: Movement-oriented after-care concept to improve participation

Methodology

• Activity Test on Wheelchair Mobility (AMR®): Objective measurement of individual performance in wheelchair handling

• Information on wheelchair mobility and physical activity: Questionnaire to identify need for consultation

Activity Assessment on Wheelchair Mobility (AMR®)

• Aim: Objective measurement of individual performance in wheelchair handling

• Origin: mobi sheets (Starter Kit DRS), testing and advice by patients and clinical experts

• Content: Items from the fields of locomotion, overcoming obstacles and handling of slopes

• Final versions: Para-version: 17 ItemsTetra-version: 16 Items

• Evaluation: 5 ability levels (min: 1; max: 5)Time measurement

• Implementation: Used in 17 rehabilitation clinics in Germany, Austria and Switzerland

Project Concept

ClinicTest and

questionnaire, implementation

and documentation

Mobility guides

Research, exchange with other guides,

documentation, consultation

FIBSSighting, reports,

data input, event

information

Insu

red

pers

ons

Statutory accident insurancesDocumentation of patients‘ mobility

Through sport therapy via

mail to

Questions via phone or

email, organization of mobility

training

Via email to

Checklist via email

Advice via

phone / email

Quest-ions

Report via mail or email

Report via mail, project information

Project information, consultation

Test dates

Sample Description

• N= 308 – 91,9% male, 46 ± 11 years old– 76,3% paraplegia– 54,2% complete– 15,3% first releases

53.9

24.7

11.0

4.5

2.6 2.3 0.6 0.3

MurnauHalleHamburgTübingenBochumDuisburgBayreuthFrankfurt

Figure: Allocation to clinics in percentage (N=308).

Need for Consultation and Action

• AMR®-results: 40,3% middle to high need for action• Consultation requests: 59,7% of the total sample• 161 consultations were conducted by five guides

n Min Max Av SD

Number of contacts between mobility guides and insured persons 161 1 10 2,88 1,44

Time span mobility test in clinics – receipt of records by mobility guides (in days)

161 0 257 22,46 29,31

Time span receipt of records by mobility guides – initial contact to insured persons (in days)

161 0 255 35,99 48,36

Time span mobility test in clinics – initial contact to insured persons (in days)

161 0 261 58,44 53,76

Time span mobility test in clinics – call from professional aid to mobility guide (in days)

3 24 167 91,33 71,86

Consultation Requests, Sport Motivation

• Need for consultation mobility training:– First releases: 63,8%– Resumptions: 34,9%

• Need for consultation physical activities:– First releases: 74,4%– Resumptions: 59,6%

• 63,3% of all resuming persons are already physically active – Highly significantly (p≤.001) higher AMR®-values:

• Average AMR® Para physically active = 73• Average AMR® Para physically inactive = 62

• 77% can imagine to exercise or to try new sports in the future

Interventions of the Mobility Guides

Kontaktvermittlung zu Handbikern

Informationen zu Auto/Führerschein

Informationen zu Messen, Veranstaltungen

Gespräche mit Vereinen/Fitnesstudios

Informationen zu Sanitätshäusern, Sportrollstühlen, Handbikes

Recherche korrekte Kontaktdaten

Ausschreibungen zu Mobilitätstrainings, Schnupperangeboten, Camps

Kontaktübermittlungen Ansprechpartner/Angebote

Recherchen geeigneter Sportarten

Lotsenkontakt für Rückfragen

0 10 20 30 40 50 60 70 80 90 100

1.2

3.1

4.3

8.7

13.7

18.0

36.6

48.4

52.2

88.2

in percentage

Figure: Interventions of the mobility guides (N=161).

Contact to guides for further consultations

Search for suitable activities

Forwarding information to contact persons

Advertisements for mobility trainings, trial offers, camps

Research of contact information

Information on health care supply stores, sport wheelchairs, handbikes

Contact to sport clubs or fitness studios

Information on fairs and events

Information concerning cars / driving licence

Contact mediation to handbikers

Evaluation of the Concept

• 94,5% of all interviewed participants rate the mobility guide concept as useful.

• 27,4% participated regularly in proposed activities, 13,7% participated irregularly and 28,8% would like to participate in proposed activities in the future.

• 18,6% joined a sports club subsequently to consultations, 20% plan on doing so.

Conclusion and Prospects

• The AMR®-test can be used economically in combination with short questionnaires to evaluate wheelchair mobility. The instruments reveal needs for consultation and support.

• The mobility guides were perceived as capable interlocutors.

• Patients could be successfully imparted to sport activities.

• The German statutory accident insurances (DGUV) wants to apply the concept in its clinics after the end of the project.

Guidelines for Future Application

Clinic, physiotherapy/sports therapyAMR®-test and questionnaire,

implementation and documentation

Mobility guides

Research, exchange with other guides,

documentation, consultation

Insu

red

pers

ons

Statutory accident insurancesDocumentation of patients‘ mobility

Questions and feedback via phone or email

Advice in clinics, via

phone or email

Questions

Arrangement of test dates

Information, consultation if

needed

Test dates

Test results via email, mail or fax to

Reports via mail or email

for information

Thank you for your attention!

Further information on the project is available at www.fi-bs.deContact: Tanja Bungter, +49-2234-2052-372, bungter@fi-bs.de