An observational study of powered wheelchair provision in Italy.

Powered wheelchairs are complex and expensive assistive devices that must be selected and configured on the basis of individual user needs, lifestyle, motivation, driving ability, and environment. Providing agencies often require evidence that their financial investment will lead to a successful outcome. The authors surveyed a sample of 79 users who had obtained powered wheelchairs from a Regional Health Service in Italy in the period 2008-2013. Follow-up interviews were conducted at the users' homes in order to collect information about wheelchair use, and its effectiveness, usefulness, and economic impact. The instruments used in the interviews included an introductory questionnaire, QUEST (Quebec User Evaluation of Satisfaction with Assistive Technology), PIADS (Psychosocial Impact of Assistive Devices Scale), FABS/M (Facilitators and Barriers Survey/Mobility), and SCAI (Siva Cost Analysis Instrument). The results indicated positive outcomes, especially in relation to user satisfaction and psychosocial impact. A number of barriers were identified in various settings that sometimes restrict user mobility, and suggest corrective actions. The provision of a powered wheelchair generated considerable savings in social costs for most users: an average of about $38,000 per person over a projected 5-year period was estimated by comparing the cost of the intervention with that of non-intervention.

Postural disorders in conservatory students: the Diesis project.

UNLABELLED: Prolonged and incorrect postures are one of the main risk factors for the development of musculoskeletal pathologies. The aims of this study were to study the prevalence of incorrect postures among conservatory students; to identify if the use of an asymmetric instrument represents a risk factor for developing postural disorders; and to investigate whether a correlation exists between years of study, physical activity, and prevalence of postural disorders. METHODS: The subjects were recruited among students of the Giuseppe Verdi Conservatory of Milano. All musical instruments were investigated and classified as asymmetric and symmetrical. The observed student posture was classified without instrument as "correct posture" or "postural disorder" and with an with instrument as "optimal posture" or "non-optimal posture." While playing, the postural disorder was classified as "unchanged" or "increased." The data were analyzed with chi-square and linear regression methods. RESULTS: Of the 148 conservatory students entered into the study, 66.2% had a postural disorder; 73.4% had a non-optimal posture, and playing an asymmetric instrument was the only variable associated (p=0.01). While playing, the postural disorder was increased in 59.2%; playing an asymmetric instrument (p=0.01) and years of practice (p=0.007) were the significantly associated variables. CONCLUSIONS: To play an asymmetric instrument exposes musicians to an increased risk of non-optimal postures and to a worsened postural disorder when present. Considering that the years of practice have an additional negative impact on postural disorders, further studies are needed to clarify the role of non-optimal postures in the development of musculoskeletal complaints among students and professional musicians.