Characteristics and psychosocial impact of assistive technology use among adults with tetraplegia

Background: Assistive technology (AT) is essential for facilitating independence, vocational engagement, and participation among individuals with spinal cord injury/disorder (SCI/D). However, there is limited evidence regarding the characteristics of AT users and the impact of AT use on psychosocial outcomes after tetraplegia. Objective: Determine the demographic/injury characteristics of AT users and the association between AT use and psychosocial outcomes. Methods: In this prospective, observational study, we enrolled 300 adults with tetraplegia. Surveys collected demographic/injury information, AT utilization, and psychosocial outcomes: self-efficacy (MSES), quality of life (SWLS), perceived manageability (PMNaC), participation (PART-O), fine motor functional ability (SCI-FI/AT), psychosocial impact of AT use (PIADS), and number of AT devices used. Multivariable regressions estimated the relationship between AT use and psychosocial outcomes. Results: Participants were mostly men (68%), with incomplete injuries (54%), and AT users (62%). Average age was 48 years, with an average of 20 years post-SCI/D. AT users tended to be younger (M = 46.7 vs. M = 50.3 non-users), women (69% vs. 57% men), had higher education (71% ≥ master’s degree vs. 41% ≤ high school diploma), vocationally engaged (72% vs. 54% vocationally unengaged), and had complete injuries (77% vs. 50% incomplete). AT use was significantly associated with lower SCI-FI/AT scores (p < 0.01). The number of AT devices used was significantly related to higher PIADS Adaptability scores (p = 0.01). Conclusions: We identified demographic and injury-related characteristics of AT users with tetraplegia. AT use was associated with greater fine motor functional ability but no other psychosocial outcomes, while using multiple devices was associated with greater adaptability.