Original Research

Mobility impairment and life satisfaction in the Northern Region of Malawi

Jared M. Alswang, William B. Belshe, Dexter Killi, Weston Bandawe, Erin S. Silliman, Aaron C. Bastian, Brooke K. Upchurch, Megan F. Bastian, Sierra M. Pinal, Mark B. Klein, Bertha Ndhlozi, Mauricio Silva, John Chipolombwe, Rachel M. Thompson
African Journal of Disability | Vol 11 | a1013 | DOI: https://doi.org/10.4102/ajod.v11i0.1013 | © 2022 Jared M. Alswang, William B. Belshe, Dexter Killi, Weston Bandawe, Erin S. Silliman, Aaron C. Bastian, Brooke K. Upchurch, Megan F. Bastian, Sierra M. Pinal, Mark B. Klein, Bertha Ndhlozi, Mauricio Silva, John Chipolombwe, Rachel M. Thompson | This work is licensed under CC Attribution 4.0
Submitted: 11 February 2022 | Published: 22 September 2022

About the author(s)

Jared M. Alswang, Harvard Medical School, Harvard University, Boston, MA, United States
William B. Belshe, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
Dexter Killi, Department of Physiotherapy, Mzuzu Central Hospital, Mzuzu, Malawi
Weston Bandawe, Department of Physiotherapy, St. John’s Hospital, Mzuzu, Malawi
Erin S. Silliman, School of Medicine, Boston University, Boston, MA, United States
Aaron C. Bastian, College of Osteopathic Medicine, New York Institute of Technology, Glen Head, NY, United States
Brooke K. Upchurch, Dell Medical School, University of Texas at Austin, Austin, TX, United States
Megan F. Bastian, School of Medicine, Saint Louis University, Saint Louis, MO, United States
Sierra M. Pinal, Department of Orthopedic Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; and Center for Cerebral Palsy, Orthopaedic Institute for Children, Los Angeles, CA, United States
Mark B. Klein, Dornsife College of Letters, Arts and Science, University of Southern California, Los Angeles, CA, United States
Bertha Ndhlozi, Malawi Against Physical Disabilities, Rumphi, Malawi
Mauricio Silva, Department of Orthopedic Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America ; and Orthopaedic Institute for Children, Los Angeles, CA, United States
John Chipolombwe, Department of Internal Medicine, Mzuzu Central Hospital, Mzuzu, Malawi
Rachel M. Thompson, Department of Orthopedic Surgery, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA United States of America; and Center for Cerebral Palsy, Orthopaedic Institute for Children, Los Angeles, CA, United States


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Abstract

Background: There exist many psychosocial sequelae associated with mobility impairment, especially in low-resource settings where access to mobility assistive devices is limited.

Objectives: This study aims to (1) define the burden and presenting aetiologies of mobility impairment in the rural Northern Region of Malawi and (2) assess the relationship between physical disability, life satisfaction and access to mobility aids.

Methods: At mobility device donation clinics throughout the Northern Region of Malawi, adults living with mobility impairment were surveyed with a demographic questionnaire and a series of validated surveys to assess their physical activity levels (Global Physical Activity Questionnaire [GPAQ]), degree of mobility impairment (Washington Group Extended Set Questions on Disability) and life satisfaction (patient-reported outcomes measurement information systems satisfaction with participation in social roles and general life satisfaction).

Results: There were 251 participants who qualified for inclusion, of which 193 completed all surveys. Higher physical activity scores were positively correlated with increased life satisfaction: (1) satisfaction with participation in social roles (0.481, p < 0.0001) and (2) general life satisfaction (0.230, p < 0.001). Respondents who had previously used a formal mobility device reported 235.5% higher physical activity levels ([139.0%, 333.0%], p = 0.006), significantly higher satisfaction with participation in social roles ([0.21, 6.67], p = 0.037) and equivocally higher general life satisfaction ([−1.77, 3.84], p = 0.470).

Conclusion: Disability and mental health do not exist in isolation from one another. Given the positive correlations between formal mobility device usage and both physical activity and life satisfaction, interventions that increase access to mobility-assistive devices in undertreated populations are imperative.

Contribution: This study contributes to the understanding of the complex relationship between physical disability, access to mobility aids, and life satisfaction. Results from this study suggest the potential benefit that increasing access to mobility aids may have in improving the quality of life of mobility impaired persons in resource-limited settings, such as the Northern Region of Malawi.


Keywords

mobility impairment; life satisfaction; physical activity; mobility assistive devices; physical disability.

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