The Clinical Decision-Making Process of Prescribing Power Mobility for a Child with Cerebral Palsy

In Brief Purpose: Powered mobility has been shown to be an effective method for children with disabilities to achieve independent mobility. The purpose of this case report is to describe the physical therapist’s clinical decision making related to power mobility for a child with multiple disabilities. Case Description: Power wheelchair evaluation for a nine-year-old child was conducted using Furumasu’s tasks for wheelchair readiness moving through a doorway, maneuvering through three cones, and driving in a hallway. Ongoing team assessment with family consultation informed clinical decision-making. Outcomes: A mid-wheel-drive chair afforded improved performance on Furumasu’s tasks compared with a rear-wheel-drive chair. Summary: This case describes the clinician’s role in prescribing power wheelchairs to affect the user’s functional skills, as well as how, in the absence of evidence, clinical experience and patients’ needs can guide clinical decision-making. In this case report, the authors describe the clinical decision-making process that led to the prescription of a mid-wheel drive wheelchair for a preteen girl with CP. Training in this chair led to increased independent mobility for this girl.