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  4. Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial

Manual Wheelchair Skills Training for Community-Dwelling Veterans with Spinal Cord Injury: A Randomized Controlled Trial

PLoS ONE, 2016 · DOI: 10.1371/journal.pone.0168330 · Published: December 21, 2016

Spinal Cord InjuryAssistive TechnologyRehabilitation

Simple Explanation

This study investigated whether a wheelchair skills training program (WSTP) could improve the wheelchair skills of veterans with spinal cord injury (SCI). Participants were divided into two groups: one received the WSTP, and the other received education about health promotion. The WSTP group received five one-on-one training sessions in their own environments, focusing on specific wheelchair skills. The education group received five sessions on health topics relevant to SCI. The study found that the WSTP group showed significant improvements in their wheelchair skills compared to the education group. These improvements were maintained even after one year.

Study Duration
1 year
Participants
106 community-dwelling veterans with SCI
Evidence Level
Level 1, Randomized Controlled Trial

Key Findings

  • 1
    Participants in the WSTP group improved their total and Advanced-level WST scores by 7.1% and 30.1% relative to baseline (p < 0.001) and retained their scores at one year follow-up.
  • 2
    The CHART Mobility sub-score improved by 3.2% over baseline (p = 0.021).
  • 3
    Individual skill success rates showed clinically meaningful improvement for two skills in the WSTP group: ascends 15 cm curb and performs 30 s stationary wheelie.

Research Summary

This randomized controlled trial evaluated the effectiveness of the Wheelchair Skills Training Program (WSTP) for community-dwelling veterans with spinal cord injury (SCI). Participants were randomly assigned to either the WSTP group or an Educational Control (EC) group. The WSTP group received individualized wheelchair skills training in their home environment, while the EC group received education on health promotion topics. Wheelchair skills capacity and participation were assessed at baseline, post-intervention, and one-year follow-up. The study found that the WSTP significantly improved total and advanced wheelchair skills capacity, and these improvements were retained at one year. There was a small impact on participation, specifically in the CHART Mobility sub-score.

Practical Implications

Clinical Practice

Wheelchair skills training should be integrated into the care of individuals with SCI, even those with long-term wheelchair use.

Policy

SCI systems of care should consider policies ensuring wheelchair skills assessments and training, both during initial rehabilitation and throughout life.

Professional Education

Increased focus on wheelchair skills training in professional schools can improve clinicians' ability to provide effective training.

Study Limitations

  • 1
    Moderate number of drop-outs may have reduced the study's power.
  • 2
    Lack of assessment of prior wheelchair skills training.
  • 3
    Failure to blind testers to group allocation.

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