How can we Improve Access to Early Powered Mobility? A Review of Completed Bugzi Loans

Purpose

Bugzi is an early powered mobility (EPM) device available on application to MERU. A review of children who returned their Bugzi between January 2017 and March 2019 was conducted to try and elicit information about use of the Bugzi Loan Scheme.

Approach

We analysed data collected from Bugzi users who had completed their Bugzi loan and compared our findings to recent systematic reviews conducted regarding Early Powered Mobility.

Outcomes

The majority of children who had returned a Bugzi had a chromosomal disorder (Unspecified Chromosome Disorder, SMA, Myotonic Dystrophy) and the next largest group at 29% had a neurological diagnosis (Cerebral Palsy).

Almost all applications were completed by either an Occupational Therapist or Physiotherapist. 5 centres were used across England and Scotland to assess and provide Bugzi to the children. There was an incidence of an extremely long wait at the beginning of the time period however this settled to all but 1 child being seen within the agreed time of 12 weeks from acceptance since 2017.

The majority of children got their Bugzi when they were 5 years old or younger, though there were a few children who were assessed up to age 10. The most common period of loan for this group of children was 2 years or less.

Implications

Bugzi is well used by children with CP and unspecified chromosomal disorders, however it would also suit as an EPM device for other specific diagnoses which were underrepresented in this small data set e.g. SMA, Arthrogryposis, skeletal dysplasia. There was good access for families to EPM, with the maximum distance travelled to assessment being 84 miles, and wait time decreased and stabilised. The Bugzi Loan Scheme currently has 7 satellite Centres with at least 4 more awaiting training, thereby improving coverage across the UK to EPM and potentially improving waiting times.

There is evidence to suggest children with cognitive disabilities as young as 12 months old can used EPM so by improving awareness of the scheme and trying to recruit younger children to access EPM, it would hope that they would use EPM for longer. A hypothetical suggestion could be that if children use EPM from a younger age then they would gain more benefits - in their driving skills, activities they engage in and participation in daily life.

Collection of this type of data is difficult as reliability and validity of assessment tools vary. In order to evidence the effectiveness of the Bugzi Loan Scheme we will be routinely collecting quantitative data using the ALP (related to driving skill) and the SDQ (related to emotional and behavioural impact); we will also be tracking the use of different driving tools the child uses - switches and joystick use. While this was a small sample size (14), it is also worth considering that during this time period 98 Bugzis were loaned out.

The purpose was to review completed loan data, but anecdotally we can report that Bugzis are not being returned regularly and therefore are being loaned out for longer periods of time.

Funding acknowledgements

Not funded. 

Additional notes

This work was presented at Physiotherapy UK 2019