R Lee Kirby1, William C Miller2, Francois Routhier3, Louise Demers4, Alex Mihailidis5, Jan Miller Polgar6, Paula W Rushton7, Laura Titus6, Cher Smith8, Mike McAllister9, Chris Theriault10, Kara Thompson10, Bonita Sawatzky11. 1. Department of Medicine, Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Nova Scotia, Canada. Electronic address: kirby@dal.ca. 2. Department of Occupational Science and Occupational Therapy, University of British Columbia; Vancouver, British Columbia, Canada. 3. Department of Rehabilitation, Laval University, Québec City, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec City Rehabilitation Institute, Québec City, Quebec, Canada. 4. School of Rehabilitation, University of Montreal, Montréal, Quebec, Canada; Research Center, University of Montreal Institute of Geriatrics, Montréal, Quebec, Canada. 5. Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada. 6. School of Occupational Therapy, Western University, London, Ontario, Canada. 7. School of Rehabilitation, University of Montreal, Montréal, Quebec, Canada; University Hospital Centre Sainte-Justine Research Center, Montréal, Quebec, Canada. 8. Department of Occupational Therapy, Capital District Health Authority, Halifax, Nova Scotia, Canada. 9. Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada. 10. Research Methods Unit, Dalhousie University, Halifax, Nova Scotia, Canada. 11. Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
OBJECTIVES: To test the hypothesis that powered wheelchair users who receive the Wheelchair Skills Training Program (WSTP) improve their wheelchair skills in comparison with a control group that receives standard care, and secondarily to assess goal achievement, satisfaction with training, retention, injury rate, confidence with wheelchair use, and participation. DESIGN: Randomized controlled trial. SETTING: Rehabilitation centers and communities. PARTICIPANTS: Powered wheelchair users (N=116). INTERVENTION: Five 30-minute WSTP training sessions. MAIN OUTCOME MEASURES: Assessments were done at baseline (t1), posttraining (t2), and 3 months posttraining (t3) using the Wheelchair Skills Test Questionnaire (WST-Q version 4.1), Goal Attainment Score (GAS), Satisfaction Questionnaire, injury rate, Wheelchair Use Confidence Scale for Power Wheelchair Users (WheelCon), and Life Space Assessment (LSA). RESULTS: There was no significant t2-t1 difference between the groups for WST-Q capacity scores (P=.600), but the difference for WST-Q performance scores was significant (P=.016) with a relative (t2/t1 × 100%) improvement of the median score for the intervention group of 10.8%. The mean GAS ± SD for the intervention group after training was 92.8%±11.4%, and satisfaction with training was high. The WST-Q gain was not retained at t3. There was no clinically significant difference between the groups in injury rate and no statistically significant differences in WheelCon or LSA scores at t3. CONCLUSIONS:Powered wheelchair users who receive formal wheelchair skills training demonstrate modest, transient posttraining improvements in their WST-Q performance scores, have substantial improvements on individualized goals, and are positive about training.
RCT Entities:
OBJECTIVES: To test the hypothesis that powered wheelchair users who receive the Wheelchair Skills Training Program (WSTP) improve their wheelchair skills in comparison with a control group that receives standard care, and secondarily to assess goal achievement, satisfaction with training, retention, injury rate, confidence with wheelchair use, and participation. DESIGN: Randomized controlled trial. SETTING: Rehabilitation centers and communities. PARTICIPANTS: Powered wheelchair users (N=116). INTERVENTION: Five 30-minute WSTP training sessions. MAIN OUTCOME MEASURES: Assessments were done at baseline (t1), posttraining (t2), and 3 months posttraining (t3) using the Wheelchair Skills Test Questionnaire (WST-Q version 4.1), Goal Attainment Score (GAS), Satisfaction Questionnaire, injury rate, Wheelchair Use Confidence Scale for Power Wheelchair Users (WheelCon), and Life Space Assessment (LSA). RESULTS: There was no significant t2-t1 difference between the groups for WST-Q capacity scores (P=.600), but the difference for WST-Q performance scores was significant (P=.016) with a relative (t2/t1 × 100%) improvement of the median score for the intervention group of 10.8%. The mean GAS ± SD for the intervention group after training was 92.8%±11.4%, and satisfaction with training was high. The WST-Q gain was not retained at t3. There was no clinically significant difference between the groups in injury rate and no statistically significant differences in WheelCon or LSA scores at t3. CONCLUSIONS: Powered wheelchair users who receive formal wheelchair skills training demonstrate modest, transient posttraining improvements in their WST-Q performance scores, have substantial improvements on individualized goals, and are positive about training.
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