Effectiveness of a Wheelchair Skills Training Program (WSTP) for Powered Wheelchair Users: A Randomized Controlled Trial
R. Lee Kirby, William Miller, Francois Routhier, Louise Demers, Alex Mihailidis, Jan Miller-Polgar, Paula Rushton, Laura Titus, Cher Smith, Mike McAllister, Chris Theriault, Kara Thompson, Bonita Sawatzky
Department of Medicine (Division of Physical Medicine and Rehabilitation), Dalhousie University, Halifax, NS (Kirby); Research Methods Unit, Dalhousie University, Halifax, NS (Theriault, Thompson); Faculty of Computer Science, Dalhousie University, Halifax, NS (McAllister); Department of Occupational Therapy, Capital District Health Authority, Halifax, NS (Smith); Department of Rehabilitation, Université Laval; Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Institut de Réadaptation en Déficience Physique de Québec, Québec City, PQ (Routhier); School of Rehabilitation, Université de Montréal, Montréal; Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, PQ (Demers); Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON (Mihailidis); School of Occupational Therapy,University of Western Ontario, London, ON (Miller-Polgar, Titus); Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC (Miller); Department of Orthopaedics, University of British Columbia, Vancouver, BC (Sawatzky); School of Rehabilitation, Université de Montréal, Montréal, CHU Ste-Justine Research Center, Montréal, Québec (Rushton)
ABSTRACT
Our primary objective was to test the hypothesis that powered wheelchair users who receive the Wheelchair Skills Training Program (WSTP) (the Intervention group) improve their post-training total percentage capacity and performance scores on the questionnaire version of the Wheelchair Skills Tests (WST-Q) in comparison with a Control group that receives standard care. We conducted a multi-centered, single-blinded, randomized controlled trial (RCT) on 116 powered wheelchair users. Those in the Intervention group received up to 5 training sessions. The mean (SE) change (T2-T1) scores in the total percentage WST-Q performance scores for the Intervention and Control groups were 3.9 (1.5)% and -1.0 (1.3)% (p = 0.016). There were no significant effects due to age (p = 0.835), sex (p = 0.633) or powered wheelchair experience (p = 0.627). For the Intervention group, the mean (SD) number of goals was 5.8 (1.8). The mean (SD) Goal Attainment Scale (GAS), expressed as the percentage of goals achieved, was 92.8% (11.4). Of the participants in the Intervention group, 39 (78%) found the training was neither stressful nor uncomfortable, 46 (92%) found it useful, 46 (92%) found they had improved their abilities to perform wheelchair skills and 50 (100%) said that they would recommend the training to others. At 3-month follow-up, there was no difference between the groups on the Wheelchair Use Confidence Scale for Power Wheelchair Users (WheelCon-P) (p = 0.503) or Life Space Assessment (LSA) (p = 0.532). Powered wheelchair users who receive formal wheelchair skills training improve their wheelchair skills performance, particularly with respect to individualized goals that they have set.
Acknowledgements:
Funded by the Canadian Institutes for Health Research, CanWheel team in Wheeled Mobility for Older Adults (AMG-100925). We thank Mark Burley, Laura Keeler, Kate Keetch, Krista Best, Anne-Marie Belley, Émilie Lacroix, Marie-Pierre Johnson, Josh Chapman, Julie De Melo, Bing Ye, Fabrizio Farronato, Deborah Stewart , Megan Barry and Amira Tawashy.