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The Experience and Use of Power Mobility by Children with Complex Non-Ambulant Cerebral Palsy: A Scoping Review

Livingstone, Roslyn ; Paleg, Ginny ; Fullerton, Bejamin W ; Claesson, Debora ; Govender, Pragashine and Nilsson, Lisbeth LU orcid (2026) In Disabilities 6(4).
Abstract
Background/Objectives: To map the literature and describe the meaning, use, and experience of power mobility for children with complex non-ambulant cerebral palsy (Gross Motor Classification System (GMFCS) levels IV–V and Manual Abilities Classification System (MACS) levels III–V). Methods: Included searches in five electronic databases, grey literature, and hand searches with no restrictions on date, study type, or language, as well as independent duplicate screening and data extraction. Outcomes and experiences were mapped to the integrated F-words Interdependence Human Activity Assistive Technology (iHAAT) framework. Results: In total, 90 studies, from randomized trials to case reports and qualitative designs, included 916 children (10... (More)
Background/Objectives: To map the literature and describe the meaning, use, and experience of power mobility for children with complex non-ambulant cerebral palsy (Gross Motor Classification System (GMFCS) levels IV–V and Manual Abilities Classification System (MACS) levels III–V). Methods: Included searches in five electronic databases, grey literature, and hand searches with no restrictions on date, study type, or language, as well as independent duplicate screening and data extraction. Outcomes and experiences were mapped to the integrated F-words Interdependence Human Activity Assistive Technology (iHAAT) framework. Results: In total, 90 studies, from randomized trials to case reports and qualitative designs, included 916 children (10 months–18 years; 432 GMFCS IV; 262 GMFCS V; 222 GMFCS IV/V), with 351 parents, therapists, or educators. Only 32 studies reported MACS levels. Power wheelchairs were used by 724 children (68 used switches rather than joysticks). Other children used modified ride-on cars, specialty pediatric devices, or platform/smart training devices. Based on 22 studies where this information was provided, alternate access/control methods were primarily used by children classified at GMFCS/MACS V, but there was considerable variability. Introduction predominantly occurred in natural settings with limited training or support. Significant and meaningful improvements in power mobility use were reported for intensive play-based, child-led, and caregiver-supported approaches; for virtual training with joystick users; and for skills-training approaches with older children who already achieved functional power wheelchair use. Conclusions: Children classified at GMFCS IV and V may benefit from power mobility experience to promote fitness, functioning, friends, family, fun, and future outcomes. Their use and experience of power mobility may be interdependent with parents, therapists, and educators, changing attitudes and perceptions of child potential. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
adolescents; child; preschool; infants; power wheelchair; assistive technology; cerebral palsy; power mobility; mixed methods
in
Disabilities
volume
6
issue
4
article number
64
publisher
MDPI AG
ISSN
2673-7272
DOI
10.3390/disabilities6040064
language
English
LU publication?
yes
id
00f02afa-d8c1-4ce1-b72d-dd612b86e539
date added to LUP
2026-07-16 18:35:12
date last changed
2026-07-20 09:57:01
@article{00f02afa-d8c1-4ce1-b72d-dd612b86e539,
  abstract     = {{Background/Objectives: To map the literature and describe the meaning, use, and experience of power mobility for children with complex non-ambulant cerebral palsy (Gross Motor Classification System (GMFCS) levels IV–V and Manual Abilities Classification System (MACS) levels III–V). Methods: Included searches in five electronic databases, grey literature, and hand searches with no restrictions on date, study type, or language, as well as independent duplicate screening and data extraction. Outcomes and experiences were mapped to the integrated F-words Interdependence Human Activity Assistive Technology (iHAAT) framework. Results: In total, 90 studies, from randomized trials to case reports and qualitative designs, included 916 children (10 months–18 years; 432 GMFCS IV; 262 GMFCS V; 222 GMFCS IV/V), with 351 parents, therapists, or educators. Only 32 studies reported MACS levels. Power wheelchairs were used by 724 children (68 used switches rather than joysticks). Other children used modified ride-on cars, specialty pediatric devices, or platform/smart training devices. Based on 22 studies where this information was provided, alternate access/control methods were primarily used by children classified at GMFCS/MACS V, but there was considerable variability. Introduction predominantly occurred in natural settings with limited training or support. Significant and meaningful improvements in power mobility use were reported for intensive play-based, child-led, and caregiver-supported approaches; for virtual training with joystick users; and for skills-training approaches with older children who already achieved functional power wheelchair use. Conclusions: Children classified at GMFCS IV and V may benefit from power mobility experience to promote fitness, functioning, friends, family, fun, and future outcomes. Their use and experience of power mobility may be interdependent with parents, therapists, and educators, changing attitudes and perceptions of child potential.}},
  author       = {{Livingstone, Roslyn and Paleg, Ginny and Fullerton, Bejamin W and Claesson, Debora and Govender, Pragashine and Nilsson, Lisbeth}},
  issn         = {{2673-7272}},
  keywords     = {{adolescents; child; preschool; infants; power wheelchair; assistive technology; cerebral palsy; power mobility; mixed methods}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{4}},
  publisher    = {{MDPI AG}},
  series       = {{Disabilities}},
  title        = {{The Experience and Use of Power Mobility by Children with Complex Non-Ambulant Cerebral Palsy: A Scoping Review}},
  url          = {{http://dx.doi.org/10.3390/disabilities6040064}},
  doi          = {{10.3390/disabilities6040064}},
  volume       = {{6}},
  year         = {{2026}},
}