Wheelchair Skills Training for Community-Based Manual Wheelchair Users: A Randomized Controlled Trial

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Objectives-To examine the effects of wheelchair skills training on confidence in older adults who are inexperienced with using a wheelchair. Design-Parallel group, single blind randomized controlled trial Setting-Vancouver, CanadaParticipants-Participants (N=20) who were community-living older adults at least 65 years old (mean = 70 years), 50% female, and who had no prior experience using a wheelchair were randomly allocated to an intervention (n=10) or control (n=10) group.Intervention-The intervention group received two 1-hour training sessions that followed the Wheelchair Skills Training Program (WSTP) protocol. The control group received a single socialization contact.Main Outcome Measure-The Wheelchair Use Confidence Scale-Manual (WheelCon-M) was used to evaluate confidence with using a manual wheelchair. The WheelCon-M is a self-report questionnaire comprised of 65 items in 6 conceptual areas.Results-A 1-way between groups analysis of covariance revealed a significant difference in post-intervention WheelCon-M scores between the intervention and control groups [F(1,17) = Corresponding author: William C. Miller, PhD, FCAOT, Department of Occupational Science and Occupational Therapy, University of British Columbia, T325-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Tel work: 604-714-4108, Fax: 604-714-4168, bcmiller@telus.net. Material in this manuscript was presented in part at the Canadian Association of Occupational Therapists Conference, Quebec City, QC, June 6-9, 2012.We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified in the title page of the manuscript.The manuscript submitted does not contain information about medical device(s). Individuals with mobility disabilities are often prescribed manual wheelchairs to promote independence with their mobility and social participation. 4,5 Ineffective use of the wheelchair, however, often compromises independence, and leads to the perception that the wheelchair itself is a barrier to doing things. 6,7 Therefore, treatment strategies that facilitate effective wheelchair use are increasing in importance. This is especially true for older adults who have been reported to more frequently lack independence using their wheelchair. 1In order for individuals to effectively use their wheelchair they must possess a variety of wheelchair skills. 8 Training to improve wheelchair skills is often employed to promote an individual's ability to use their wheelchair. For example, the Wheelchair Skills Training Program (WSTP) 9 was developed to provide an evidence-based, standardized approach to increase the likelihood of improving an individual's ability to use his/her wheelchair safely and effectively. 9 The WSTP has had positive results among wheelchair users undergoing initial rehabilitation, 10 and ...

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Wheelchair Skills Training to Improve Confidence With Using a Manual Wheelchair Among Older Adults: A Pilot Study

Sakakibara¹,

Miller²,

Souza³

et al. 2013

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“…Previous research has documented the psychometric properties of the WST 5-8 and a number of studies have used it as an outcome measure. [9][10][11][12][13][14][15] Previous investigations have also examined the WST-Q. 16,17 The objective, performance-based WST and the subjective, self-report WST-Q each have merits and limitations.…”

Section: Introductionmentioning

confidence: 99%

Manual Wheelchair Skills: Objective Testing Versus Subjective Questionnaire

Rushton

Kirby

Miller

2012

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Objectives-To test the hypothesis that the total scores of the Wheelchair Skills Test (WST) version 4.1, an observer rated scale of wheelchair performance, and the Wheelchair Skills Test Questionnaire (WST-Q) version 4.1, a self-report of wheelchair skills, are highly correlated. We also anticipate the WST-Q will be slightly higher indicating an overestimation of capacity to perform wheelchair skills, as compared to actual capacity. Design-A cross-sectional, within-subjects comparison design.Participants-Convenience sample of 89 community-dwelling, experienced manual wheelchair users ranging in age from 21-94 years. Setting-Three Canadian cities. Intervention-Not applicable.Main Outcome Measures-Participants completed the subjective WST-Q version 4.1, followed by the objective WST version 4.1 in one testing session.Results-The mean ± SD total percentage scores for WST and WST-Q were 79.5% ±14.4 and 83.0% ±12.1 for capacity and 99.4% ±1.5 and 98.9% ±2.5 for safety. The correlations between the WST and WST-Q scores were ρ=0.89 (p=0.000) for capacity and ρ=0.12 (p=0.251) for safety. WST-Q total score mean differences were an average of 3.5%±6.5 higher than WST scores for Corresponding Author: Paula Rushton, PhD, Rehabilitation Research Lab, GF Strong Rehabilitation Centre, 4255 Laurel Street, Vancouver, BC, Canada, V5Z 2G9, paula.rushton@umontreal.ca. Presented in part at: Annual Meeting of RESNA, Toronto, June 5-8, 2011, Toronto, ON, Canada. Reprints: Not available from the authors.Clinical Trials Registry Number: NA.Authors' financial disclosure: We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated and we certify that all financial and material support for this research are clearly identified in the title page of the manuscript. The authors declare that they have no competing interests. CIHR Author ManuscriptCIHR Author Manuscript CIHR Author Manuscript capacity (p = 0.000) and 0.52%±2.8 lower for safety (p = 0.343). For the 32 individual skills, the percentage agreement between the WST and WST-Q scores ranged from 82-100% for capacity and 90-100% for safety.Conclusion-WST and WST-Q version 4.1 capacity scores are highly correlated although the WST-Q scores are slightly higher. Decisions on which of these assessments to use can safely be based on the circumstances and objectives of the evaluation. KeywordsWheelchairs; Outcome assessment (health care); RehabilitationThe World Health Organization has recognized wheelchair-skills assessment and training as important elements of the wheelchair-provision process. 1 Recent systematic reviews have evaluated the assessment of wheelchair skills. 2,3 These reviews ranked the Wheelchair Skills Test (WST) 4 highly. The WST is an objective test of a set of skills and a questionnaire version (the WST-Q) is also available. Previous research has documented the psychometric properties of the WST 5-8 and a number of studies have use...

“…Interventions aimed at addressing barriers in the social environment, either by training power mobility users or through public awareness campaigns may also be considered. This is important, given that both wheelchair skills and wheelchair confidence are modifiable factors that can be improved with training (21,40,41). Although it may be that perceived limitations in participation are related to frequency of participation, a selffulfilling prophecy might also be in effect.…”

Section: Discussionmentioning

confidence: 99%

Exploratory Validation of a Multidimensional Power Wheelchair Outcomes Toolkit

Mortenson

Demers

Rushton

et al. 2015

OBJECTIVES-To evaluate the relationship among the measures in a power wheelchair outcomes toolkit. DESIGN-We performed path analysis of cross-sectional data from self-report questionnaires and one objective measure. SETTING-Data were collected in six Canadian sites.PARTICIPANTS-A convenience sample of 128 power wheelchair users. The majority, 69 (53.9%), were female. Multiple sclerosis and spinal cord injury/disease were the most common diagnoses. RESULTS-Wheelchair confidence was independently associated with less difficulty with activity (β =0.08, 0.01

0.05) and participation (β=0.39, p<0.01), increased life space (β=0.09, p<0.03) and greater wheelchair skills (β=0.37, p<0.01) Less perceived difficulty with activity was independently associated with increased frequency of participation (β=0.30, p<0.01). Life space mobility was independently associated with increased frequency of participation ((β=0.31, p<0.01). Less difficulty with participation was independently associated with greater life-space mobility (β=0.32, p<0.01) and greater frequency of participation (β=0.13, p<0.01). INTERVENTIONS-NotCONCLUSION-This study provides empirical support for the measures included as part of the power wheelchair outcomes toolkit. They appear to provide complementary information on a variety of constructs related to power wheelchair use.