OBJECTIVE: To test the hypothesis that a brief, formalized period of additional wheelchair skills training is safe and results in significantly greater improvements in wheelchair skills performance than a standard rehabilitation program. DESIGN: Randomized controlled trial. SETTING: Rehabilitation center. PARTICIPANTS: Thirty-five wheelchair users (20 with musculoskeletal disorders, 15 with neurologic disorders) admitted for initial rehabilitation. Subjects' mean age +/- standard deviation (SD) was 59+/-18.3 years. INTERVENTION: Subjects randomly allocated to the treatment group participated in the Wheelchair Skills Training Program (WSTP), averaging 4.5+/-1.5 training sessions, each 30 minutes long. Subjects in the control group did not receive any wheelchair skills training beyond that given in a typical rehabilitation stay. MAIN OUTCOME MEASURES: Wheelchair Skills Test (WST), version 2.4, before and after training. Changes in total percentage WST score and individual skill scores were examined. RESULTS: There were no adverse incidents. The control group's mean percentage score +/- SD increased from 60.1%+/-14.4% to 64.9%+/-13.3%, an 8% improvement of the posttest relative to the pretest (P=.01). The WSTP group's mean score increased from 64.9%+/-9.4% to 80.9%+/-5.6%, a 25% improvement of the posttest relative to the pretest (P<.000). The WSTP group showed significantly greater improvements than the control group (P<.000). Among the specific skills, significantly greater improvements were seen in the WSTP group for the gravel and high-curb descent skills (P<.001). CONCLUSIONS: The WSTP is safe and practical and has a clinically significant effect on the independent wheeled mobility of new wheelchair users. These findings have implications for the standards of care in rehabilitation programs.
RCT Entities:
OBJECTIVE: To test the hypothesis that a brief, formalized period of additional wheelchair skills training is safe and results in significantly greater improvements in wheelchair skills performance than a standard rehabilitation program. DESIGN: Randomized controlled trial. SETTING: Rehabilitation center. PARTICIPANTS: Thirty-five wheelchair users (20 with musculoskeletal disorders, 15 with neurologic disorders) admitted for initial rehabilitation. Subjects' mean age +/- standard deviation (SD) was 59+/-18.3 years. INTERVENTION: Subjects randomly allocated to the treatment group participated in the Wheelchair Skills Training Program (WSTP), averaging 4.5+/-1.5 training sessions, each 30 minutes long. Subjects in the control group did not receive any wheelchair skills training beyond that given in a typical rehabilitation stay. MAIN OUTCOME MEASURES: Wheelchair Skills Test (WST), version 2.4, before and after training. Changes in total percentage WST score and individual skill scores were examined. RESULTS: There were no adverse incidents. The control group's mean percentage score +/- SD increased from 60.1%+/-14.4% to 64.9%+/-13.3%, an 8% improvement of the posttest relative to the pretest (P=.01). The WSTP group's mean score increased from 64.9%+/-9.4% to 80.9%+/-5.6%, a 25% improvement of the posttest relative to the pretest (P<.000). The WSTP group showed significantly greater improvements than the control group (P<.000). Among the specific skills, significantly greater improvements were seen in the WSTP group for the gravel and high-curb descent skills (P<.001). CONCLUSIONS: The WSTP is safe and practical and has a clinically significant effect on the independent wheeled mobility of new wheelchair users. These findings have implications for the standards of care in rehabilitation programs.
Authors: R Lee Kirby; William C Miller; Francois Routhier; Louise Demers; Alex Mihailidis; Jan Miller Polgar; Paula W Rushton; Laura Titus; Cher Smith; Mike McAllister; Chris Theriault; Kara Thompson; Bonita Sawatzky Journal: Arch Phys Med Rehabil Date: 2015-07-30 Impact factor: 3.966
Authors: Krista L Best; William C Miller; Janice J Eng; François Routhier; Charles Goldsmith Journal: Can J Occup Ther Date: 2014-12 Impact factor: 1.614
Authors: Joelle Pineau; Athena K Moghaddam; Hiu Kim Yuen; Philippe S Archambault; François Routhier; François Michaud; Patrick Boissy Journal: IEEE J Transl Eng Health Med Date: 2014-10-30 Impact factor: 3.316
Authors: Gianluca U Sorrento; Philippe S Archambault; François Routhier; Danielle Dessureault; Patrick Boissy Journal: J Neuroeng Rehabil Date: 2011-05-24 Impact factor: 4.262
Authors: Brodie M Sakakibara; William C Miller; Melanie Souza; Viara Nikolova; Krista L Best Journal: Arch Phys Med Rehabil Date: 2013-02-04 Impact factor: 3.966