The Clinician Task Force (CTF) has released a position statement, “Scope of Practice for Seating and Wheeled Mobility Clinical Services,” completed in December 2023.
In a Feb. 27 announcement, the CTF said, “This document aims to define the occupational and physical therapy role and responsibilities in seating and wheeled mobility services for educators, rehabilitation professionals, medical providers, funding sources, policy makers, seating and wheeled mobility manufacturers, and more.”
On the CTF website, the Scope of Practice paper “aims to clearly describe best practice methods for providing clinical services in seating and wheeled mobility (SWM). Clinical practice in SWM depends on many factors, including, but not limited to, the practitioners’ expertise, practice settings, organization within which SWM clinical services are provided, available funding, and the clients themselves, their health status, diagnoses, ages, and more.”
Roles and responsibilities of seating clinicians
The paper’s topics include establishing the roles and responsibilities for occupational and physical therapists practicing clinical services related to SWM; and educating stakeholders on the clinical practices in SWM.
“It is intended to educate and define the knowledge base while secondarily speaking against unethical practices and barriers in SWM clinical service provision,” the paper said.
The paper defines an “appropriate wheelchair”; delineates the knowledge base for SWM clinical practice; describes the SWM clinical process; and explores practice settings and service delivery models, including and specifically involving the use of telehealth.
The CTF position includes the assertion that SWM clinicians should have an understanding of not just the wheelchair base and accessories, but also the most common funding sources. “The clinician must educate the client and caregivers regarding the available equipment options that meet their needs, then facilitate decision-making with a conversation about funding and payment,” the paper said.
The paper also discusses collaborating with stakeholders. “The client must remain at the center of the process as the main decision maker, as the acquired wheelchair, accessories, and features greatly influence their health and function; is not returnable; and will likely remain with them for the next three to five or more years,” the CTF position said.
Detailing the steps in the provision process
The SWM clinical process section includes a list of 10 “key steps to perform a best-practice, evidence-based wheelchair, and accessory evaluation.”
And the position emphasized the personal, individual nature of SWM provision: “It is unethical to solely utilize chart review information or indirectly provided information (e.g., via telephone) to justify a wheelchair base and accessories.”
The position addressed practice settings, service delivery models, and the role of telehealth. For telehealth evaluations, CTF’s position describes the criteria that the clinician should document, including why telehealth was chosen, the names of everyone who participated in the seating evaluation, their locations, and the private telehealth platform.
“The client’s well-being remains at the forefront of these directives, benefitting from decreased risk in pressure injuries, gravity-inducing postural asymmetries, and increased function from receiving services that follow these practices,” the paper said.
The CTF is a 501(c)(4) non-profit comprising primarily occupational and physical therapists who specialize in seating and wheeled mobility in the United States. Other downloadable resources include CTF Guides on navigating Medicaid denials; and evidence on standing frames for insurance denials.
