The Functioning Everyday with a Wheelchair (FEW) instrument.

THE FEW

The Functioning Everyday with a Wheelchair (FEW) instrument is a self-report questionnaire, designed by the University of Pittsburg, which is administered over time to consumers of wheeled mobility and seating technology. This questionnaire serves as a dynamic indicator of perceived user function related to wheelchair use. Developed by a team of clinical researchers at the University of Pittsburg, this tool helps fill the void of available outcome measures related to function with the use of a wheelchair.

The FEW Administration

According to the University of Pittsburgh, this questionnaire can be self-administered or as an interview by the phone. While no examiner training is required for the administration of such questionnaire, Access Medical requires all its Seating and Mobility specialists to have a knowledge and understanding of its contents as well as what the results dictate. 

Target Population

The FEW was designed to measure perceived functional performance for individuals with progressive (e.g., muscular dystrophy, amyotrophic lateral sclerosis) or non-progressive (e.g., cerebral palsy, spinal cord injury) conditions, who use a wheelchair or scooter as their primary seating and mobility device.

By utilizing this clinical approach throughout the evaluation process, we are able to better assess the needs of the patients we work with. Then, with the assistance of physical and occupational therapists, patients receive the proper equipment that meets their functional, social, and environmental needs.

Background

In order to provide wheelchair seating-mobility interventions we are faced with the challenge of identifying evidence-based outcomes to determine the effectiveness of new and existing technologies, evaluation techniques, and to provide its patients a means of measuring the functional success of such interventions.

Significance of the Problem

The expected number of wheelchair/scooter users in both institutionalized and non-institutionalized settings is expected to increase to over 2.8 million (institutionalized setting = 1 million, non-institutionalized setting = 1.7 million) in the United States (Jones, 1999; Kaye, Kang, & LaPlante, 2000). Therefore, the rapid pace of technology advancement is appropriate in comparison to the vast number of individuals in need of technology solutions, and the increasing demand on providers to meet consumer needs.

On average one-third of all assistive technology devices are abandoned by users (Scherer & Cushman, 2001). A review of the literature by Galvin and Scherer (1996) indicated that although a person may no longer need an assistive technology device, the most significant factor associated with technology abandonment is the failure to consider user opinions and preferences in device selection.

Outcomes Measure Selection

In order to ensure the accuracy of assistive technology prescriptions, a functional assessment is needed to evaluate the capabilities, needs, and environmental interactions of potential users.

Data from functional assessments are beneficial for assisting a team of assistive technology practitioners to determine the best possible fit of the technology to an individual’s needs. (e.g., sitting tolerance, performance of home and community tasks), therapeutic and/or medical concerns (e.g., exercise routine, swelling, positioning), and technical and engineering constraints (e.g., durability, operation, chair dimensions).

Utilizing the fundamental principles and concepts presented through the FEW instrument, combined with accurate functional assessments, will reduce the prevalence of equipment abandonment. As a team, we believe this approach will help our patients meet their mobility needs while reducing the onset of secondary complications due to improper equipment.