Name of the Procedure:

Manual wheelchair accessory, push-rim activated power assist system (HCPCS E0986)

Summary

A push-rim activated power assist system is an accessory added to a manual wheelchair to help users propel their wheelchair more easily. It works by providing motorized assistance when the user pushes on the wheelchair's hand rims, reducing the effort required to move and navigate.

Purpose

The push-rim activated power assist system is designed to help individuals who struggle with propelling a manual wheelchair due to limited strength or endurance. The goal is to enhance mobility, reduce physical strain, and prevent injuries related to repetitive arm movements.

Indications

This system is indicated for individuals with:

• Limited upper body strength or endurance
• Conditions like muscular dystrophy, multiple sclerosis, or spinal cord injuries
• Chronic pain or fatigue that impairs the ability to use a manual wheelchair effectively

Preparation

• There is usually no need for fasting or medication adjustments before using a power assist system.
• A comprehensive assessment by a healthcare professional, including a physical and occupational therapy evaluation, is required to determine suitability.

Procedure Description

1. Assessment: A healthcare professional assesses the user's needs and wheelchair specifications.
2. Selection: A suitable push-rim activated power assist system is chosen based on the user’s manual wheelchair and personal requirements.
3. Installation: The system is installed by a trained technician or mobility specialist.
4. Demonstration and Training: The user is trained on how to operate the system safely, including how to activate and deactivate the power assist.
5. Testing: The user practices using the system under supervision to ensure proper use and comfort.

Duration

Initial assessment and installation can take a few hours. Training sessions typically last 1-2 hours.

Setting

This procedure is usually performed in a mobility clinic, rehabilitation center, or by a certified wheelchair technician at an outpatient facility or the user’s home.

Personnel

• Occupational or physical therapists
• Certified wheelchair technicians or mobility specialists
• Rehabilitation specialists

Risks and Complications

• Common risks include adjusting to the power assist system and learning to control it.
• Rare complications might include mechanical failure or battery issues, which require servicing.
• Potential for increased speed leading to accidents or falls if not used correctly.

Benefits

• Reduced physical strain on arms and shoulders
• Increased mobility and independence
• Potential to reduce long-term costs associated with shoulder and arm injuries
• Benefits are often realized immediately upon correct use of the system.

Recovery

• No recovery time as it's a non-invasive procedure.
• Users might need a short period to adapt to the new system and learn to control it effectively.
• Regular follow-up appointments to ensure the system is functioning correctly and make any necessary adjustments.

Alternatives

• Traditional manual wheelchair use without power assistance.
• Fully motorized wheelchairs.
• Pros of the push-rim system: Maintains upper body exercise benefits of a manual wheelchair, is lighter and more portable than a fully motorized wheelchair.
• Cons: More expensive than a traditional manual wheelchair, requires battery maintenance.

Patient Experience

• During and after the installation and training, patients might experience excitement coupled with a short learning curve.
• Some users may feel mild discomfort initially from adjusting to the new system.
• Pain management is not typically required, but training focuses on comfort and safety to enhance the overall experience.