Clinicians

To All NRRTS Registrants and Friends of NRRTS

Our industry and profession has been plagued by a lack of scientific data to support the effectiveness of the seating, positioning and wheeled mobility interventions that we all apply on a daily basis. This makes policy change and justifications to payers difficult if not impossible. We have long needed tools that payers, regulators and legislators will understand and accept as convincing sources for medical and functional justifications and reasonable predictors of positive outcomes.

Here is some background information that help put the RESNA position papers in context.

Levels of evidence

• Level I - systematic reviews or meta-analysis
• Level II – one or more well-designed study
• Level III – a well designed study but without randomization
• Level IV – well designed non-experimental study from more than one facility or research group
• Level V - subjective opinions of well known respected authorities based on clinical experience, case studies, or expert committee reports also known as expert opinions or position papers.

What is a RESNA position paper?

• Official statement by the organization that, based on the consensus of experts, summarizes current research and best-practice trends in relevant areas.
• These position papers are the first in the wheeled mobility and seating industry issued by an international professional organization declaring the medical and functional necessity of specific assistive technology devices

Why do we need position papers?

• Best summary of related scientific evidence
• considers “clinical evidence”
• It comprehensively reviews all benefits and disadvantages
• Fills a void resulting from the lack of scientific evidence

Use of a position paper

• Teaching tool in colleges and universities
• Teaching tool in the clinical setting, whether to help educate other team members or the client
• Guide to practitioners in the development and provision of interventions
• Support material to help obtain funding
• Evidence in organized lobbying efforts for policy changes

RESNA, with input from RTSs, clinicians and academicians, has so far developed four position papers on the following topics:

• Application of Tilt, Recline, and Elevating Legrests for Wheelchair
• Application of Power Wheelchairs for Pediatric Users
• Application of Seat-Elevating Devices for Wheelchair Users
• Application of Wheelchair Standing Devices

Each of these papers presents physiologic and functional justification, best practice standards and other invaluable information in justifying the client needs for these classes of equipment. They are attached for your review and use in your daily clinical and business practice.

Many thanks to Mark Schmeler, PhD, Director, RSTCE, University of Pittsburgh for sharing this information.
http://www.rstce.pitt.edu