Name of the Procedure:

Manual Wheelchair Accessory, One-Arm Drive Attachment (HCPCS Code E0958)

Summary

This procedure involves attaching a specialized accessory to a manual wheelchair, allowing it to be propelled using one arm. This modification is particularly useful for individuals who have limited or no use of one arm.

Purpose

This attachment is designed to help individuals with disabilities affecting one arm to independently maneuver a manual wheelchair. The primary goal is to enhance mobility and independence.

Indications

• Hemiplegia or paralysis of one arm
• Severe injury to one arm
• Conditions such as stroke, multiple sclerosis, or cerebral palsy affecting one arm
• Amputees with only one functional upper limb

Preparation

• No specific fasting or medication adjustments are typically required.
• Assessment of the patient's overall health and manual dexterity.
• Measurements and fitting of the wheelchair to ensure compatibility with the one-arm drive attachment.

Procedure Description

1. Initial Assessment: A healthcare professional evaluates the patient's need for the attachment and assesses the patient's wheelchair for compatibility.
2. Attachment: The one-arm drive accessory is affixed to either the left or the right side of the wheelchair, depending on which arm is functional.
3. Adjustment: The attachment is adjusted for optimal functionality, ensuring it is secure and easy to use for the patient.
4. Training: The patient is instructed and trained on how to use the attachment effectively.

Duration

The installation and training process typically takes 1 to 2 hours.

Setting

• Performed in outpatient clinics or specialized wheelchair service centers.

Personnel

• Occupational therapist or trained wheelchair technician.
• Occasionally a physician or rehabilitation specialist for initial assessment.

Risks and Complications

• Errors in installation could lead to instability of the wheelchair.
• Potential for repetitive strain injury to the functional arm.
• Improper use can result in accidents or falls.

Benefits

• Improved mobility and independence.
• Enhanced ability to perform daily activities.
• Increased self-esteem and quality of life.

Recovery

• No significant recovery period.
• Immediate use following installation and training.
• Follow-up visits may be required to adjust the attachment and optimize its use.

Alternatives

• Electric wheelchairs for users with limited arm functionality.
• Ergonomic wheelchairs designed for users with specific disabilities.
• Pros: Electric wheelchairs offer easy mobility without physical exertion.
• Cons: They may be more expensive and require maintenance.

Patient Experience

• Minimal discomfort during attachment fitting.
• Initial period of adjustment to become accustomed to the new driving method.
• Customization and training can help ease the transition and maximize comfort. Pain management is not typically required for this procedure.