Systematic review of power mobility outcomes for infants, children and adolescents with mobility limitations.

OBJECTIVE: To summarize and critically appraise the evidence related to power mobility use in children (18 years or younger) with mobility limitations.

DATA SOURCES: Searches were performed in 12 electronic databases along with hand searching for articles published in English to September 2012 and updated February 2014.

REVIEW METHODS: The search was restricted to quantitative studies including at least one child with a mobility limitation and measuring an outcome related to power mobility device use. Articles were appraised using American Academy of Cerebral Palsy and Developmental Medicine (AACPDM) criteria for group and single-subject designs. The PRISMA statement was followed with inclusion criteria set a priori. Two reviewers independently screened titles, abstracts and full-text articles. AACPDM quality ratings were completed for levels I-III studies.

RESULTS: Of 259 titles, 29 articles met inclusion criteria, describing 28 primary research studies. One study, rated as strong level II evidence, supported positive impact of power mobility on overall development as well as independent mobility. Another study, rated as moderate level III evidence, supported positive impact on self-initiated movement. Remaining studies, rated evidence levels IV and V, provided support for a positive impact on a broad range of outcomes from to International Classification of Functioning (ICF) components of body structure and function, activity and participation. Some studies suggest that environmental factors may be influential in successful power mobility use and skill development.

CONCLUSION: The body of evidence supporting outcomes for children using power mobility is primarily descriptive rather than experimental in nature, suggesting research in this area is in its infancy.