OPTIMA 2.0: Towards the Optimal Match between Child and Wheelchair

Joining in, playing along and developing your full potential; for this purpose, a properly fitting wheelchair is indispensable for over 7,000 children in the Netherlands. The wheelchair provision process (WDP) is a complex and time-consuming process of determining which wheelchair is most suitable. This involves several consecutive steps and many parties. This does not always lead to the best-fitting solution, with much impact on the child's participation.    

In the OPTIMA 2.0 project, we join forces to design and test an ideal distribution process (WDP2.0) for children's wheelchairs in three different rehabilitation centres (as living labs). We measure the difference between the current and ideal wheelchair distribution process and investigate whether it is actually simpler, faster and more cost-effective. A properly fitting wheelchair ensures that the child can develop optimally physically, emotionally and socially. A smooth running reduces the burden on children and their parents/carers and benefits all parties involved, including occupational therapists, Wmo consultants from municipalities, wheelchair suppliers as well as manufacturers. 

OPTIMA 1.0 results and recommendations

The preliminary OPTIMA 1.0 study (conducted in 2023) on the wheelchair distribution process (WDP) for children aged 0-18 years identified bottlenecks and produced the recommendations below: 

1. Reducing the duration of the distribution process 
2. Creating local networks of paediatric wheelchair experts 
3. Improving collaborative decision-making (parents and children are always included in the decision-making) 
4. Child participation is the starting point 
5. Guidance from specialised Zit Advies Teams (ZAT) (Sitting Advisory Teams) of rehabilitation centres 

" The first OPTIMA survey shows that only 53% of children and their parents feel that the wheelchair provided matches their schedule of requirements."  

" When a wheelchair is too heavy, driving is less fun, children are less likely to do it themselves and they are dependent on being pushed, which further reduces the challenge to get moving themselves." 

Together with stakeholders, all insights from the OPTIMA 1.0 study were used to arrive at concrete and relevant areas for improvement within the distribution process. The infographics below (in Dutch) have been developed for providers, parents and child, care professionals, policy staff and a general audience:

• Optimal match between child and wheelchair
• Parents and child
• Healthcare professional
• Wmo consultant
• Supplier/manufacturer

The OPTIMA 2.0 study continues with these recommendations from OPTIMA 1.0. 

Approach

The OPTIMA 2.0 project consists of 3 components: 

1. How satisfied are children and parents now? (Control group) 
   We will measure how satisfied child/parent are now with their wheelchair and the process for getting a wheelchair. We also gather qualitative insights through focus groups.
2. What would we, together, want it to look like? (Co-creation) 
   We will sit down with all the different parties to determine what we think the ideal distribution process for children's wheelchairs would look like. We do this in co-creation sessions, during which all stakeholders involved in this project can give their input on the design and decision process. In addition to parents and children, Wmo consultants from municipalities, wheelchair suppliers, physio- and occupational therapists and manufacturers are also involved.
3. Putting the ideal process into practice: how satisfied are the child and the parent then? (Intervention group in three testing grounds)
    We will then put the results of this optimal process into practice in three different “testing grounds”.  Here too, we measure how satisfied the child and parent are with their wheelchair and the course of the process. Qualitative insights are also retrieved here through focus groups.

We compare the results of the control group with the results of the intervention group. We focus on participation, the child-wheelchair match of wheelchair and child, wheelchair skills and the duration and course of the wheelchair distribution process. A cost-effectiveness study is also carried out with the data retrieved: what exactly are the benefits of a different distribution process? 

Duration

This project runs from December 2024 to November 2028. 

Funding

The OPTIMA 2.0 is funded by ZonMw.

Collaboration

Collaborating partners are: Amsterdam University of Applied Sciences, HU University of Applied Sciences Utrecht, Vrije Universiteit Amsterdam, CP Netherlands and Handicap NL. 

The research takes place at three different rehabilitation centres: Basalt (municipality The Hague), Reade (municipality Amsterdam) and Heliomare (smaller municipalities in North Holland). 

Project group 

• The Hague University of Applied Sciences: Monique Berger, Agnes Kloosterman, Caroline Doorenbosch (research group Assistive Technology for Mobility and Sports) and Luc de Witte (research group Technology for Health Care)
• Amsterdam University of Applied Sciences: Margo van Hartingsveldt, Koen van Dijk
• HU University of Applied Sciences Utrecht Marleen Sol, Manon Bloemen
• Vrije Universiteit Amsterdam: Hanneke van Dongen
• Heliomare: Linda Valent
• CP Netherlands Marike Willems

Want to know more? 

The NPO 1 television and radio programme Focus made a podcast about the match between wheelchair and child: The wheelchair move #2 - make your wheelchair your favourite shoes. 

Updates from this survey are also tracked at: checkjezit.nl 

Contact

Monique Berger, OPTIMA 2.0 project manager: [email protected].

Want to keep up to date with developments? Follow us on LinkedIn or Instagram, or share your contact details via, [email protected].